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Minokamo, Japan

Fushimi K.,Kizawa Memorial Hospital | Miyamoto K.,Gifu University | Hioki A.,Gifu University | Hosoe H.,Gifu Prefectural General Medical Center | And 2 more authors.
Bone and Joint Journal | Year: 2013

There have been a few reports of patients with a combination of lumbar and thoracic spinal stenosis. We describe six patients who suffered unexpected acute neurological deterioration at a mean of 7.8 days (6 to 10) after lumbar decompressive surgery. Five had progressive weakness and one had recurrent pain in the lower limbs. There was incomplete recovery following subsequent thoracic decompressive surgery. The neurological presentation can be confusing. Patients with compressive myelopathy due to lower thoracic lesions, especially epiconus lesions (T10 to T12/L1 disc level), present with similar symptoms to those with lumbar radiculopathy or cauda equina lesions. Despite the rarity of this condition we advise that patients who undergo lumbar decompressive surgery for stenosis should have sagittal whole spine MRI studies pre-operatively to exclude proximal neurological compression. © 2013 The British Editorial Society of Bone & Joint Surgery. Source

Hiroyasu S.,Osaka City University | Ozawa T.,Osaka City University | Kobayashi H.,Osaka City University | Ishii M.,Osaka City University | And 6 more authors.
American Journal of Pathology | Year: 2013

Bullous pemphigoid (BP) is an autoimmune blistering skin disease induced by pathogenic autoantibodies against a type II transmembrane protein (BP180, collagen type XVII, or BPAG2). In animal models, BP180 autoantibody-antigen interaction appears insufficient to develop blisters, but involvement of complement and neutrophils is required. However, cultured keratinocytes treated with BP-IgG exhibit a reduction in the adhesive strength and a loss of expression of BP180, suggesting that the autoantibodies directly affect epidermal cell-extracellular matrix integrity. In this study, we explored the consequences of two distinct epithelial cells treated with BP-IgG, particularly the fate of BP180. First, we followed the distribution of green fluorescent protein-tagged BP180 in an epithelial cell line, 804G, and normal human epidermal keratinocytes after autoantibody clustering. After BP-IgG treatment, the adhesive strength of the cells to their substrate was decreased, and BP180 was internalized in both cell types, together with the early endosomal antigen-1. By using various endocytosis inhibitors and a fluid-uptake assay, we demonstrated that BP-IgG-induced BP180 internalization is mediated via a macropinocytic pathway. Moreover, a macropinocytosis inhibitor rescued a BP-IgG-induced reduction in the adhesive strength of the cells from their substrate. The results of this study suggest that BP180 internalization induced by BP-IgG plays an important role in the initiation of disease pathogenesis. Copyright © 2013 American Society for Investigative Pathology. Source

Kamiya H.,Kizawa Memorial Hospital
Nihon rinsho. Japanese journal of clinical medicine | Year: 2012

Early radiation dermatitis develops after large doses of X-radiation. Inflammatory erythema develops within about a week. This may heal with desquamation and pigmentation. If the dose was high enough, painful blisters may develop at the site of erythema. In that case, healing usually takes place with atrophy, teleangiectasia, and irregular hyperpigmentation. Subsequent to very large doses, ulceration occurs, generally within 2 months. Such an ulcer may heal ultimately with severe atrophic scarring. Chronic radiation dermatitis occurs from a few months to many years. The skin shows atrophy, teleangiectasia, and irregular hyper- and hypopigmentation. Ulceration may be seen within the areas of atrophy. Radiation ulcerations should be studied by biopsy if they have been present for three or more months. After a long latent period, various malignant neoplasms may form. Most frequent is the basal cell carcinoma, followed by squamous cell carcinoma. Source

Kaneko Y.,Kizawa Memorial Hospital
Japanese Journal of Clinical Radiology | Year: 2015

Sarcomatoid renal cell carcinoma (SRCC), also known as renal cell carcinoma of the spindle cell type, is a relatively rare and aggressive renal tumor with poor prognosis. We present two cases of SRCC that showed intense uptake on FDG-PET. We may need to consider the possibility of SRCC when a renal tumor shows intense FDG uptake on FDG-PET. Source

Aoyama Y.,Okayama University | Nagai M.,Gifu University | Kitajima Y.,Kizawa Memorial Hospital
British Journal of Dermatology | Year: 2010

Background Pemphigus vulgaris (PV) is characterized by autoantibodies against desmoglein (Dsg) 3 or both Dsg1 and Dsg3, i.e. desmosomal adhesion molecules. Objectives We examined whether or not PV IgG binding to Dsg3 directly impairs the adhesion of desmosomes. Methods For immunofluorescence microscopy, keratinocytes were first incubated with PV IgG for 30 min in low Ca2+ medium, in which no desmosomes were formed, and then for 1 h in high Ca 2+ medium to generate desmosomes. For immunoelectron microscopy, after a 30-min incubation with PV IgG in low Ca2+ medium, cells were incubated with antihuman IgG with 5-nm gold particles for 5 min; after washing, cells were further incubated in high Ca2+ medium for 1 h. For tracing of PV IgG/Dsg3 immune complexes formed in the desmosomal core domain, cells were first incubated with PV IgG for 5 min to allow PV IgG to bind the desmosomal core domain and were further incubated with PV IgG-free medium for different times. Results Immunofluorescence microscopy revealed that PV IgG bound in a random-punctate pattern on the cell surface in low Ca2+ medium was translocated to the cell-cell contacts forming a dotted-linear distribution, suggesting desmosome generation even in the presence of PV IgG. Immunoelectron microscopy revealed that half-desmosome-like structures decorated with gold particles in low Ca2+ keratinocytes coupled to form desmosomes and gold particles were sandwiched in the desmosomal core domain after Ca2+ switch, even though their surfaces were covered with PV IgG/antihuman IgG 5-nm gold particles. In the tracing experiments, although PV IgG demonstrated a dotted-linear distribution along the cell-cell contacts colocalized with desmoplakin (DPK) after a 30-min tracing, it disappeared from cell-cell contacts after a 5-h tracing, leaving DPK and desmocollin 3. Conclusions These results suggest that the PV IgG/Dsg3 immune complexes are excluded from the desmosomal core domain rather than directly splitting the desmosome. © 2010 British Association of Dermatologists. Source

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