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Deguchi R, Ueda T, Kaneko M, Arase Y, Tsuruya K, Kawanishi A, Kodama T, Morimachi M, Ogimi T, Kagawa T. Low-grade Appendiceal Mucinous Neoplasm with Appendiceal Reduction and Re-expansion Over a Two-year Period: A Case Report. Intern Med 2024:3136-23. [PMID: 38369352 DOI: 10.2169/internalmedicine.3136-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
A 71-year-old woman was found to have submucosal tumor-like lesion on colonoscopy (CS) before gastric surgery, and computed tomography (CT) showed a 12-mm structure at the base of the appendix. The lesion could not be clearly detected on CT nine months later, but it had enlarged again on CT one year later; therefore, CS and endoscopic ultrasound (EUS) were performed. The lesion was determined to be cystic with viscous contents, and laparoscopic appendicectomy was performed. This is the first report of low-grade appendiceal mucinous neoplasm (LAMN) diagnosed by a histopathologic examination of a resected specimen showing shrinkage and re-expansion of the appendix.
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Affiliation(s)
- Ryuzo Deguchi
- Department of Gastroenterology, Tokai University School of Medicine, Japan
| | - Takashi Ueda
- Department of Gastroenterology, Tokai University School of Medicine, Japan
| | - Motoki Kaneko
- Department of Gastroenterology, Tokai University School of Medicine, Japan
| | - Yoshitaka Arase
- Department of Gastroenterology, Tokai University School of Medicine, Japan
| | - Kota Tsuruya
- Department of Gastroenterology, Tokai University School of Medicine, Japan
| | - Aya Kawanishi
- Department of Gastroenterology, Tokai University School of Medicine, Japan
| | - Toshiki Kodama
- Department of Gastroenterology, Tokai University School of Medicine, Japan
| | - Masashi Morimachi
- Department of Gastroenterology, Tokai University School of Medicine, Japan
| | - Takashi Ogimi
- Department of Surgery, Tokai University School of Medicine, Japan
| | - Tatehiro Kagawa
- Department of Gastroenterology, Tokai University School of Medicine, Japan
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Nakamura K, Hayashi H, Kawano R, Ishikawa M, Aimono E, Mizuno T, Kuroda H, Kojima Y, Niikura N, Kawanishi A, Takeshita K, Suzuki S, Ueno S, Okuwaki K, Sasaki J, Yamaguchi M, Masuda K, Chiyoda T, Yamagami W, Okada C, Nohara S, Tanishima S, Nishihara H. BRCA1/2 reversion mutations in a pan-cancer cohort. Cancer Sci 2024; 115:635-647. [PMID: 38041241 PMCID: PMC10859608 DOI: 10.1111/cas.16033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/09/2023] [Accepted: 11/17/2023] [Indexed: 12/03/2023] Open
Abstract
Tumor sensitivity to platinum (Pt)-based chemotherapy and poly(adenosine diphosphate ribose) polymerase (PARP) inhibitors is increased by homologous recombination deficiency-causing mutations; in particular, reversion mutations cause drug resistance by restoring protein function. Treatment response is predicted by breast cancer susceptibility gene 1/2 (BRCA1/2) mutations; however, BRCA1/2 reversion mutations have not been comprehensively studied in pan-cancer cohorts. We aimed to characterize BRCA1/2 reversion mutations in a large pan-cancer cohort of Japanese patients by retrospectively analyzing sequencing data for BRCA1/2 pathogenic/likely pathogenic mutations in 3738 patients with 32 cancer types. We identified somatic mutations in tumors or circulating cell-free DNA that could restore the ORF of adverse alleles, including reversion mutations. We identified 12 (0.32%) patients with somatic BRCA1 (n = 3) and BRCA2 (n = 9) reversion mutations in breast (n = 4), ovarian/fallopian tube/peritoneal (n = 4), pancreatic (n = 2), prostate (n = 1), and gallbladder (n = 1) cancers. We identified 21 reversion events-BRCA1 (n = 3), BRCA2 (n = 18)-including eight pure deletions, one single-nucleotide variant, six multinucleotide variants, and six deletion-insertions. Seven (33.3%) reversion deletions showed a microhomology length greater than 1 bp, suggesting microhomology-mediated end-join repair. Disease course data were obtained for all patients with reversion events: four patients acquired mutations after PARP-inhibitor treatment failure, two showed somatic reversion mutations after disease progression, following Pt-based treatment, five showed mutations after both treatments, one patient with pancreatic cancer and BRCA1 reversion mutations had no history of either treatment. Although reversion mutations commonly occur in BRCA-associated cancers, our findings suggest that reversion mutations due to Pt-chemotherapy might be correlated with BRCA1/2-mediated tumorigenesis even in non-BRCA-associated histologies.
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Affiliation(s)
- Kohei Nakamura
- Genomics Unit, Keio Cancer CenterKeio University School of MedicineTokyoJapan
- Department of Obstetrics and GynecologyKumagaya General HospitalKumagayaJapan
| | - Hideyuki Hayashi
- Genomics Unit, Keio Cancer CenterKeio University School of MedicineTokyoJapan
| | - Ryutaro Kawano
- Genomics Unit, Keio Cancer CenterKeio University School of MedicineTokyoJapan
| | - Marin Ishikawa
- Genomics Unit, Keio Cancer CenterKeio University School of MedicineTokyoJapan
| | - Eriko Aimono
- Genomics Unit, Keio Cancer CenterKeio University School of MedicineTokyoJapan
- Department of Cancer Pathology, Faculty of MedicineHokkaido UniversitySapporoJapan
| | - Takaaki Mizuno
- Genomics Unit, Keio Cancer CenterKeio University School of MedicineTokyoJapan
| | - Hajime Kuroda
- Department of Diagnostic Pathology, Adachi Medical CenterTokyo Women's Medical UniversityTokyoJapan
| | - Yasuyuki Kojima
- Showa University Institute for Clinical Genetics and GenomicsTokyoJapan
| | - Naoki Niikura
- Department of Breast OncologyTokai University School of MedicineIseharaJapan
| | - Aya Kawanishi
- Division of Gastroenterology and Hepatology, Department of Internal MedicineTokai University School of MedicineIseharaJapan
| | - Kei Takeshita
- Department of Clinical GeneticsTokai University HospitalIseharaJapan
| | | | - Shinichi Ueno
- Cancer CenterKagoshima University HospitalKagoshimaJapan
| | - Kosuke Okuwaki
- Department of GastroenterologyKitasato University School of MedicineSagamiharaJapan
| | - Jiichiro Sasaki
- Division of Clinical Oncology, Department of Comprehensive Medicine, Research and Development Center for New Medical FrontiersKitasato University School of MedicineSagamiharaJapan
| | | | - Kenta Masuda
- Department of Obstetrics and GynecologyKeio University School of MedicineTokyoJapan
| | - Tatsuyuki Chiyoda
- Department of Obstetrics and GynecologyKeio University School of MedicineTokyoJapan
| | - Wataru Yamagami
- Department of Obstetrics and GynecologyKeio University School of MedicineTokyoJapan
| | - Chihiro Okada
- Department of Biomedical Informatics, Communication Engineering Center, Electronic Systems Business GroupMitsubishi Electric Software Co., Ltd.AmagasakiJapan
| | - Sachio Nohara
- Department of Biomedical Informatics, Communication Engineering Center, Electronic Systems Business GroupMitsubishi Electric Software Co., Ltd.AmagasakiJapan
| | - Shigeki Tanishima
- Department of Biomedical Informatics, Communication Engineering Center, Electronic Systems Business GroupMitsubishi Electric Software Co., Ltd.AmagasakiJapan
| | - Hiroshi Nishihara
- Genomics Unit, Keio Cancer CenterKeio University School of MedicineTokyoJapan
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Imai J, Hanamura T, Kawanishi A, Ueda T, Mishima Y, Ito A, Shirataki Y, Morimachi M, Kodama T, Sato H, Kaneko M, Sano M, Teramura E, Monma M, Tsuda S, Tsuruya K, Mizukami H, Arase Y, Fujisawa M, Miyahara S, Nakamura N, Suzuki T, Matsushima M, Suzuki H, Takashimizu S, Kagawa T, Nishizaki Y. A case of breast cancer with extensive colon metastasis. DEN Open 2023; 3:e189. [PMCID: PMC9702338 DOI: 10.1002/deo2.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/12/2022] [Accepted: 11/01/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Jin Imai
- Department of Clinical Health ScienceTokai University School of MedicineIseharaKanagawaJapan
| | - Toru Hanamura
- Department of Breast and Endocrine SurgeryTokau University School of MedicineIseharaKanagawaJapan
| | - Aya Kawanishi
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Takashi Ueda
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Yusuke Mishima
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Ayano Ito
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Yoshihiro Shirataki
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Masashi Morimachi
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Toshio Kodama
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Hirohiko Sato
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Motoki Kaneko
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Masaya Sano
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Erika Teramura
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Makiko Monma
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Shingo Tsuda
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Kota Tsuruya
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Hajime Mizukami
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Yoshitaka Arase
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Mia Fujisawa
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Saya Miyahara
- Department of PathologyTokai University School of Medicine IseharaKanagawaJapan
| | - Naoya Nakamura
- Department of PathologyTokai University School of Medicine IseharaKanagawaJapan
| | - Takayoshi Suzuki
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Masashi Matsushima
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Hidekazu Suzuki
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Shinji Takashimizu
- Department of Clinical Health ScienceTokai University School of MedicineIseharaKanagawaJapan
| | - Tatehiro Kagawa
- Department of Internal Medicine, Division of GastroenterologyTokai University School of MedicineIseharaKanagawaJapan
| | - Yasuhiro Nishizaki
- Department of Clinical Health ScienceTokai University School of MedicineIseharaKanagawaJapan
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4
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Yamaji Y, Kawashima Y, Kodama T, Kawanishi A, Ito A, Ito H, Ogawa M, Kawaguchi Y, Kagawa T. Efficacy and Safety of Endoscopic Removal for Asymptomatic Common Bile Duct Stones in Comparison with Symptomatic Stones. Tokai J Exp Clin Med 2022; 47:143-148. [PMID: 36073287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Endoscopic removal is recommended for common bile duct stones (CBDs). However, in patients with asymptomatic CBDs, follow-up without treatment may be recommended because of the increased complication risks associated with asymptomatic CBDs removal. The objective of our study was to investigate the efficacy and safety of CBDs removal in asymptomatic patients. METHODS Consecutive patients with naive papilla who underwent endoscopic retrograde cholangiopancreatography (ERCP) for the treatment of CBDs from April 2016 to August 2020 were retrospectively analyzed. We compared the efficacy and safety of CBDs removal in asymptomatic and symptomatic patients. RESULTS We enrolled 300 patients, 53 asymptomatic and 247 symptomatic patients. Endoscopic CBDs removal was successful in all patients, except one symptomatic patient. However, the complete stone removal rate in a single session was significantly higher in the asymptomatic group than that in the symptomatic group. ERCP-related complications did not differ between the asymptomatic and symptomatic patients. The incidence of post-ERCP pancreatitis was similar and liver cirrhosis was the only significant risk factor for pancreatitis. CONCLUSION Complication risks associated with endoscopic CBDs removal was not significantly different between asymptomatic and symptomatic patients. Liver cirrhosis was a significant risk factor of ERCP-related pancreatitis.
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Affiliation(s)
- Yoko Yamaji
- Division of Hepatology and Gastroenterology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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5
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Ito H, Kojima S, Moriyama K, Yokota M, Shinma Y, Ito A, Kodama T, Kawanishi A, Kagawa T, Watanabe N, Suzuki T. Analysis of Comorbidity for Patients with Pancreatic Cysts in Medical Checkup Screening. Tokai J Exp Clin Med 2022; 47:60-63. [PMID: 35801549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/17/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES We investigated whether there is a difference in the frequency of comorbidity between patients with pancreatic cysts and those without pancreatic cysts by abdominal ultrasonography in patients undergoing medical checkup screening. METHODS The subjects were 6,627 patients who underwent abdominal ultrasonography at Tokai University Hachioji Hospital's Health Screening Center between April 2019 and March 2020. RESULTS Of the total 6,627 patients, 158 (2.4%) were pointed out to have pancreatic cysts. Multivariate analysis revealed that the related factors were female sex, age 60 years or older, diabetes, lung cancer, and uterine/ovarian cancer. CONCLUSION Unlike pancreatic cancer, pancreatic cysts are more common in women. In addition, it is known that pancreatic cysts have a high complication rate of cancers of other organs; lung cancer and uterine/ovarian cancer were identified as high-risk factors in this study.
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Affiliation(s)
- Hiroyuki Ito
- Department of Gastroenterology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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6
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Saika T, Hirabayashi K, Itoh H, Miyajima Y, Serizawa A, Kato N, Oyamada H, Machida T, Kawanishi A, Nakamura N. Cancer-associated fibroblasts are a useful cytological finding for diagnosing pancreatic ductal adenocarcinoma. Cytopathology 2021; 31:310-314. [PMID: 32472717 DOI: 10.1111/cyt.12868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/11/2020] [Accepted: 05/22/2020] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Cancer-associated fibroblasts (CAFs) are activated fibroblasts or myofibroblasts that play a crucial role in the invasiveness of pancreatic ductal adenocarcinoma (PDAC). In this study, the cytological features and diagnostic significance of CAFs based on pancreatic duct brushing cytology (PDBC) were evaluated. METHODS The prevalence of fibrous stroma (FS) including CAFs on PDBC in 42 PDAC cases and 33 benign cases was retrospectively investigated. The average nuclear size of fibroblasts was compared between PDAC and benign cases to distinguish CAFs from normal FS. RESULTS Overall, FS was observed in 25 PDAC cases (60%) and eight benign cases (24%). The average nuclear size of FS in PDAC cases was significantly larger than that in benign cases. From the receiver operating characteristics analysis, the cut-off value of the nuclear size of FS for the diagnosis of PDAC was defined as 10.22 µm. FS with nuclei over 10.22 µm in size in PDAC cases had clear prominent nucleoli. In contrast, FS in benign cases had no clear nucleoli. Thus, CAFs on PDBC were considered to be FS with nuclei over 10.22 µm in size and prominent nucleoli. The presence of CAFs on PDBC had 100% positive predictive value and specificity for the diagnosis of PDAC. CONCLUSIONS This study suggested that CAFs on PDBC could be distinguished from normal FS by large nuclear size (over 10.22 µm) and prominent nucleoli and that CAFs on PDBC may be used for the diagnosis of PDAC.
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Affiliation(s)
- Tsubasa Saika
- Division of Diagnostic Pathology, Tokai University Hospital, Isehara, Japan
| | - Kenichi Hirabayashi
- Department of Pathology, Tokai University School of Medicine, Isehara, Japan
| | - Hitoshi Itoh
- Division of Diagnostic Pathology, Tokai University Hospital, Isehara, Japan
| | - Yoko Miyajima
- Division of Diagnostic Pathology, Tokai University Hospital, Isehara, Japan
| | - Akihiko Serizawa
- Division of Diagnostic Pathology, Tokai University Hospital, Isehara, Japan
| | - Nobuaki Kato
- Division of Diagnostic Pathology, Tokai University Hospital, Isehara, Japan
| | - Hiroyuki Oyamada
- Department of Clinical Laboratory, Tokai University Oiso Hospital, Oiso, Japan
| | - Tomohisa Machida
- Department of Diagnostic Pathology, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan
| | - Aya Kawanishi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara, Japan
| | - Naoya Nakamura
- Department of Pathology, Tokai University School of Medicine, Isehara, Japan
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Yamaji Y, Kawashima Y, Kodama T, Kawanishi A, Kagawa T, Mashiko T, Masuoka Y, Nakagohri T, Tomita S, Hirabayashi K. [A case of simultaneous multicentric cancer in the gallbladder duct and the common bile duct without pancreaticobiliary maljunction]. Nihon Shokakibyo Gakkai Zasshi 2021; 118:366-373. [PMID: 33840718 DOI: 10.11405/nisshoshi.118.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A 68-year-old man who underwent cholecystectomy for acute cholecystitis and was diagnosed with gallbladder duct carcinoma was referred to our hospital. Postoperative computed tomography showed thickening of the middle to lower bile duct without any tumorous lesions. Endoscopic retrograde cholangiopancreatography and intraductal ultrasonography revealed irregular wall thickening of the lower bile duct and apparent infiltration of gallbladder duct tumor to the common bile duct without pancreaticobiliary maljunction. Subtotal stomach-preserving pancreaticoduodenectomy was performed. Pathological examination showed papillary adenocarcinoma and tubular adenocarcinoma in the gallbladder duct and BilIN-3 lesion in the distal bile duct. The final diagnosis was biliary simultaneous multicentric cancer without pancreaticobiliary maljunction.
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Affiliation(s)
- Yoko Yamaji
- Department of Gastroenterology, Tokai University School of Medicine
| | - Yohei Kawashima
- Department of Gastroenterology, Tokai University School of Medicine
| | - Toshiki Kodama
- Department of Gastroenterology, Tokai University School of Medicine
| | - Aya Kawanishi
- Department of Gastroenterology, Tokai University School of Medicine
| | - Tatehiro Kagawa
- Department of Gastroenterology, Tokai University School of Medicine
| | - Taro Mashiko
- Department of Gastrointestinal Surgery, Tokai University School of Medicine
| | - Yoshihito Masuoka
- Department of Gastrointestinal Surgery, Tokai University School of Medicine
| | - Toshio Nakagohri
- Department of Gastrointestinal Surgery, Tokai University School of Medicine
| | - Sakura Tomita
- Department of Pathology, Tokai University School of Medicine
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Matsuda Y, Ohkubo S, Nakano-Narusawa Y, Fukumura Y, Hirabayashi K, Yamaguchi H, Sahara Y, Kawanishi A, Takahashi S, Arai T, Kojima M, Mino-Kenudson M. Objective assessment of tumor regression in post-neoadjuvant therapy resections for pancreatic ductal adenocarcinoma: comparison of multiple tumor regression grading systems. Sci Rep 2020; 10:18278. [PMID: 33106543 PMCID: PMC7588464 DOI: 10.1038/s41598-020-74067-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 09/24/2020] [Indexed: 12/11/2022] Open
Abstract
Neoadjuvant therapy is increasingly used to control local tumor spread and micrometastasis of pancreatic ductal adenocarcinoma (PDAC). Pathology assessments of treatment effects might predict patient outcomes after surgery. However, there are conflicting reports regarding the reproducibility and prognostic performance of commonly used tumor regression grading systems, namely College of American Pathologists (CAP) and Evans' grading system. Further, the M.D. Anderson Cancer Center group (MDA) and the Japan Pancreas Society (JPS) have introduced other grading systems, while we recently proposed a new, simple grading system based on the area of residual tumor (ART). Herein, we aimed to assess and compare the reproducibility and prognostic performance of the modified ART grading system with those of the four grading systems using a multicenter cohort. The study cohort consisted of 97 patients with PDAC who had undergone post-neoadjuvant pancreatectomy at four hospitals. All patients were treated with gemcitabine and S-1 (GS)-based chemotherapies with/without radiation. Two pathologists individually evaluated tumor regression in accordance with the CAP, Evans', JPS, MDA and ART grading systems, and interobserver concordance was compared between the five systems. The ART grading system was a 5-tiered system based on a number of 40× microscopic fields equivalent to the surface area of the largest ART. Furthermore, the final grades, which were either the concordant grades of the two observers or the majority grades, including those given by the third observer, were correlated with patient outcomes in each system. The interobserver concordance (kappa value) for Evans', CAP, MDA, JPS and ART grading systems were 0.34, 0.50, 0.65, 0.33, and 0.60, respectively. Univariate analysis showed that higher ART grades were significantly associated with shorter overall survival (p = 0.001) and recurrence-free survival (p = 0.005), while the other grading systems did not show significant association with patient outcomes. The present study revealed that the ART grading system that was designed to be simple and more objective has achieved high concordance and showed a prognostic value; thus it may be most practical for assessing tumor regression in post-neoadjuvant resections for PDAC.
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Affiliation(s)
- Yoko Matsuda
- Oncology Pathology, Department of Pathology and Host-Defense, Faculty of Medicine, Kagawa University, Kagawa, Japan.,Department of Pathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Satoshi Ohkubo
- Division of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Yuko Nakano-Narusawa
- Oncology Pathology, Department of Pathology and Host-Defense, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Yuki Fukumura
- Department of Human Pathology, Juntendo University, School of Medicine, Tokyo, Japan
| | - Kenichi Hirabayashi
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
| | - Hiroshi Yamaguchi
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Yatsuka Sahara
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Aya Kawanishi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Kanagawa, Japan
| | - Shinichiro Takahashi
- Division of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Tomio Arai
- Department of Pathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Motohiro Kojima
- Division of Pathology, Research Center for Innovative Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa-shi, Chiba, Japan.
| | - Mari Mino-Kenudson
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Warren 122, Boston, MA, USA.
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Morimachi M, Hirabayashi K, Takanashi Y, Kawanishi A, Saika T, Ueyama Y, Nakagohri T, Nakamura N, Suzuki H, Kagawa T. Low expression of DDX5 is associated with poor prognosis in patients with pancreatic ductal adenocarcinoma. J Clin Pathol 2020; 74:741-745. [PMID: 33097588 DOI: 10.1136/jclinpath-2020-207002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/16/2020] [Accepted: 10/06/2020] [Indexed: 11/03/2022]
Abstract
AIMS Pancreatic ductal adenocarcinoma (PDAC) is one of the most fatal malignancies. Hence, there is a need for new markers and treatment strategies. P68/DEAD box protein 5 (DDX5) is an ATP-dependent RNA helicase of the DEAD box protein family. It is a prognostic marker for several cancers. In this study, we aimed to evaluate the expression and clinical relevance of DDX5 in PDAC. METHODS DDX5 expression in tissue microarray blocks containing 230 PDAC samples was examined using immunohistochemical analysis. DDX5 expression was considered high when more than 50% of the cells were stained and low when less than 50% of the cells were stained. We investigated the association between DDX5 expression and clinicopathological parameters, including patient survival. RESULTS The nuclei of normal pancreatic ducts, normal acinar cells and PDAC cells were stained positive for DDX5 although the intensity and distribution of DDX5 expression varied. Islet cells showed strong and diffuse staining of DDX5. DDX5 expression was low and high in 148 (64.3%) and 82 cases (35.7%), respectively. Low DDX5 expression was significantly associated with an advanced pT factor (pT2-pT3: tumour size,>20 mm), lymphatic involvement, advanced tumour-node-metastasis (TNM) stage (stages IIB, III, and IV), and venous involvement. In addition, the multivariate analysis revealed that DDX5 expression is an independent prognostic factor for PDAC. CONCLUSION These results suggest that DDX5 plays an important role in tumour invasiveness and PDAC prognosis.
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Affiliation(s)
- Masashi Morimachi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Kenichi Hirabayashi
- Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Yumi Takanashi
- Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Aya Kawanishi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Tsubasa Saika
- Division of Diagnostic Pathology, Tokai University Hospital, Isehara, Kanagawa, Japan
| | - Yumiko Ueyama
- Division of Diagnostic Pathology, Tokai University Hospital, Isehara, Kanagawa, Japan
| | - Toshio Nakagohri
- Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Naoya Nakamura
- Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Hidekazu Suzuki
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Tatehiro Kagawa
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
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Hirabayashi K, Kawanishi A, Morimachi M, Yamada M, Takanashi Y, Hori S, Serizawa A, Saika T, Nakagohri T, Nakamura N. Hyalinized stroma is a characteristic feature of pancreatic intraductal oncocytic papillary neoplasm: An immunohistochemical study. Ann Diagn Pathol 2020; 49:151639. [PMID: 33069084 DOI: 10.1016/j.anndiagpath.2020.151639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 08/27/2020] [Accepted: 09/27/2020] [Indexed: 11/17/2022]
Abstract
Hyalinized stroma (HS) is a dense, eosinophilic, and amorphous extracellular material in the stroma. HS is observed in several tumors; however, it has not been comprehensively studied in pancreatic intraductal papillary mucinous neoplasm (IPMN) or intraductal oncocytic papillary neoplasm (IOPN). Here, we aimed to evaluate the immunohistochemical and microscopic characteristics of HS in IPMN and IOPN. The prevalence of HS was determined in 168 cases of IPMN, including intestinal type (IPMN-I), gastric type (IPMN-G), and pancreatobiliary type (IPMN-PB), as well as in 11 cases of IOPN. Immunohistochemical staining for laminin and collagen (types I, II, III, IV, and V), as well as Congo red staining were performed in IPMN and IOPN cases containing HS. The prevalence of HS among the IPMN and IOPN specimens was 1.2% (2/168 cases) and 45.5% (5/11 cases), respectively. The prevalence rates of HS in each IPMN subtype were as follows: 2.2% (2/91 cases) in IPMN-G, and 0% in IPMN-PB and IPMN-I. All seven HS cases were positive for collagen I, III, IV, and V but were negative for Congo red staining. Most cases showed negative, focal, or weak expression of laminin and type II collagen. These findings indicate that HS is associated with IOPN and is primarily composed of collagen fibers.
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Affiliation(s)
- Kenichi Hirabayashi
- Department of Pathology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
| | - Aya Kawanishi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Masashi Morimachi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Misuzu Yamada
- Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Yumi Takanashi
- Department of Pathology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Sadaaki Hori
- Division of Diagnostic Pathology, Tokai University Hospital, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Akihiko Serizawa
- Division of Diagnostic Pathology, Tokai University Hospital, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Tsubasa Saika
- Division of Diagnostic Pathology, Tokai University Hospital, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Toshio Nakagohri
- Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | - Naoya Nakamura
- Department of Pathology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
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Kawashima Y, Ogawa M, Yamaji Y, Kodama T, Yokota M, Kawanishi A, Hirabayashi K, Mine T. A Case of Endoscopic Mucosal Resection of Carcinoma in Adenoma at the Minor Duodenal Papilla. Case Rep Oncol 2019; 12:354-363. [PMID: 31182951 PMCID: PMC6547284 DOI: 10.1159/000499968] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 03/26/2019] [Indexed: 12/28/2022] Open
Abstract
Here, we describe a case of minor papillary adenocarcinoma in adenoma that was treated with endoscopic mucosal resection (EMR). In a 67-year-old woman, sigmoid colon cancer was incidentally detected on preoperative upper gastrointestinal endoscopy. Endoscopy revealed a slightly elevated lesion at the minor duodenal papilla. The findings of a histopathologic examination were suggestive of adenocarcinoma. Computed tomography and magnetic resonance images identified a minute tumor, whereas endoscopic ultrasonography revealed that the tumor did not spread to the pancreas. We performed EMR of this lesion. There were no complications, and relapse has not occurred in 3 years. Cases of minor papillary adenocarcinoma treated with EMR are quite rare.
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Affiliation(s)
- Yohei Kawashima
- Department of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
| | - Masami Ogawa
- Department of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
| | - Yoko Yamaji
- Department of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
| | - Toshiki Kodama
- Department of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
| | - Masashi Yokota
- Department of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
| | - Aya Kawanishi
- Department of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
| | - Kenichi Hirabayashi
- Department of Pathology, Tokai University School of Medicine, Isehara, Japan
| | - Tetsuya Mine
- Department of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
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12
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Morimachi M, Ogawa M, Yokota M, Kawanishi A, Kawashima Y, Mine T. Successful Endoscopic Removal of a Biliary Stent with Stent-Stone Complex after Long-Term Migration. Case Rep Gastroenterol 2019; 13:113-117. [PMID: 31011310 PMCID: PMC6465713 DOI: 10.1159/000498914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 02/14/2019] [Indexed: 11/19/2022] Open
Abstract
A 49-year-old man was referred to our hospital for an abnormality of the hepatobiliary enzyme. The patient was diagnosed with primary sclerosing cholangitis 9 years ago, and he had a biliary stent with a string placed as an inside stent. We attempted to remove the stent 6 months later, but the string was cut off, so the stent could not be removed. Removal was attempted again, but the patient cancelled the outpatient appointments. During the examination performed at the present visit, we discovered that the biliary stent had migrated into the bile duct, and a stone had formed around the stent. We attempted to remove the stent-stone complex by endoscopic retrograde cholangiopancreatography, but it was difficult; thus, we decided to implant a new biliary stent and remove the other stent later. When we performed endoscopic retrograde cholangiopancreatography again 2 days later, the bile duct axis was linearized thanks to the additional stent, enabling us to grab the migrated stent with stent-stone complex using grasping forceps and to successfully pull it out. By implanting an additional plastic stent temporarily, we were able to straighten the biliary axis and endoscopically remove the biliary stent that migrated and caused the development of stent-stone complex in a 2-staged approach.
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Affiliation(s)
- Masashi Morimachi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Kanagawa, Japan
| | - Masami Ogawa
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Kanagawa, Japan
| | - Masashi Yokota
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Kanagawa, Japan
| | - Aya Kawanishi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Kanagawa, Japan
| | - Yohei Kawashima
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Kanagawa, Japan
| | - Tetsuya Mine
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Kanagawa, Japan
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13
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Kawashima Y, Kawaguchi Y, Kawanishi A, Ogawa M, Hirabayashi K, Nakagohri T, Mine T. Comparison between Endoscopic Treatment and Surgical Drainage of the Pancreatic Duct in Chronic Pancreatitis. Tokai J Exp Clin Med 2018; 43:117-121. [PMID: 30191547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 06/11/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Treatment of recurrent chronic obstructive pancreatitis is pancreatic duct decompression with endoscopic drainage (endoscopic pancreatic stenting [EPS] with extracorporeal shockwave lithotripsy [ESWL]) or surgical drainage. Despite the recent popularization of endoscopic drainage, treatment or stent removal is difficult in many patients. We compared the efficacy, safety, and medical cost of endoscopic and surgical treatments. PATIENTS AND METHODS We retrospectively compared the treatment course and medical cost of hospitalization between 41 patients who had undergone pancreatic stenting between 2006 and 2010 (EPS group) and 10 patients who had undergone surgery for poor control of pancreatitis between 2001 and 2005 (surgical drainage group). RESULTS No intergroup differences were observed in causes, symptoms, disease duration, smoking history, or endocrine and exocrine functions. The technical success rate was 100% in both groups, and pain had improved in all of the patients in both groups. The incidences of complications did not differ significantly, and the mortality rate was 0% in both groups. The rehospitalization rate was significantly higher in the EPS group (78%) than that in the surgical drainage group (20%; P<0.01). This was considered attributable to rehospitalization for stent replacement. The effects to improve endocrine and exocrine functions were not different between the two groups before and after treatment, and the current condition was maintained in 80% or more of the patients. For the entire EPS group, the mean hospitalization period was 18 days and the mean medical cost of hospitalization was 2,133,330 yen. For the entire surgical drainage group, the mean hospitalization period was 23 days and the mean medical cost of hospitalization was 2,246,548 yen, thus indicating no significant differences between the two groups. CONCLUSIONS Although both endoscopic and surgical treatments achieved high symptom control and safety rates, re-hospitalization is required for stent replacement, which leads to poor cost-effectiveness, particularly in patients in whom stent removal is difficult. Endoscopic treatment for severe pancreatic duct stenosis will need to be advanced and evaluated in the future.
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Affiliation(s)
- Yohei Kawashima
- Department of Gastroenterology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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14
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Yamada M, Hirabayashi K, Kawanishi A, Hadano A, Takanashi Y, Izumi H, Kawaguchi Y, Mine T, Nakamura N, Nakagohri T. Nectin-1 expression in cancer-associated fibroblasts is a predictor of poor prognosis for pancreatic ductal adenocarcinoma. Surg Today 2017; 48:510-516. [PMID: 29256146 DOI: 10.1007/s00595-017-1618-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 11/27/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE Nectin-1 is a cell adhesion molecule that regulates the formation of adherens junctions and tight junctions. We measured the expression of nectin-1 in cancer-associated fibroblasts (CAFs) in patients with pancreatic ductal adenocarcinoma (PDAC). METHODS Nectin-1 expression was measured via immunohistochemistry using tissue microarray blocks constructed from resected PDAC tissue from 258 patients. We screened for associations between nectin-1 expression and clinicopathological parameters. According to the percentage of CAFs stained, expression was classified as negative at ≤ 30% and positive at > 30%. RESULTS Nectin-1 expression was confirmed in CAFs from 64 patients (24.8%), and was associated with lymph node metastasis (p = 0.016), advanced Union for International Cancer Control stage (p = 0.016), perineural invasion (p = 0.022), pancreatic head tumors (p = 0.023), and shorter overall survival (p = 0.003). Multivariate analysis revealed that nectin-1 expression in CAFs was an independent prognostic factor (p = 0.038). CONCLUSIONS Diffuse nectin-1 expression in the CAFs of PDAC patients is associated with invasion, metastasis, and shorter survival.
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Affiliation(s)
- Misuzu Yamada
- Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan
| | - Kenichi Hirabayashi
- Department of Pathology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
| | - Aya Kawanishi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan
| | - Atsuko Hadano
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan
| | - Yumi Takanashi
- Department of Pathology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Hideki Izumi
- Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan
| | - Yoshiaki Kawaguchi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan
| | - Tetsuya Mine
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan
| | - Naoya Nakamura
- Department of Pathology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Toshio Nakagohri
- Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan
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15
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Tsuda S, Matsushima M, Suzuki T, Kawanishi A, Carreras J, Nakamura J, Tsukune Y, Uchida T, Koike J, Igarashi M, Mine T, Imai Y. A Case of Pedunculated Esophageal Leiomyoma Successfully Treated by Endoscopic Mucosal Resection. Tokai J Exp Clin Med 2017; 42:121-125. [PMID: 28871579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 06/19/2017] [Indexed: 06/07/2023]
Abstract
Leiomyoma is one of the most commonly observed esophageal submucosal tumors, often appearing as a smooth-surfaced and semicircular protruded lesion. It sometimes grows toward the esophageal lumen and may be pedunculated in rare cases. We encountered a case of a pedunculated esophageal submucosal tumor diagnosed before treatment as a leiomyoma originating in the muscularis mucosae of a 68-year-old man. As the tumor arose in the muscularis mucosae, it could be safely resected via an endoscopic procedure. Only one case of pedunculated leiomyoma has been reported to date, and we herein report the second case, which was successfully treated by a minimally invasive endoscopic technique.
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Affiliation(s)
- Shingo Tsuda
- Departments of Internal Medicine (Gastroenterology), Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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16
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Kawanishi A, Hirabayashi K, Yamada M, Takanashi Y, Hadano A, Kawaguchi Y, Nakagohri T, Nakamura N, Mine T. Clinicopathological significance of Necl-4 expression in pancreatic ductal adenocarcinoma. J Clin Pathol 2017; 70:619-624. [PMID: 27980052 DOI: 10.1136/jclinpath-2016-204028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 11/10/2016] [Accepted: 11/27/2016] [Indexed: 12/31/2022]
Abstract
AIMS The loss, or decreased expression, of nectin-like molecule 4 (Necl-4; an immunoglobulin-like cell adhesion molecule) is reported to be associated with the development and progression of certain types of cancer. We investigated the clinicopathological significance of Necl-4 expression in patients with pancreatic ductal adenocarcinoma (PDAC). METHODS Immunohistochemical analyses of Necl-4 (n=258) and E-cadherin (n=256) expression were performed using tissue microarray blocks of PDAC samples. Necl-4 expression of 38 pancreatic intraepithelial neoplasia (PanIN) lesions included in tissue microarray cores was also evaluated. Necl-4 and E-cadherin expression was considered positive if >30% of cells were stained, and negative if ≤30% of cells were stained. RESULTS Necl-4 expression was positive in 45.7% (n=118) and negative in 54.3% (n=140) of PDAC cases. Necl-4 staining was positive in 96.7% (n=29) and negative in 3.3% (n=1) of low-grade PanIN cases, and positive in 62.5% (n=5) and negative in 37.5% (n=3) of high-grade PanIN cases. The number of cases with positive Necl-4 expression decreased in the order low-grade PanIN>high-grade PanIN>PDAC (p<0.001). Negative Necl-4 expression was significantly associated with a larger tumour size of >30 mm, perineural invasion, lymphatic involvement, lymph node metastasis (pN1), an advanced TNM (tumour, node, metastases) stage (stage IIB-IV), an advanced histological grade (G2/3), and shorter overall survival. E-cadherin staining was positive in 46.1% (n=118) and negative in 53.9% (n=138) of PDAC cases. Necl-4 expression correlated positively with E-cadherin expression (r=0.405, p<0.001). CONCLUSIONS The results suggest that Necl-4 is associated with carcinogenesis and aggressiveness of PDAC.
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Affiliation(s)
- Aya Kawanishi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Kanagawa, Japan
| | - Kenichi Hirabayashi
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
| | - Misuzu Yamada
- Department of Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Yumi Takanashi
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
| | - Atsuko Hadano
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Kanagawa, Japan
| | - Yoshiaki Kawaguchi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Kanagawa, Japan
| | - Toshio Nakagohri
- Department of Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Naoya Nakamura
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
| | - Tetsuya Mine
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Kanagawa, Japan
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17
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Hirabayashi K, Yamada M, Kono H, Hadano A, Kawanishi A, Takanashi Y, Kawaguchi Y, Nakagohri T, Mine T, Nakamura N. Epidermoid cysts are a characteristic feature of intrapancreatic but not of extrapancreatic accessory spleens. Virchows Arch 2017; 471:91-98. [DOI: 10.1007/s00428-017-2139-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 02/17/2017] [Accepted: 04/27/2017] [Indexed: 11/28/2022]
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Kawanishi A, Hirabayashi K, Kono H, Takanashi Y, Hadano A, Kawashima Y, Ogawa M, Kawaguchi Y, Yamada M, Nakagohri T, Nakamura N, Mine T. A Serous Cystic Neoplasm of the Pancreas Coexisting with High-Grade Pancreatic Intraepithelial Neoplasia Mimicking an Intraepithelial Papillary Mucinous Neoplasm: A Case Report. Case Rep Oncol 2017; 10:143-150. [PMID: 28413390 PMCID: PMC5346927 DOI: 10.1159/000456611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 01/17/2017] [Indexed: 01/29/2023] Open
Abstract
Serous cystic neoplasms of the pancreas are rare exocrine pancreatic neoplasms, most of which are benign and do not communicate with the pancreatic duct. Pancreatic intraepithelial neoplasm (PanIN) is considered a precursor of ductal adenocarcinoma that is microscopically recognized in pancreatic ducts. A 67-year-old Japanese woman presented with a 10-mm multilocular cystic lesion at the pancreatic body. Magnetic resonance pancreatography showed stenosis of the main pancreatic duct at the pancreatic body and dilatation of the distal side of the main pancreatic duct. Furthermore, communication between the cystic lesion and the main pancreatic duct was suspected based on magnetic resonance pancreatography findings. Distal pancreatectomy was performed under the preoperative diagnosis of intraductal papillary mucinous neoplasm. Histologically, the cystic lesion was lined with a non-atypical cuboidal or flat epithelium with clear cytoplasm and was thus diagnosed as a serous cystic neoplasm. High-grade PanIN lesions with stromal fibrosis were observed at the main and branch pancreatic ducts. Histological examination revealed no communication between the serous cystic neoplasm and the pancreatic ducts. Immunohistochemically, the epithelium of the serous cystic neoplasm showed positive anti-von Hippel-Lindau antibody staining, whereas the epithelium of the PanIN showed negative staining. A serous cystic neoplasm coexisting with another pancreatic neoplasm is rare. When dilatation of the main or branch pancreatic ducts coexists with a serous cystic neoplasm, as in this case, the lesion clinically mimics an intraductal papillary mucinous neoplasm.
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Affiliation(s)
- Aya Kawanishi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara, Japan
| | - Kenichi Hirabayashi
- Department of Pathology, Tokai University School of Medicine, Isehara, Japan
| | - Hirotaka Kono
- Department of Pathology, Tokai University School of Medicine, Isehara, Japan
| | - Yumi Takanashi
- Department of Pathology, Tokai University School of Medicine, Isehara, Japan
| | - Atsuko Hadano
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara, Japan
| | - Yohei Kawashima
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara, Japan
| | - Masami Ogawa
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara, Japan
| | - Yoshiaki Kawaguchi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara, Japan
| | - Misuzu Yamada
- Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Toshio Nakagohri
- Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Naoya Nakamura
- Department of Pathology, Tokai University School of Medicine, Isehara, Japan
| | - Tetsuya Mine
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Isehara, Japan
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19
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Mizuno M, Kawaguchi Y, Kawanishi A, Kawashima Y, Maruno A, Ogawa M, Tomioku M, Furukawa D, Nabeshima K, Nakamura K, Hirabayashi K, Mine T. An Intra-Abdominal Desmoid Tumor, Embedded in the Pancreas, Preoperatively Diagnosed as an Extragastric Growing Gastrointestinal Stromal Tumor. Case Rep Oncol 2017; 10:301-307. [PMID: 28512414 PMCID: PMC5422749 DOI: 10.1159/000468983] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 03/07/2017] [Indexed: 12/01/2022] Open
Abstract
A 45-year-old woman was found to have a pancreatic tumor by abdominal ultrasound performed for a medical check-up. Abdominal contrast-enhanced computed tomography showed a hypovascular tumor measuring 30 mm in diameter in the pancreatic tail. Endoscopic ultrasound-guided fine needle aspiration was performed. An extragastric growing gastrointestinal stromal tumor was thereby diagnosed preoperatively, and surgical resection was planned. Laparoscopic surgery was attempted but conversion to open surgery was necessitated by extensive adhesions, and distal pancreatectomy, splenectomy, and partial gastrectomy were performed. The histological diagnosis was an intra-abdominal desmoid tumor. A desmoid tumor is a fibrous soft tissue tumor arising in the fascia and musculoaponeurotic tissues. It usually occurs in the extremities and abdominal wall, and only rarely in the abdominal cavity. We experienced a case with an intra-abdominal desmoid tumor that was histologically diagnosed after laparotomy, which had been preoperatively diagnosed as an extragastric growing gastrointestinal stromal tumor. Although rare, desmoid tumors should be considered in the differential diagnosis of intra-abdominal tumors. Herein, we report this case with a literature review.
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Affiliation(s)
- Mari Mizuno
- aDepartment of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
| | - Yoshiaki Kawaguchi
- aDepartment of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
| | - Aya Kawanishi
- aDepartment of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
| | - Yohei Kawashima
- aDepartment of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
| | - Atsuko Maruno
- aDepartment of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
| | - Masami Ogawa
- aDepartment of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
| | - Mifuji Tomioku
- bDepartment of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Daisuke Furukawa
- bDepartment of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Kazuhito Nabeshima
- bDepartment of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Kenji Nakamura
- bDepartment of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Kenichi Hirabayashi
- cDepartment of Pathology, Tokai University School of Medicine, Isehara, Japan
| | - Tetsuya Mine
- aDepartment of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
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20
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Hadano A, Hirabayashi K, Yamamuro H, Takanashi Y, Yamada M, Kawanishi A, Kawaguchi Y, Furukawa D, Nakagohri T, Imai Y, Nakamura N, Mine T. Bone morphogenetic protein-2 expression in an intraductal papillary mucinous neoplasm with marked ossification: A case report. Pathol Int 2016; 66:343-347. [PMID: 27162090 DOI: 10.1111/pin.12416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/02/2016] [Accepted: 04/13/2016] [Indexed: 11/28/2022]
Abstract
Intratumoral ossification has been reported in a number of epithelial tumors, but its presence in intraductal papillary mucinous neoplasms (IPMNs) is very rare. Herein, we present a rare case of IPMN with marked ossification. A 56-year-old Japanese man was under follow-up for a previously diagnosed IPMN. Seven years later, he was found to have dilatation of the main pancreatic duct and an enlarged solid mass, for which pancreaticoduodenectomy was performed. Macroscopically, multiple and cystically dilated pancreatic branch ducts, as well as a dilated main pancreatic duct, were identified. There was a solid, polypoid hard mass measuring 15 × 12 mm in the cystically dilated branch of the duct in the pancreatic head. Histological examination revealed papillary proliferation of atypical cuboidal or columnar epithelial cells in the dilated main and branch pancreatic ducts. The solid mass included an invasive adenocarcinoma component with a tubular or trabecular structure that showed pronounced ossification. We diagnosed the patient with invasive IPMN accompanied by marked ossification. Immunohistochemically, tumor cells in both the non-invasive and invasive lesions expressed bone morphogenetic protein-2 (BMP-2). While the mechanism of intratumoral ossification is unclear, it may have involved BMP-2 in the present case.
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Affiliation(s)
- Atsuko Hadano
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine
| | | | | | - Yumi Takanashi
- Department of Pathology, Tokai University School of Medicine
| | - Misuzu Yamada
- Department of Pathology, Tokai University School of Medicine.,Department of Surgery, Tokai University School of Medicine
| | - Aya Kawanishi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine
| | - Yoshiaki Kawaguchi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine
| | | | | | - Yutaka Imai
- Department of Radiology, Tokai University School of Medicine
| | - Naoya Nakamura
- Department of Pathology, Tokai University School of Medicine
| | - Tetsuya Mine
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine
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21
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Hadano A, Hirabayashi K, Yamada M, Kawanishi A, Takanashi Y, Kawaguchi Y, Nakagohri T, Nakamura N, Mine T. Molecular alterations in sporadic pancreatic neuroendocrine microadenomas. Pancreatology 2016; 16:411-5. [PMID: 26905832 DOI: 10.1016/j.pan.2016.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 01/26/2016] [Accepted: 01/28/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pancreatic neuroendocrine microadenomas (pNEMAs) are neuroendocrine tumors measuring <5 mm in diameter. They are considered the precursor of pancreatic neuroendocrine tumors (pNETs). The aim of this study was to investigate the immunohistochemical differences between pNEMA, pNET, and hyperplasia of pancreatic islet cells (HPIL) in patients with non-familial syndromes. METHODS We evaluated 21 pNEMAs, 19 HPILs, and 21 non-functional pNETs (10 G1 and 11 G2 cases) in patients with non-familial syndromes. Immunohistochemistry for tumor-associated markers death domain-associated protein (DAXX), alpha thalassemia/mental retardation X-linked (ATRX), cytokeratin 19 (CK19), bcl-2, and CD99 was performed. RESULTS DAXX was expressed in 95%, 71%, and 71% of HPIL, pNEMA, and pNET samples, respectively; the differences were not significant. ATRX expression in pNEMA and pNET was significantly lower than that in HPIL, whereas there was no significant difference between pNEMA and pNET (HPIL: 95%, pNEMA: 43%, and pNET: 52%). All HPIL and pNEMA cases were negative for bcl-2 and positive for CD99, whereas 29% of pNETs were positive for bcl-2 and 24% were negative for CD99. CK19 expression in HPIL was significantly lower than in pNEMA and pNET, although no significant difference was observed between pNEMA and pNET (HPIL: 5%, pNEMA: 57%, and pNET: 43%). Among G1 and G2 pNETs, CD99 was expressed in 50% of G1 pNETs but not in any G2 pNET cases. CONCLUSION Non-familial HPIL, pNEMA, and pNET patients exhibit distinct ATRX, CD99, CK19, and bcl-2 molecular profiles.
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Affiliation(s)
- Atsuko Hadano
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Japan
| | | | - Misuzu Yamada
- Department of Surgery, Tokai University School of Medicine, Japan
| | - Aya Kawanishi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Japan
| | - Yumi Takanashi
- Department of Pathology, Tokai University School of Medicine, Japan
| | - Yoshiaki Kawaguchi
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Japan
| | - Toshio Nakagohri
- Department of Surgery, Tokai University School of Medicine, Japan
| | - Naoya Nakamura
- Department of Pathology, Tokai University School of Medicine, Japan
| | - Tetsuya Mine
- Department of Gastroenterology and Hepatology, Tokai University School of Medicine, Japan
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22
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Mitamura K, Nambu Y, Tanaka M, Kawanishi A, Kitahori J, Shimada K. HIGH-PERFORMANCE LIQUID CHROMATOGRAPHIC SEPARATION OF VITAMIN D3 3-FATTY ACID ESTERS AND THEIR LIQUID CHROMATOGRAPHY/MASS SPECTROMETRY. J LIQ CHROMATOGR R T 2007. [DOI: 10.1081/jlc-100101666] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- K. Mitamura
- a Faculty of Pharmaceutical Sciences , Kanazawa University , 13-1 Takara-machi, Kanazawa , 920-0934 , Japan
| | - Y. Nambu
- a Faculty of Pharmaceutical Sciences , Kanazawa University , 13-1 Takara-machi, Kanazawa , 920-0934 , Japan
| | - M. Tanaka
- a Faculty of Pharmaceutical Sciences , Kanazawa University , 13-1 Takara-machi, Kanazawa , 920-0934 , Japan
| | - A. Kawanishi
- a Faculty of Pharmaceutical Sciences , Kanazawa University , 13-1 Takara-machi, Kanazawa , 920-0934 , Japan
| | - J. Kitahori
- a Faculty of Pharmaceutical Sciences , Kanazawa University , 13-1 Takara-machi, Kanazawa , 920-0934 , Japan
| | - K. Shimada
- b Faculty of Pharmaceutical Sciences , Kanazawa University , 13-1 Takara-machi, Kanazawa , 920-0934 , Japan
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23
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Dohgomori H, Nagata S, Tanioka K, Kawanishi A, Kanai J, Kanemaru R. Crit Care 2006; 10:P363. [DOI: 10.1186/cc4710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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24
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Kawanishi A, Nakayama M, Kadota K. Heading injury precipitating subdural hematoma associated with arachnoid cysts--two case reports. Neurol Med Chir (Tokyo) 1999; 39:231-3. [PMID: 10344112 DOI: 10.2176/nmc.39.231] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 14-year-old boy and a 11-year-old boy presented with subdural hematomas as complications of preexisting arachnoid cysts in the middle cranial fossa, manifesting as symptoms of raised intracranial pressure. Both had a history of heading the ball in a soccer game about 7 weeks and 2 days before the symptom occurred. There was no other head trauma, so these cases could be described as "heading injury." Arachnoid cysts in the middle cranial fossa are often associated with subdural hematomas. We emphasize that mild trauma such as heading of the ball in a soccer game may cause subdural hematomas in patients with arachnoid cysts.
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Affiliation(s)
- A Kawanishi
- Department of Neurosurgery, Kagoshima University School of Medicine
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25
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Affiliation(s)
- M Mochizuki
- Department of Veterinary Medicine, Faculty of Agriculture, Kagoshima University, Japan
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26
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Abstract
During a virus survey carried out in the period 1989-90 with 148 fecal samples collected from cats in Japan, three reovirus strains were isolated in feline cell cultures. Two strains (Nos. 114 and 140) were from 48 diarrheal fecal samples and another strain (No. 32/41) was from 100 normal fecal samples. The strains grew in feline and simian cell cultures with producing typical intracytoplasmic inclusion bodies in which virus particles were densely packed. All strains, especially Nos. 32/41 and 140 strains, showed trypsin-dependent growth in vitro. Their ultrastructural and genomic properties were characteristic of genus reovirus in the Reoviridae. All strains agglutinated erythrocytes of human type O but not of bovine. Although they were identified as serotype 2 by hemagglutination-inhibition test with the hyperimmune sera against human reovirus prototype strains, No. 114 strain was typical and the other two strains were atypical serotype 2 reoviruses. Furthermore, from the reason that Nos. 32/41 and 140 strains possessed some common properties though derived from cats in distant locations, they were considered to be reoviruses having been maintained in the cat population. Seroepizootiologic survey revealed that the prevalence of serotype 3 infection was most widespread and serotype 2 was least among three serotypes of reovirus in a cat population.
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Affiliation(s)
- M Mochizuki
- Department of Veterinary Medicine, Faculty of Agriculture, Kagoshima University, Japan
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27
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Kawanishi A. [Metabolism of mesangial cells from isolated rat glomeruli using GC-MS]. Nihon Jinzo Gakkai Shi 1987; 29:1375-83. [PMID: 3450897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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28
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Maeda K, Niwa T, Asada H, Yamamoto N, Kawanishi A, Yokoyama M, Shibata M. [Analysis of organic acids in uremic serum during intravenous infusion of essential amino acids using gas chromatography-mass spectrometry]. Nihon Jinzo Gakkai Shi 1983; 25:1003-9. [PMID: 6668741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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29
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Abstract
Organic acids in rabbit renal tissue biopsy were analyzed by capillary column gas chromatography--mas s spectrometry. The change of these organic acids under ischemic conditions was determined over 60 min after clamping the renal artery and vein. The results showed that lactic acid, glycolic acid, 2-hydroxybutyric acid, 3-hydroxypropionic acid, 2-methyl-glyceric acid, glyceric acid and malic acid increased at 4 and 6 min after clamping, but then decreased at 15 min. Glycerol increased 2 min after clamping and then decreased. However, 3-deoxyaldonic acids of 3-deoxytetronic acid, 3-deoxy-2-C-hydroxymethyltetronic acid and 3-deoxypentonic acid decreased in the renal tissue biopsy from 2 min after clamping.
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Niwa T, Asada H, Yamamoto N, Maeda K, Naotsuka Y, Kobayashi S, Yokoyama M, Kawanishi A, Kawaguchi S, Shibata M. [Therapeutic effect of prostaglandin E1 infusion in chronic renal patients with decreased renal function]. Nihon Jinzo Gakkai Shi 1983; 25:205-14. [PMID: 6684704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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31
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Shibata M, Kawanishi A, Kishi T, Kobayashi K, Kuno T, Sasaki M, Yasuda B. Inhibitory effect of elastase on the glomerular capillary basement membrane thickening of the experimental congenital diabetic mice (N.S.Y. mice). Nagoya J Med Sci 1981; 43:111-5. [PMID: 6912384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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