Date: 24 March 2014
Hakkaisan sake (Nihonshu)
Copyright:
Fungal Research Trust
Notes:
Varieties of traditional sake and shochu made in different parts of Japan.
From left to right:
Shochu, made from barley and distilled, similar to whisky.
Shochu made by Furusawa from Miazaki prefecture on Kyoshu Island (25% alcohol)
High quality sake called Shochikubai made by Takara brewery in Kyoto from polished rice and used for purification in ceremonies such as weddings, within a Shinto religious ceremony (15% alcohol).
Sake made near the mountains of Hakkaisan in Niigata prefecture, top quality.
Sake made near the mountains of Hakkaisan in Niigata prefecture.
Sake made near the mountains of Hakkaisan in Niigata prefecture.
Dry sake called Suizin, made in the Iwate prefecture in the north of Japan.
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Embolisation 7 – patient WC. Angiogram of the lateral thoracic artery on subtraction film showing grossly abnormal vasculature inferiorly shunting along several anterior intercostal arteries to the internal mammary artery. In addition a pseudoaneurysm is shown.
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Embolisation 6 – patient WC. Catheter tip in the lateral thoracic artery on screening film.
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Grocott (silver) stain showing branching septate hyphae fairly typical of Aspergillus in mucus. The apparent right angle branching is unusual.
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Bronchial mucosa under H & E stain showing numerous eosinophils deep to the mucosa, and mucus in the lumen of the bronchiole.
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Grocott (silver) stain showing branching septate hyphae fairly typical of Aspergillus in mucus. The apparent right angle branching is unusual.
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Severe kyphoscoliosis caused by greater than 40 years of prednisolone for ABPA and asthma.
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These pictures show remarkable curvature of the spine as a result of collapse of the vertebral bodies of the thoracic vertebrae. This is a gross example of steroid-induced osteoporosis. The dose was not large in the last 10 years, typically 5-10mg daily, but multiple high dose courses and slow tapering lead to this outcome.
Her corticosteroid warning card is also demonstrated, as additional steroids are required for any significant illness or surgery, as her adrenal glands had completely atrophied.
Kindly supplied by Prof David Denning, South Manchester University Hospitals NHS Trust, Manchester UK
(© Fungal Research Trust)
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