Teruyuki Nakashima

Asplenia and polysplenia syndrome.

This report described the morphological characteristics of seven cases of asplenia syndrome and three of polysplenia syndrome. Each syndrome has been characterized by a tendency for symmetric development of normally asymmetric organs, with varying degrees of cardiovascular anomalies. These latter anomalies are usually present in asplenia syndrome to a greater extent than in polysplenia syndrome. While, as observed in our material, the conotruncal anomalies were present more commonly in cases with asplenia, and absence of inferior vena cava with azygos continuation was seen specifically in all the cases with polysplenia. This evidence implied the presence of some pathogenetic distinction between the two syndromes. ACTA PATHOL. JPN. 32: 505∼511, 1982.

A Study of Human Aortic Distensibility With Relation To Atherosclerosis and Aging

In 1960 a comparative study on coronary atherosclerosis of Caucasians in Boston and of Japanese in Kyushu, Japan was done by Gore, Nakashima, Imai and Whitel by means of Gore Tejada’s atherosclerotic index [in 1960]. There was a remarkable difference between these two groups. Bostonian coronary atherosclerosis was much severer than that of the Japanese. Japanese 7th decade arteries, for instance, had the atherosclerosis comparable to that of 5th decade of Bostonians. We had thought since that time, Japanese arteries were much younger than American arteries. But, there is a question: &dquo;Is the atherosclerosis proportionate to the index of arterial senility?&dquo; Statisticians report the increase of cardiac death in Japan. Increasing fat intake and increasing environmental stress are thought to be main causes for this increase. According to Sumiyoshi, Tanaka, Gore and Hirst2 (1965), however, the frequency of myocardial infarction in autopsy cases of Kyushu University in Japan is still 2.3% and less than one-tenth of Bostonian cases. It can not be thought that the Japanese atherosclerosis had become so different in these 5 years. Now, let us come back to the first question: &dquo;Is the atherosclerosis proportionate to the index of arterial senility?&dquo; Burton3 reported that arterial distensibility diminished with aging, but did not relate it to atherosclerosis. It is very interesting, but it is not clear whether he thought the arterial distensibility had different meaning from the intimal change, because Burton cited the definition of arteriosclerosis seen in Stedman’s medical dictionary (1953): &dquo;fibrous overgrowth, mainly of the inner coat of an artery, associated with degenerative changes in the middle coat causing thickening of the arterial wall with loss of elasticity and contractility.&dquo; We would like to know whether these two pathologic changes, the intimal changes and the loss of elasticity, are in the same category or not.

Primary causes of perinatal death. An autopsy study of 1000 cases in Japanese infants.

The primary causes of death in 1000 autopsy cases of perinatal death during the eight years from 1972 through 1979 are discussed. On the basis of the clinical data and gross and microscopic findings, each case was assigned to one of the following categories of primary causes of death: pulmonary hyaline membrane disease, infection, malformation, anoxia, immaturity, maternal causes, other causes, and unaccounted for. Definitions of perinatal infant diseases, essential points of diagnosis, and statistics relating to perinatal infant death are also discussed.

HYPOXIC‐ISCHEMIC BRAIN LESIONS FOUND IN ASPHYXIATING NEONATES

Early hypoxic‐ischemic brain lesions were examined regarding 26 autopsy cases which had severe asphyxia at birth and died within the first week. All cases were divided into three groups according to the birth weight: group A of less than 1,000 grams, group B of 1,001–2,500 grams, and group C of more than 2,501 grams. Neocortical and deep gray matter revealed pyknotic and karyorrhectic neuronal changes; however, in group A, these changes tended to be obscure. The hippocampus was the predictive site of the neuronal changes such as pyknotic neurons in Sommers sector and karyorrhectic neurons in subiculum. In 12 cases, pontosubicular‐type necrosis was found. White matter lesions were relatively characteristic and there was an early appearance of pathological astrocytes such as gemistocytic, Alzheimer‐type 2 and stellate astrocytes, periventricular leukomalacia with or without hemorrhage. The brain stem and cerebellar lesions were also found occasionally revealing neuronal or glial changes. We applied the immunoperoxidase method using antisera to glial fibrillary acidic protein (GFAP) and S‐100 protein for determination of pathological astrocytes. GFAP was a useful marker for pathological astrocytes in the subpial region and in the white matter. S‐100 protein was present in Bergmanns glia and satellite glia as well as pathological astrocytes.

Aneurysm of the ductus arteriosus.

A 59-year-old man with an aneurysm of the ductus arteriosus is described. Macroscopically and histologically it was ascertained that the aneurysm had originated from the ductus arteriosus itself. We suggest the following pathogenesis: after obliteration of the pulmonary end, the aneurysm was formed, and as a result of a gradual increase in pressure in the lumen, the obliterated pulmonary end, the aneurysm was formed, and as a result of a gradual increase in pressure in the lumen, the obliterated pulmonary end recanalized.

THE ROLE OF ENDOTHELIAL CELLS IN THE PATHOGENESIS OF ATHEROSCLEROSIS

Using mainly rabbits and rats investigations on the endothelial permeability of the aorta, on relation between thrombus formation and endothelial damage, and on tissue culture of the endothelial cells of the rabbit aorta have been carried out.

Anaplastic Giant Cell Tumor With Mucinous Cystadenocarcinoma of The Ovary Origin of the Giant Cells

The present case is that of a 27 years old woman who had received right oophorectomy for ovarian cancer nine years previously. The histological diagnosis at that time was mucinous cystadenocarcinoma with anaplastic areas. The patient expired ten years after oophorectomy due to widespread metastases of the tumor. Review of the histological slides revealed ovarian giant cell tumor which was considered to be of epithelial origin differing from those appearing in giant cell tumor of bone.

NODULAR REGENERATIVE HYPERPLASIA OF THE LIVER IN A PATIENT WITH MULTIPLE MYELOMA and SYSTEMIC AMYLOIDOSIS

A 68‐year‐old man with multiple myeloma and systemic amyloidosis also had nodular regenerative hyperplasia (NRH) of the liver. This unusual case is discussed and the association of NRH with various other systemic disorders are reviewed. ACTA PATHOL. JPN. 35 : 961–967, 1985.

Bilateral cystic nephroblastomas and botryoid sarcoma involving vagina and urinary bladder in a child with microcephaly, arhinencephaly, and bilateral cataracts

The case of a 1‐year‐old infant with bilateral cystic nephroblastomas, a botryoid sarcoma involving the vagina and urinary bladder, microcephaly, arhinencephaly and bilateral cataracts is reported. The unusual association of these lesions suggests a syndrome due to genetic abnormalities.

THANATOPHORIC DYSPLASIA OF IDENTICAL TWINS

The autopsy cases of thanatophoric dysplasia of identical female twins were reported. These babies showed short limbs, long and narrow thoraxes, and depressed nasal roots. Disorganization of endochondral ossification and hypertrophic periosteum were recognized histologically at the epiphyseal plate of femur. The cause of death was respiratory distress caused by hypoplastic and atelectatic lungs. Their mother had no complaints except hydramnios. Female identical twins of this disease are very rare. It could be considered that the disease would be induced by some genetic disorders occurring at the earliest developmental stage.