Intractable bronchopleural fistula caused by radiofrequency ablation: endoscopic bronchial occlusion with silicone embolic material.

A 58-year-old man with primary lung cancer underwent lung radiofrequency (RF) ablation. Pneumothorax developed 12 days after lung RF ablation. Despite chest drainage for 1 month, air leakage continued through a bronchopleural fistula. Bronchial occlusion was performed with a silicone embolus, causing cessation of the air leakage.

Ultrastructure of the water-clear cell in the parathyroid gland of SAMP6 mice.

Although the parathyroid water-clear cell is very rare, it has clinical significance because of its association with parathyroid hyperplasia or adenoma. SAMP6, a substrain of senescence-accelerated mouse, was developed as an animal model for senile osteoporosis. We investigated the morphology of the parathyroid glands in SAMP6 and age-matched normal mouse SAMR1. The parathyroid water-clear cells, which contained numerous vacuoles and the crystalloid inclusions, were found in SAMP6 mice at 5, 8 and 12 months of age. It was noted that the number of water-clear cells increased with aging, which are fairly consistent with the change of the serum parathyroid hormone (PTH) level. We did not find any water-clear cells in the parathyroid glands of SAMR1 mice. The existence of water-clear cells may represent hyperfunction of the parathyroid glands in SAMP6.

Ultrastructural changes in bones of the senescence-accelerated mouse (SAMP6): a murine model for senile osteoporosis.

SAMP6, a substrain of senescence-accelerated mice, was developed as an animal model for senile osteoporosis. In the present study, we investigated the bone morphology, together with serum calcium and bone mineral density (BMD) in SAMP6 and age-matched normal mice SAMR1. We did not find any significant differences between SAMR1 and SAMP6 at 1 month of age with regard to the serum compositions and bone morphology. As compared with SAMR1, BMD, the femoral weight, femoral calcium and phosphorus levels were significantly reduced in SAMP6 at 2 and 5 months of age. The number of osteoblasts in trabecular bones was also significantly reduced. Swollen mitochondria and myelin-like structures were found in osteoblasts and osteocytes of SAMP6 mice at 2 and 5 months of age. There was a greater proportion of resting surface and less forming surface in the femoral endosteal surfaces of SAMP6 mice. The amount of trabecular bone in the lumbar vertebra and the distal metaphysis of the femur was reduced. The number of the mast cells in bone marrow of the tibia significantly increased in SAMP6 mice. These findings indicate that the lower bone mass in SAMP6 was due to the reduction in osteoblast formation and suggested that mast cells in bone marrows play a role in the pathogenesis of senile osteoporosis.

[Acute purulent pericarditis due to Haemophilus influenzae treated successfully with subxiphoid pericardial drainage; report of a case].

A surgical case of acute purulent pericarditis in 1-year 2-month old boy who developed pericardial tamponade rapidly is reported. A subxiphoid pericardiectomy through a median incision was performed. Haemophilus influenzae was isolated from the effusion. He recovered successfully with an administration of antibiotics after the drainage procedures and did not develop constructive pericarditis. Our experience suggested that early subxiphoid pericardial drainage was effective in treatment of acute purulent pericarditis.

Effects of cigarette smoke exposure on the ultrastructure of the golden hamster parathyroid gland.

Cigarette smoking has been identified as one of the risk factors to induce osteoporosis. However, we find no study on the morphology of the parathyroid gland under smoking exposure. We studied the ultrastructure of the parathyroid gland, lung and femur of the golden hamster exposed to cigarette smoke. Four-week-old male hamsters were housed in a plastic case (48x31x30 cm) and were exposed to cigarette smoke for 12 weeks, 5 minutes exposure, 4 times a day, 4 days a week. There were no differences in serum calcium level and the whole bone mineral density between the control and the smoke-exposed groups. In the parathyroid gland of the smoke-exposed animals, the Golgi complexes associated with many prosecretory granules were well developed and many secretory granules were located near the plasma membrane. Large lipid-like inclusion bodies were observed in the alveolar macrophages of the smoke-exposed animals. The femur morphology showed a wider area of resorbing surface in the smoke-exposed group than in the control group. From these findings, it is conceivable that the secretory activity of the parathyroid gland was stimulated with cigarette smoke exposure.

Occurrence of the parathyroid cyst in golden hamsters.

Parathyroid cyst is a rare lesion, but has clinical significance because of it's ability to mimic a thyroid mass and it's association with hyperparathyroidism. The occurrence and morphology of parathyroid cysts in golden hamsters from neonatal to senile periods were investigated using light and electron microscopy. The results demonstrate the presence of chief cell cysts in the parathyroid glands of 5-day-old hamsters. Some chief cells lining the cyst wall showed mitosis and apoptosis. The existence of chief cell cysts may represent the rapid proliferation of the parathyroid chief cells in 5-day-old hamsters. Ciliated cysts were observed in the parathyroid glands of 5-day-, 1- and 3-month-old hamsters. Three cell types were distinguished in the wall of the ciliated cyst: Ciliated, mucous and basal cells. Ciliated cysts possessed the features of the pharyngeal epithelia without endocrine cells and may arise from embryological remnants of pharyngeal pouches in the neck undergoing cystic degeneration and entrapping portions of parathyroid tissue. The frequency of parathyroid cysts decreased with age.

[An operative case of left ventricular-right atrial communication complicated with aortic valve stenosis and regurgitation].

A 70-year-old woman suffering from aortic valve stenosis and regurgitation and tricuspid valve regurgitation was admitted to our hospital. At the operation, the right atrium and both ventricles were dilated, and a thrill was felt over the aortic root and right atrium. The aortic valve was bicuspid and heavily calcified. After aortic leaflets were resected, a defect was seen in the left ventricle. Then the right atrium was opened. The defect was located in the atrioventricular membranous septum just above the septal leaflet of the tricuspid valve. The defect was diagnosed to be a left ventricular-right atrial communication (group I according to Riemenschneider's classification). The defect was repaired directly and then the aortic valve was replaced with a prosthesis. After the operation, the heart murmur disappeared. Eleven days after the operation, the patient developed a transient complete AV block for a month.

Macrophages in the hamster parathyroid gland: immunohistochemical and ultrastructural investigations.

The distribution and morphology of the parathyroid macrophages in golden hamsters from neonatal to senile periods were investigated using the monoclonal antibody to ED2 and electron microscopy. The results showed that definite ED2-positive cells were hardly detectable in the parathyroid gland of 1-day-old hamsters. A few ED2-positive cells could be identified in the parathyroid gland of 10-day-old hamsters. The ED2-positive cells were more densely and became conspicuous in 1-, 3-, and 12-month-old hamsters. The number of the cells seems to be increased with aging. Ultrastructurally, we did not find any macrophages in parathyroid glands of 1-day-old hamsters. In the 10-day-old hamster parathyroid gland, a few macrophages existed only in the interstitial tissues. In the parathyroid gland of 1-, 3-, and 12-month-old hamsters, many macrophages were found in the perivascular regions, some cells located among the parenchymal chief cells with no obvious vascular association. These cells showed some physical contacts with chief cells. These results suggest that the parathyroid macrophages exhibit dramatical changes in their distribution and morphology from neonatal to senile periods.

Nuclear bodies of the human lung in psittacosis.

Lung piece obtained from a female patient with psittacosis by biopsy. A nuclear bodies of five different types were observed, depending on their degree of ultrastructural development. First type showed fibrillary nuclear bodies surrounded by a clear halo. Type II resembled the nuclear body of type I but showed heterogeneously electron density. Type III comprised nuclear bodies with a fibrillary cortex containing a central granular component. These bodies were separated from the nucleoplasm by a clear halo. Type IV was characterized by a more complex structure and resembled the nuclear body of type III but with dense osmiophilic granules. Nuclear bodies of type V were comprised of numerous osmiophilic granules.

[A successful repair of left ventricular rupture after surgical treatment of ventricular septal perforation complicated due to acute myocardial infarction].

A 75-year-old woman was admitted complaining of anterior chest pains, and peripheral coldness. The 6th day after admission, a loud systolic murmur of Levine IV/VI was audible at the apex. The chest X-ray film demonstrated a cardiomegaly and ST elevation in the V1-V5 leads. UCG and right-heart catheterization revealed an intraventricular shunt from left to right, and the diagnosis of ventricular septal perforation after acute antero-septal myocardial infarction was confirmed. Although, we were continuing and aggressive medical treatment with the intraaortic balloon pumping, an emergency operation for ventricular septal perforation was performed, 15 days after onset. The direct closure of the septal perforation and the plication of the left ventricular free wall with two felt strips were performed. The postoperative course seemed well. But in the 3rd postoperative day, massive bleeding was recognized through the drainage tube. The left ventricular rupture was suggested, and a massive blood transfusion was done. An emergency operation was performed. Another left ventricular free wall was lacerated about 6 mm at the apex. The laceration was closed with teflon felt strips. The patient survived through the operation, and is doing well after 7 years since the operation.

Effects of progesterone on the ultrastructure of the golden hamster parathyroid gland.

The ultrastructure of the parathyroid glands in golden hamsters after administration of progesterone was investigated. In the parathyroid glands of the female hamsters after administration of progesterone, the mean serum calcium concentration was significantly higher when compared to that of the control hamsters. In the male experimental hamsters, the percentage area occupied by Golgi complexes and lipid droplets was significantly increased when compared to that of the control hamsters, respectively. In the female hamsters after administration of progesterone, the percentage area occupied by large vacuolar bodies was significantly decreased when compared to that of the control hamsters. In the male and female experimental hamsters, the mean number of secretory granules per 100 microns2 of cytoplasm showed a significant increase compared with that of the male and female control hamsters, respectively. These findings suggest that the secretory activity of the parathyroid glands may be stimulated in response to hypocalcemia induced by progesterone.

Effects of cadmium on the ultrastructure of the mouse parathyroid gland.

Electron-microscopic studies were made on the parathyroid gland of cadmium-treated mice. Most chief cells in treated mice were rich in free ribosomes and secretory granules compared to the control mice. In the parathyroid gland after 3 and 4 weeks of administration of cadmium, interdigitations between adjacent chief cells became more complex than in the control mice. In most chief cells of the parathyroid gland after 2, 3 and 4 weeks of administration of cadmium, the Golgi complexes associated with numerous prosecretory granules were better developed than in the control mice. These ultrastructural appearances suggest that parathyroid gland cellular activity was stimulated in response to cadmium treatment.