Severity of tubulointerstitial lesions, especially fibrosis has been proposed as one important risk factor on the prognosis of renal diseases. The purpose of this paper is to investigate the effectiveness of drugs such as both Angiotensin II type-1 receptor blockade (Olmesartan) and an immunosuppressant agent (Mycophenolate mof etil: MMF) on puromycin aminonucleoside and protamin nephropathy (PAPN) in a prototypical rat model of human focal segmental glomerulosclerosis associated with nephrotic syndrome and tubulointerstitial fibrosis. When the group of rats treated with both drugs were compared with a non-treated group on the 12th week after treatment, body weight and mean blood pressure in both groups were found to have no significant difference. The amount of proteinuria, the severity of both glomerulosclerosis and tubulointerstitial fibrosis, and the intensity of both hyaluronic acid (HA) and osteopontin (OPN) staining in the tubulointerstitial tissues (TIT) of the treated rats was significantly reduced : in contrast, the intensity of angiotensin II (Ang II) in the TIT was significantly increased. The relationship between percent occupancy of TIT fibrosis and factors, such as proteinuria, glomerulosclerosis, alf a smooth muscle actin HA and CD44 positive cells showed a positive correlation sohile Ang II and AT1 showed a negative correlation. These studies suggest that Olmesartan may reduce glomerular blood pressure and the severity of glomerular sclerosis : in addition, MMF may reduce the production of inflammatory factors such as OPN which contribute to the reduction of TIT and result in amelioration of PAPN.

View full abstract

On 60 cases of breast cancer with lymph node metastasis who received surgery in Showa University Hospital from 1994 to 1998, we investigated the relation of estrogen receptor (ER), Her-2, histological grade, multidrug resistance (MDR-1 MRP-1, MRP-2), MIB-1, topoiso melase- II, and recurrence retrospectively. On f ormalin-fixed paraffin-embedded sections, following antibody, ER, Her-2, MIB-1, MDR-1, MRP-1, MRP-2 were used for immunohistochemical staining. We investigated the recurrence value with clinical factors, MIB-1 labeling index, toppisomelase- II labeling index and expression of ER, Her-2, MRP-1. Immunohistochemically, 1.7% of cases were positive in MDR-1, 68.3% of cases were positive in MRP-1, 96.7% of cases were positive in MRP-2, respectively. An expression of MRP-1 and an increase of MIB-1 labeling index correlated with risk of recurrence. Therefore, MRP-1 was a good indicator to predict recurrence.

View full abstract

In a student course of gross anatomy dissection at Showa University School of Medicine in 2003, we found an extremely rare case of the hepatic artery arising from the superior mesenteric artery of an 88-years-old Japanese female cadaver who had died of hepatopathy. This case belonged to type VI of Adachi's classification of the celiac trunk and the superior mesenteric artery (1928) . The left gastric artery and the splenic artery which form the gastro-splenic arterial trunk arose from the abdominal aorta, and the hepatic artery arose from the superior mesenteric artery and passed the dorsum of the portal vein. In addition, the Inferior phrenic artery arose from the gastro-splenic arterial trunk.

View full abstract

A case of the left vertebral artery arising directly from the aortic arch was found in a 58-year-old Japanese man during dissection at the Showa University School of Medicine in 2003. In this case, the aortic arch had four branches : brachiocephalic artery, left common carotid artery, left vertebral artery and left subclabian artery. In addition, the left vertebral artery penetrated the transverse foramen of the 4th cervical vertebra. This case can be classified as type C according to the classification of Adachi (1928), Williams et al (1935) and Nakagawa (1939) .

View full abstract

A rare case of colonic leiomyoblastoma in a girl 2 years of age is reported. The patient complained of abdominal pain, mucous bloody stool and presented with a palpable mass at the right flank. She was found to have a hematocrit of 28.5%. Computed tomography demonstrated a well defined homogenous ovoid mass of soft tissue density. Air-contrast barium enema findings revealed a round and constant filling defect of the proximal ascending colon. At surgery, a firm, rubbery mass measuring 4 cm in diameter was identified arising from the posterior wall of the ascending colon. The colonic mass was removed using primary colocolic anastomosis, and the ileocecal valve was preserved. Macroscopically, the mass was a 4.0×3.5×3.0 cm submucosal tumor. Histopathologically, the tumor was diagnosed to be a leiomyoblastoma. After an extended follow up of 20 years, the patient has remained healthy with no recurrence.To our knowledge, sixteen cases of colonic gastrointestinal stromal tumors (GIST) and related lesions in children have been reported in the literature during the past 25 years. A colonic leiomyoblastoma is especially uncommon. Despite the rarity in children, GIST shoud be considered in differential diagnosis of abdominal pain, masses and hematochezia after excluding common causes. The surgical approach need not always be aggressive, but immunohistochemical diagnosis and prolonged follow-up are essential.

View full abstract