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Clinico-pathological diagnosis of gliomatosis cerebri

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Clinico-pathological diagnosis of gliomatosis cerebri

中国抗癌协会神经肿瘤专业委员会第八届学术会议

作者： Jiro Akimoto department of Neurosurgery Tokyo Medical University 6-7-1 Nishishinjuku Shinjuku-ku Tokyo 160-0023 Japan

Distinction of gliomatosis cerebri （GC）, a rare entity characterized by a widespread infiltration of the brain by tumor, from diffuse glioma is a difficult clinical problem. Most previously reported cases of GC have been autopsy cases because of the lack of objective and quantitative clinical diagnostic criteria. In order to better define this entity, we report the neuroradiological and pathological findings of eight cases of GC. Eight patients （ three men and five women, aged 46-71 years） presented with symptoms of mild increased intracranial pressure, cognitive impairment, or seizure. Magnetic resonance imaging （MRI） was done with T1-weighted images after gadolinium injection, and with T2-weighted images and fluid attenuated inversion recovery （FLAIR） in all cases. Histological confirmation of glial proliferation was obtained in all cases by craniotomy. The topography of the tumoral infiltration was characteristic, involving mainly the white matter, basal ganglia, thalamus, and commissural fibers. More than three cerebral lobes were affected. Contrast enhancement was absent, and mass effects were minimal compared with the extent of tumoral infiltration, but three patients presented with a small frontal enhanced mass during the clinical course. The pathological analyses demonstrated infiltration of the brains by variably differentiated neoplastic glial （ 6 astrocytic and 2 oligodendroglial ） cells with destruction of the myelin sheath, but the involved axis cylinder and neuronal cells were preserved. Diagnosis of GC should be faithful to the pathological diagnosis criteria of Scheinker and Evans, and therefore the precise assessment of MRI findings according to these criteria is required for clinical, antemortem diagnosis of GC.

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一患儿眼眶淋巴管瘤的组织病理学研究

世界核心医学期刊文摘（眼科学分册） 2005年第6期1卷 52-53页

作者： Goto H. Usui M. Okada S. 肖颖 department of ophthalmology Tokyo Medical University 6- 7- 1 Nishishinjuku Shinjuku-ku Tokyo 160- 0023 Japan

Background: There has been controversy over whether orbital lymphangioma is a true entity in the orbit or various venous malformations. Case: A 1- year-old girl was referred to us with subcutaneous induration of the right upper eyelid. Rapid enlargement of the eyelid mass with blepharoptosis and dislocation of the eyeball were noted within 1 week. A diagnosis of an orbital lymphangiomawas made from the clinical course and findings of magnetic resonance imaging. Surgical resection of the tumor was performed to prevent amblyopia. Observations: Histopathologically, the lumen of the expanded cystic tumor consisted of a single layer of endothelium and was filled with erythrocytes as well as lymph. Immunohistochemical study revealed positive staining for factor VIII-related protein and CD31, weak positive staining for thrombomodulin, and negative staining for CD34 at the endothelium of the lymphangioma. The endothelium of the capillary vessels around the lymphangioma was positive for factor VIII-related protein, CD31, and CD34. Although a part of the tumor remained in the orbit postoperatively, orthophoria was achieved and no recurrence was observed for 2 years. Conclusion: Immunohistochemical study suggested that the cellular composition of the endothelium of the orbital lymphangiomawas different from that of the surrounding capillary vessels.

关键词：病理学研究淋巴管瘤上睑免疫组织化学眼球脱位实体肿瘤瘤体残留眼位皮下硬结囊样

眼部受累的Behcet引起视力低下的危险因素及预后因素

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世界核心医学期刊文摘（眼科学分册） 2006年第5期2卷 36-37页

作者： Takeuchi M. Hokama H. Tsukahara R. 陈立军 department of ophthalmology Tokyo Medical University 6-7-1Nishishinjuku Shinjuku-Ku Tokyo 160-0023 Japan

PURPOSE: The purpose of the study was to determine factors correlated with the progression of irreversible visual disturbance in Behcet’s disease (BD) with ocular involvement. Methods: Forty-seven BD patients with ocular inflammation, who presented with the first ocular episode, and who had been followed continuously for 5-10 years in our hospital, were studied. Charts were reviewed for gender, onset age of uveitis, complete or incomplete type BD, HLA-B51 status, final visual acuity at the last remission period, mean number of ocular attacks per year, and clinical findings of iridocyclitis with profuse hypopyon, strong vitreous opacity blocking the observation of retinal vessels, diffuse retinal vasculitis, and exudates with hemorrhage within the retinal vascular arcade. Results: Patients with a visual acuity of 20/200 and those with >20/200 differed significantly in the mean number of ocular attacks per year and clinical findings of strong vitreous opacity and exudates within the retinal vascular arcade, but not with regard to the other factors. In addition, the frequency of ocular attacks showed a significant negative correlation with the outcome of visual acuity. Logistic regression analysis indicated a signifi-cant association of an average of more than three ocular attacks per year, strong vitreous opacity, and exudates within the retinal vascular arcade with poor visual outcome. Conclusions: This study indicates that more than three ocular attacks per year, strong vitreous opacity, and exudates within the retinal vascular arcade are the risk and prognostic factors for a poor outcome of visual acuity in BD patients.

关键词：视力低下眼部受累预后因素危险因素视网膜血管炎玻璃体混浊虹膜睫状体炎不完全性发作次数视力损害

Diagnosis and Treatment of Keloids and Hypertrophic Scars—japan Scar Workshop Consensus Document 2018

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Burns & Trauma 2019年第1期7卷 356-395页

作者： Rei Ogawa Sadanori Akita Satoshi Akaishi Noriko Aramaki-Hattori Teruyuki Dohi Toshihiko Hayashi Kazuo Kishi Taro Kono Hajime Matsumura Gan Muneuchi Naoki Murao Munetomo Nagao Keisuke Okabe Fumiaki Shimizu Mamiko Tosa Yasuyoshi Tosa Satoko Yamawaki Shinichi Ansai Norihisa Inazu Toshiko Kamo Reiko Kazki Shigehiko kuribayashi department of Plastic Reconstructive and Aesthetic SurgeryNippon Medical School1-1-5 Sendagi Bunkyo-kuTokyo 113-8603Japan department of Plastic Surgery Wound Repair and RegenerationFukuoka UniversityFukuoka 814-0180Japan department of Plastic Surgery Nippon Medical School Musashikosugi Hospital1-396 KosugichoNakahara-kuKawasaki-shiKanagawa 211-8533Japan department of Plastic and Reconstructive Surgery Keio University School of Medicine35 ShinanomachiShinjuku-kuTokyo 160-8582Japan department of Plastic and Reconstructive Surgery Faculty of Medicine and Graduate School of MedicineHokkaido UniversityKita-15Nishi-7Kita-kuSapporo 060-8638Japan department of Plastic Surgery Tokai University School of Medicine4-1-1 KitakanameHiratsukaKanagawa 259-1292Japan department of Plastic and Reconstructive Surgery Tokyo Medical University6-7-1 NishishinjukuShinjuku-kuTokyo 160-0023Japan department of Plastic and Reconstructive Surgery Osaka Saiseikai Nakatsu Hospital2-10-39 ShibataKita-kuOsaka 530-0012Japan department of Plastic Reconstructive and Aesthetic SurgeryIwate Medical University School of Medicine19-1 UchimaruMoriokaIwate 020-8505Japan department of Plastic Surgery Oita University Hospital1-1 IdaigaokaHasamamachiYufu-shiOita 879-5503Japan department of Plastic Surgery Showa University Fujigaoka Hospital1-30 FujigaokaAoba-kuYokohamaKanagawaJapan department of Plastic and Reconstructive Surgery Japanese Red Cross Fukui Hospital2-4-1 TsukimiFukui 918-8501Japan Division of Dermatology and Dermatopathology Nippon Medical School Musashikosugi Hospital1-396KosugichoNakahara-kuKawasaki-shiKanagawa 211-8533Japan Faculty of Pharmaceutical Sciences Teikyo Heisei University4-21-2 NakanoNakano-kuTokyo 164-8530Japan Wakamatsu-cho Mental and Skin Clinic 9-4 Wakamatsu-choShinjyuku-kuTokyo 162-0056Japan department of Radiation Oncology Nippon Medical School HospitalTokyo 113-8603Japan

There has been a long-standing need for guidelines on the diagnosis and treatment of keloids and hypertrophic scars that are based on an understanding of the pathomechanisms that underlie these skin fibrotic *** is particularly true for clinicians who deal with Asian and African patients because these ethnicities are highly prone to these *** contrast,Caucasians are less likely to develop keloids and hypertrophic scars,and if they do,the scars tend not to be *** ethnic disparity also means that countries vary in terms of their differential diagnostic *** lack of clear treatment guidelines also means that primary care physicians are currently applying a hotchpotch of treatments,with uneven *** overcome these issues,the japan Scar Workshop(JSW)has created a tool that allows clinicians to objectively diagnose and distinguish between keloids,hypertrophic scars,and mature *** tool is called the JSW Scar Scale(JSS)and it involves scoring the risk factors of the individual patients and the affected *** tool is simple and easy to *** a result,even physicians who are not accustomed to keloids and hypertrophic scars can easily diagnose them and judge their *** JSW has also established a committee that,in cooperation with outside experts in various fields,has prepared a Consensus Document on keloid and hypertrophic scar treatment *** guidelines are simple and will allow even inexperienced clinicians to choose the most appropriate treatment *** Consensus Document is provided in this *** describes(1)the diagnostic algorithm for pathological scars and how to differentiate them from clinically similar benign and malignant tumors,(2)the general treatment algorithms for keloids and hypertrophic scars at different medical facilities,(3)the rationale behind each treatment for keloids and hypertrophic scars,and(4)the body site-specific treatment protocols for these *** believe that t

关键词： Keloid Hypertrophic scars Pathological scars Guideline Pathology Surgery Radiotherapy Steroid Laser

肝细胞癌动脉性富血供对比剂增强超声与钆塞酸二纳增强MRI评价的对照性研究

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国际医学放射学杂志 2012年第4期 401-402页

作者： K. Sugimoto F. Moriyasu J . Shiraishi K. Saito J. Taira T. Saguchi 唐光健 department of Gastroenterology and Hepatology Tokyo Medical University6 -7 -1 Nishishinjuku Shinjuku-ku Tokyo 160 - 0023 Japan

摘要目的以CT肝动脉增强(CTHA)影像为参照标准,对照对比剂增强(CE)超声与钆塞酸二钠增强MRI对肝细胞癌(HCC)与发育不良性结节(DN)动脉性富血管程度的评估。方法54例连续病人纳入研究,其中组织学证实HCC57个,DN(高分级)3个。所有病例均... 详细信息

摘要目的以CT肝动脉增强(CTHA)影像为参照标准,对照对比剂增强(CE)超声与钆塞酸二钠增强MRI对肝细胞癌(HCC)与发育不良性结节(DN)动脉性富血管程度的评估。方法54例连续病人纳入研究,其中组织学证实HCC57个,DN(高分级)3个。所有病例均接受了CE超声、钆塞酸二钠增强MRI与CTHA检

关键词：超声对比剂 MRI 钆塞酸肝细胞癌

局部应用异丙基乌诺前列酮滴眼对正常眼压性青光眼患者和对照者视神经乳头循环的影响

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世界核心医学期刊文摘(眼科学分册) 2006年第1期 56-57页

作者： Kimura I. Shinoda K. Tanino T. 韩静 shinjuku-ku department of ophthalmology Keio university School of Medicine 35 Shinanomachi tokyo 160- 8582 japan

Purpose: To evaluate the effect of unoprostone isopropyl on microcirculation in the optic nerve head (ONH) of controls and patients with normal-tension glaucoma (NTG). Methods: Thirty healthy volunteers were randomly placed in a placebo group or a control group. For ten NTG patients, one eye was selected to receive the placebo drops and the contralateral eye received the unoprostone in a masked fashion. In both studies, the intraocular pressure (IOP) and the parameters of the blood hemodynamics of the ONH were obtained before and at 1 and 2 h after the instillation. Blood flow measurements were made with a scanning laser Doppler flowmeter. Results: In both control subjects and NTG patients, the changes in the IOPs after the instillation of either unoprostone or the placebo were not significant because almost all of the NTG patients had IOPs lower than 15 mmHg. Although the hemodynamic parameters were not significantly changed in the placebo-treated eyes of the controls, the eyes of the controls treated with unoprostone had mean blood velocity and flow values that were significantly higher than the baseline values 1 and 2 h after instillation (P 1). The velocity values of the controls treated with unoprostone were significantly higher than in those controls receiving the placebo at 2 h postinstillation (P=0.027). The values for the three circulation parameters (volume, velocity, flow) were significantly higher than the baseline values after instillation in the eyes of the NTG patients treated with unoprostone (P < 0.05). In contrast, none of these parameters was significantly different from the baseline in the eyes of NTG patients treated with placebo. Conclusions: These results showed that unoprostone significantly increased microcirculation in the ONH in control subjects and in NTG patients without reducing the IOP significantly.

关键词：视神经乳头正常眼压性青光眼患者滴眼

比较0.1%溴芬酸钠和0.1%吡嘧司特钾治疗过敏性结膜炎的疗效

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世界核心医学期刊文摘（眼科学分册） 2005年第6期1卷 51-52页

作者： Miyake-Kashima M. Takano Y. Tanaka M. H. Fujishima 肖颖 department of ophthalmology Keio University School of Medicine35 Shinanomachi Shinjuku-ku Tokyo 160- 8582 Japan

Purpose: We compared the efficacy of a new nonsteroidal antiinflammatory drug (NSAID) eye drop, 0.1% bromfenac sodium (Bromfenac), with that of an antiallergic agent, 0.1% pemirolast potassium (Pemirolast), in the treatment of seasonal allergic conjunctivitis in japanese patients. Methods: Twenty-two subjects with seasonal allergic conjunctivitis were enrolled in the study. One eye was treated with Bromfenac eye drops and the contralateral eye was treated with Pemirolast eye drops for 1 week. Subjective ocular symptoms and objective ocular signs evaluated by slit-lamp examination were scored and recorded before and after treatment. Results: Both drugs significantly decreased ocular signs after 1 week, but not symptoms. No significant differences in subjective symptoms or objective signs were observed between the two drugs. Ten patients (45.5% ) selected Bromfenac as more effective, nine patients (40.9% ) selected Pemirolast, and three patients found no difference in efficacy between the two drugs. Conclusion: Bromfenac sodium is as safe and effective for the treatment of allergic conjunctivitis as pemirolast potassium.

关键词：溴芬酸钠吡嘧司特过敏性结膜炎对侧眼裂隙灯检查客观体征非甾体抗炎药抗过敏药

白血病前期病变骨髓增生异常综合征的眼部并发症

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世界核心医学期刊文摘(眼科学分册) 2006年第2期 42-42页

作者： Kezuka T Usui N Suzuki E. 邢咏新 department of ophthalmology tokyo medical university 6- 7- 1 nishishinjuku shinjuku-ku tokyo 160- 002 3 japan

Purpose: To identify ocular complications in patients with myelodysplastic syndromes (MDS), who have a propensity to progress to acute myeloid leukemia (AML). Methods: Fortyone patients with MDS were the subjects in this retrospective study, and 21 patients with AML were selected as controls. Reviewing their clinical records, we verified that corneal ulcer, iridocyclitis, vitreous hemorrhage, retinal hemorrhage, and optic neuritis had been evaluated using slit-lamp assessment and opthalmoscopy in all the patients. In this study, the MDS patients were classified into those with refractory anemia (RA)-and those with refractory anemia with excess blasts (RAEB). Results: Ocular complications were found in 19 (46.3% ) of the 41 patients with MDS, comprising corneal ulcer (two cases), iridocyclitis (five), vitreous hemorrhage (one), retinal hemorrhage (ten), cotton wool spots (one), and optic neuritis (two). (Some patients had more than one ocular complication.) Ocular complications were identified in 12 of the 21 (57.1% ) patients with AML. There was no significant difference in frequency of ocular complications between MDS and AML (P=0.4892). In MDS, retinal hemorrhage was associated with significantly reduced platelet counts (P=0.0063). The frequency of ocular complications was significantly higher in MDS-RAEB than in MDS-RA (P=0.0478). Retinal hemorrhage was significantly more frequent in patients with MDS-RAEBthan in patients with MDS-RA (P=0.0433). Conclusion: Ocular complications in MDS patients should be carefully examined as prognostic factors for progression to acute leukemia.

关键词：眼部患者 DS 骨髓增生异常综合征并发症并发病疾病

围手术期血糖控制对糖尿病视网膜病变和黄斑病变进展的影响

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世界核心医学期刊文摘(眼科学分册) 2006年第4期 19-20页

作者： Suto C. Hori S. Kato S. 石圆圆 Dr. department of ophthalmology tokyo Women’s medical university 8-1 Kawada-cho shinjuku-ku tokyo 162-8666 japan

Objective: To evaluate the contribution of perioperative glycemic control to progression of diabetic retinopathy and maculopathy. Methods: Postoperative progression of diabetic retinopathy and maculopathy were compared in 87 patients with type 2 diabetesmellitus who underwentmonocular phacoemulsification cataract surgery performed by a single surgeon. Twenty-seven patients had had poor glycemic control preoperatively and underwent rapid preoperative glycemic correction;30 patients had poor control preoperatively that was not corrected postoperatively; and 30 patients had good preoperative glycemic control. The grade of diabetic retinopathy and maculopathy in the operated-on eye and the fellow eye was assessed preoperatively and for 12 months postoperatively. Results: There were no significant differences in the progression rate of diabetic retinopathy among the 3 groups (P = .27). However, the progression rate of diabetic maculopathy was significantly higher in the group that underwent rapid control than in the other 2 groups (P = .02). Patients with moderate to severe nonproliferative diabetic retinopathy preoperatively in the rapid control group had significantly higher progression rates of diabetic retinopathy and maculopathy (P = .002 and .008, respectively). Conclusions: Rapid preoperative glycemic control should be avoided in patients with moderate to severe nonproliferative diabetic retinopathy because it may increase the risk of postoperative progression of retinopathy and maculopathy.

关键词：糖尿病视网膜病变患者黄斑病变视网膜疾病血糖控制围手术期