Natori Y,  Ishiwata H, Akabane H, Miura H, Kimula Y, Kurumatani N.
The relationship between shipyard works, asbestos-associated pathological findings and number of asbestos bodies in autopsy lung. In Adv Prev Occup Respir Dis, Eds by Chiyotani K, Hosoda Y, Aizawa Y. Elsevier, Amsterdam, 1998, pp 832-837
In autopsy, few studies have been carried out on the extent and degree of asbestos exposure in the shipyard. This study aimed at estimating shipyard asbestos exposure using autopsy cases. From 1,117 continuous autopsy cases at Yokosuka-Kyosai Hospital, the Asbestos bodies (AB) in 72 shipyard cases and 20 control cases were examined between 1986 and 1992 using Rogglis method. All of these cases were men. The shipyard group had experienced 27.7 +/- 11.3 years of asbestos exposure at the shipyard. The control group had no occupational asbestos exposure. The asbestos-associated pathological findings in the shipyard group were very high (asbestosis with or without pleural plaque 45 cases, plaque without asbestosis 12 cases, lung cancer 20 cases, malignant mesothelioma foure cases). However, there was no asbestosis or plaque found in the control group. The AB found in the shipyard group (1,613/5g wet lung) were significantly different from the AB fond in the control group (16.7/5g wet lung) (Mann-Whitney test: p<0.001). We divided the shipyard group into nine occupational subgroups. The smallest AB of shipyard clerk (administration) among shipyard subgroup (518/5g wet lung) was significantly different from the AB found in the control group, (Mann-Whitney test: p<0.001). Asbestosis and malignant mesothelioma were related to the AB found among the shipyard group (Mann-Whitney test: asbestosis p<0.01, malignant mesothelioma p<0.05).

Noguchi M,  Kimula Y, Ogata T
Muddy lung.
Am J Clin Pathol 1985 Feb;83(2):240-244
A 31-year-old man, a racing car driver, was submerged in muddy water as the result of an accident. He died from respiratory failure after a 17-day clinical course. Foreign body granulomatosis and massive fibrosis of the lung were revealed at autopsy. The crystalline foreign bodies mainly were composed of silicon and ranged in size from 20 micron to 500 micron in diameter (average, 90 micron). Their distribution in the lungs corresponded to the areas of lung carnification. In this study, the authors demonstrate that near drowning in muddy water causes pulmonary silicate granulomatosis associated with carnificating fibrosis of the lung and term the pulmonary changes "muddy lung."

Okayasu I,  Hatakeyama S, Yoshida T, Yoshimatsu S, Tsuruta K, Miyamoto H, Kimula Y
Selective and persistent deposition and gradual drainage of iodized oil, Lipiodol in the hepatocellular carcinoma after injection into the feeding hepatic artery. Am J Clin Pathol 1988 Nov;90(5):536-544
The selective and long-term deposition of iodized oil in the hepatocellular carcinoma (HCC) and its gradual drainage were clinicopathologically analyzed in 13 cases. All patients were Japanese and had an intrahepatic arterial injection of Lipiodol (LIP) mixed with Mitomycin C. The comparison among the follow-up computerized tomography (CT) findings, the observation of the soft x-ray radiogram, and histopathologic studies of the surgical or autopsy materials revealed that the selective deposition of LIP in HCC lasted for a long term, particularly in cases treated by LIP combined with transcatheter arterial embolization (TAE). Also revealed was an extremely gradual decrease of LIP from the HCC. It was thus postulated that, mainly, the accumulated macrophages surrounding LIP around the necrotic cancer tissue and, partially, the intrahepatic lymphatic system itself contributed to this drainage. Further, in histologic sections with lipid staining, x-ray microanalysis proved that the lipid droplets in the cancer tissue included highly concentrated iodine, as a deposition of LIP.

Sakamoto N,  Aoyagi Y, Ozaki Y, Kanayama M, Kimula Y, Akabane H
[Hodgkin's disease associated with Tolosa-Hunt syndrome].
Rinsho Ketsueki 1990 Feb;31(2):172-176
A thirty-eight-year-old man developed gradually progressing right retro-orbital pain, diplopia on the left lateral gaze, and left ptosis. On examination paresthesia was present on the first division of right trigeminal nerve. Orbital venography revealed obstruction of right superior orbital vein on the entering portion to the cavernous sinus. A daily administration of 30 mg of prednisolone resulted in a rapid improvement of the symptoms. Diagnosis of Tolosa-Hunt syndrome was made on the basis of neurological symptoms, roentgenographic findings and responsiveness to prednisolone. One year later, weakness of right leg accompanied with left cervical and axillary lymphadenopathy was developed. A biopsy specimen of cervical lymph node was identical with the Hodgkin's disease, lymphocyte predominance type. He was treated with COPP regimen; lymphadenopathy decreased in size. We reported a rare case of Hodgkin's disease preceded by Tolosa-hunt syndrome which might be caused by the extranodal lesions.

Satoh S,  Ohdama S, Matsubara O, Okochi Y, Tanaka R, Kimula Y.
CT-guided automated cutting needle biopsy by a combined method for accurate specific diagnosis of focal lung lesions.
Radiat Med. 2005 Feb;23(1):30-6.
PURPOSE: The purpose of our study was to evaluate a method of automated cutting needle biopsy (ACNB) that combines the use of a long-throw needle, higher mean number of needle passes, and tandem system, in terms of the accuracy of specific diagnosis of small and large lung lesions and the safety of the procedure. MATERIALS AND METHODS: Fifty-seven ACNBs were performed under computed tomography guidance using a tandem system with a 20-gauge and 18-gauge (through non-aerated lung) automated cutting needle with a throw length of 23 mm. We classified the nodules into 21 small nodules (< or =2 cm) and 36 large nodules (>2 cm). All ACNB diagnoses were divided into three groups: specific, non-specific, and false diagnoses. All of the complications were recorded. RESULTS: The mean number of ACNB specimens obtained was 2.0. Of the 35 ACNB procedures for malignant lesions, 33 yielded a specific malignant diagnosis (33/35, 94%). Of the 22 procedures for benign lesions, 17 gave a specific benign diagnosis (17/22, 77%). The diagnostic accuracy for small nodules was no lower than that for large nodules. Postbiopsy pneumothorax occurred in 18 patients (32%). CONCLUSION: The diagnostic accuracy of the combined method is as high for small lung nodules as for large ones. The procedure has high diagnostic accuracy for the subtypes of lung cancer and an acceptable complication rate.

Shimohara Y,  Tanno M, Yamada H, Kimura Y, Nishino H, Ide H, Kurihara N, Chiba K
[Clinical evaluation of gallium-67 scintigraphy in comparison with autopsy findings in the elderly, with particular reference to histological findings and classification of pulmonary cancer].
Radioisotopes 1987 Apr;36(4):176-180
A correlative study of autopsy findings and retrospective review of gallium scintigrams were performed in 106 elderly patients. Of the cases studied, 57% demonstrated positive gallium study in the present series. Histological correlation was undertaken in cases of lung cancer. Among them, squamous cell carcinoma showed the highest incidence of positive results (83%), whereas adenocarcinoma was the lowest (35%). There is no apparent correlation between subtypes of histological classification of adenocarcinoma and abnormal accumulation of gallium. However, abnormal accumulation of the nuclide seems to be rather related with interstitial reactions, namely fibrotic changes, lymphocyte infiltration and vascularization.

Shioya S,  Haida M, Tsuji C, Ohta Y, Yamabayashi H, Fukuzaki M, Kimula Y
Acute and repair stage characteristics of magnetic resonance relaxation times in oxygen-induced pulmonary edema.
Magn Reson Med 1988 Dec;8(4):450-459
Proton magnetic relaxation times, T1 and T2, were determined for rat lungs exposed to 80% oxygen for a duration of 2 weeks. The transverse magnetization decay curve of the lung tissue was multiexponential. A linear combination of two decay curves with different T2 values fits the multiexponential decay suggesting that there are at least two different components of tissue water in the lung. Remarkable prolongation of T1 and T2 was demonstrated as lung injuries progressed in the acute stage of pulmonary edema. Both 1/T1 and 1/T2 were significantly correlated with 1/water content of the lung tissue. In the repair stage, T1 and T2 were significantly shortened. Shortening coincided with the spontaneous resolution of pulmonary edema. Relaxation rates showed no significant correlation with 1/water content in this stage. These results indicate that the physical state of water in the tissue is affected not only by the water content but also by the derangement of macromolecules in pulmonary edema. T2 was more sensitive than T1 for detecting pulmonary damage.

Suzuki E,  Takahashi Y, Aida S, Kimula Y, Ito Y, Miura T
Alteration in surface structure of Clara cells and pulmonary cytochrome P-450b level in rats exposed to ozone.
Toxicology 1992;71(3):223-232
Changes in the surface structure of Clara cells in the terminal bronchioles following exposure of rats to 0.4 ppm ozone (O3) for 14 days were evaluated and compared to the content of pulmonary cytochrome P-450, an enzyme active in xenobiotic metabolism. Exposure to O3 caused a striking alteration of Clara cells in the terminal bronchiole. After 6 h exposure apical protrusions of Clara cells enlarged and these Clara cells formed clusters. However after 24 h exposure, the Clara cells decreased in number and flattened. They increased in number and enlarged again during the subsequent period of exposure. By the 14th day of O3 exposure the number of Clara cells had increased significantly. The content of cytochrome P-450b (IIB1), a main isozyme of pulmonary cytochromes P-450 of rats, was determined by an immuno-blotting method using anti-cytochrome P-450b antibody. The cytochrome P-450b in the rats exposed to O3 increased significantly to 1.37- and 1.81-times that of the control on the 7th and 14th days, respectively. Immuno-electron microscopy demonstrated that cytochrome P-450b was localized abundantly in endoplasmic reticulum of Clara cells. Morphological alterations in Clara cells appear to be closely related with changes in the cytochrome P-450b content of the lung.

Suzuki K,  Kimula Y, Ogata T, Nakagawa H
Bronchial carcinoid with multiple aerogenous implanted foci.
J Surg Oncol 1987 Mar;34(3):211-215
A case of bronchial carcinoid with intrapulmonary dissemination was demonstrated. A right upper lobectomy was performed because of an abnormal shadow in the lung detected by an X-ray mass survey. A carcinoid tumor originated from the spur region of the right upper lobe bronchus. The tumor protruded into the bronchial lumen and also extensively expanded into the surrounding alveolar tissue. The tumor showed typical histological features of bronchial carcinoid with a mixed insular, trabecular, and glandular pattern. Multiple implanted foci of tumor cells were found in the periphery of the lobe. The implanted tumor cells replaced the alveolar epithelium without destruction of the alveolar structure, which suggests the possibility of aergenous spread of bronchial carcinoid. This is the first report on bronchial carcinoid with aerogenous spread.

Soares D,  Kimula Y
Squamous cell carcinoma of the foot arising in chronic ulcers in leprosy patients.
Lepr Rev 1996 Dec;67(4):325-329
Squamous cell carcinoma (SCC) of the foot is a rare sequelae of chronic ulceration secondary to leprosy neuropathy. Most of the tumours are relatively slow growing and tend to metastasize late. Survival after local excision is generally good. In this series of 17 patients so far there have been 3 deaths attributable to SCC, all of whom presented with locally advanced tumours and lymph node metastasis.