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Iwasaki T, Shimoda-Komatsu Y, Ida Y, Shimoyamada H, Fukuda T, Ohyama M. A case of chromomycosis due to Cladosporium halotolerans: Successful identification of previously unreported pathogen with a molecular approach. J Dermatol 2024. [PMID: 38291997 DOI: 10.1111/1346-8138.17125] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/26/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Affiliation(s)
- Tatsuro Iwasaki
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo, Japan
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | | | - Yoko Ida
- Division of Clinical Laboratory, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Hiroaki Shimoyamada
- Department of Pathology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Tomoo Fukuda
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo, Japan
- Department of Dermatology, Saitama Medical Center, Saitama, Japan
| | - Manabu Ohyama
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo, Japan
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2
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Yamada A, Umemoto N, Shimoyamada H, Demitsu T, Kitamura O. Deck-chair sign as a diagnostic clue for insidious T-cell lymphoma: An autopsy case of mycosis fungoides. Leg Med (Tokyo) 2023; 65:102326. [PMID: 37778204 DOI: 10.1016/j.legalmed.2023.102326] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 09/11/2023] [Accepted: 09/24/2023] [Indexed: 10/03/2023]
Abstract
Skin reflects the presence of systemic diseases, leading to an unexpected diagnosis of insidious diseases. Deck-chair sign is a unique skin eruption characterized by widespread erythematous papules that become erythrodermic with spare skin folds. An association between the deck-chair sign and malignancies, especially hematological neoplasms, has been suggested. We report a forensic case of mycosis fungoides unexpectedly diagnosed in the presence of a deck-chair sign. Mycosis fungoides is representative of cutaneous T-cell lymphomas. Here, we successfully demonstrated the feasibility of analyzing mycosis fungoides in a forensic autopsy case using basic histopathology and serology. We emphasize that the underlying malignancy should be primarily considered in cadavers with a positive deck-chair sign and review current reports about this characteristic skin manifestation.
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Affiliation(s)
- Atsushi Yamada
- Department of Legal Medicine, Kyorin University, Faculty of Medicine, Tokyo, Japan; Department of Dermatology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
| | - Naoka Umemoto
- Department of Dermatology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Hiroaki Shimoyamada
- Department of Pathology, Kyorin University, Faculty of Medicine, Tokyo, Japan
| | - Toshio Demitsu
- Department of Dermatology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Osamu Kitamura
- Department of Legal Medicine, Kyorin University, Faculty of Medicine, Tokyo, Japan
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Satomi K, Saito K, Shimoyamada H, Onizuka H, Shibayama T, Hibiya T, Hayashi A, Nagahama K, Yamagishi Y, Sasaki N, Kobayashi K, Gomyo M, Nagane M, Shibahara J. The role of nonlinear dimension reduction of genome-wide DNA methylome in integrated diagnosis: A case study of glioblastoma, IDH-wildtype. Pathol Int 2023; 73:523-526. [PMID: 37530489 DOI: 10.1111/pin.13359] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/15/2023] [Indexed: 08/03/2023]
Affiliation(s)
- Kaishi Satomi
- Department of Pathology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Kuniaki Saito
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Hiroaki Shimoyamada
- Department of Pathology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Hiromi Onizuka
- Department of Pathology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Takahiro Shibayama
- Department of Pathology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Takashi Hibiya
- Department of Pathology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Akimasa Hayashi
- Department of Pathology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Kiyotaka Nagahama
- Department of Pathology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Yuki Yamagishi
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Nobuyoshi Sasaki
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Keiichi Kobayashi
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Miho Gomyo
- Department of Radiology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Motoo Nagane
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Junji Shibahara
- Department of Pathology, Kyorin University Faculty of Medicine, Tokyo, Japan
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Shimoda-Komatsu Y, Ida Y, Noda A, Oda M, Shimoda M, Shimoyamada H, Narita Y, Ohyama M. Histological assessment of granuloma formation for the management of cutaneous Mycobacterium chelonae infection. J Dermatol 2021; 49:e32-e33. [PMID: 34693557 DOI: 10.1111/1346-8138.16208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/21/2021] [Accepted: 10/11/2021] [Indexed: 01/17/2023]
Affiliation(s)
| | - Yoko Ida
- Division of Clinical Laboratory, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Akinari Noda
- Department of Respiratory Medicine, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Miku Oda
- Department of Respiratory Medicine, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Masafumi Shimoda
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-tuberculosis Association, Tokyo, Japan
| | - Hiroaki Shimoyamada
- Department of Pathology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Yoko Narita
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Manabu Ohyama
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo, Japan
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Mikura S, Saraya T, Yoshida Y, Oda M, Ishida M, Honda K, Nakamoto K, Tamura M, Takata S, Shimoyamada H, Fujiwara M, Ishii H. Successful Treatment of Mepolizumab- and Prednisolone-resistant Allergic Bronchopulmonary Aspergillosis with Dupilumab. Intern Med 2021; 60:2839-2842. [PMID: 33642487 PMCID: PMC8479224 DOI: 10.2169/internalmedicine.6679-20] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
A 45-year-old man with allergic bronchopulmonary aspergillosis (ABPA) was treated with oral prednisolone (PSL) (30 mg/day), inhaled corticosteroids, and long-acting beta2-agonists. After confirmation of a PSL-dependent status (8 mg/day), subcutaneous injection with anti-interleukin (IL)-5 antibody (mepolizumab, 100 mg/month) was performed, and the PSL dose was tapered to 5 mg/day. However, ABPA recurred and proved refractory to oral itraconazole (200 mg/day). Alternative subcutaneous injection therapy with dupilumab (induction dose of 600 mg followed by a maintenance dose of 300 mg/2 weeks) enabled the successful withdrawal of oral PSL without clinical deterioration. This case demonstrates the potential utility of dupilumab for steroid-dependent ABPA via the synergistic suppression of IL-4 and IL-13 compared to monotherapy with anti-IL-5 antibody.
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Affiliation(s)
- Sunao Mikura
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Takeshi Saraya
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Yuki Yoshida
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Miku Oda
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Manabu Ishida
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Kojiro Honda
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Keitaro Nakamoto
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Masaki Tamura
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | - Saori Takata
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
| | | | | | - Haruyuki Ishii
- Department of Respiratory Medicine, Kyorin University School of Medicine, Japan
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Kii T, Taguchi S, Nagahama K, Shimoyamada H, Honda K, Tomida Y, Matsumoto R, Kitamura J, Ninomiya N, Masuda K, Nakamura Y, Yamaguchi T, Kinjo M, Tambo M, Okegawa T, Higashihara E, Shibahara J, Fukuhara H. Pigmented median raphe cyst of the penis that developed after middle age without infection or trauma history. IJU Case Rep 2021; 4:172-175. [PMID: 33977252 PMCID: PMC8088894 DOI: 10.1002/iju5.12271] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/14/2021] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Median raphe cysts are rare benign lesions of the male genitalia that can develop anywhere along the midline from meatus to anus. They are believed to be caused by a defect in closure of median raphe during embryonic development. These cysts commonly appear in childhood or adolescence, although some are diagnosed after middle age, typically triggered by infection or trauma. Pigmented median raphe cysts, or those containing melanin pigment and/or melanocytes, are extremely rare. CASE PRESENTATION A 78-year-old man visited our hospital with a complaint of a penile mass that he first noticed in his 50s which slowly grew, eventually causing voiding difficulty. He had no history of infection or trauma. The lesion was excised, and the pathological diagnosis was pigmented median raphe cyst. CONCLUSION We successfully treated a rare case of pigmented median raphe cyst of the penis that developed after middle age without infection or trauma history.
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Affiliation(s)
- Toshihiko Kii
- Department ofUrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Satoru Taguchi
- Department ofUrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Kiyotaka Nagahama
- Department ofPathologyKyorin University School of MedicineMitakaTokyoJapan
| | | | - Kazuki Honda
- Department ofUrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Yoshihiro Tomida
- Department ofUrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Ryuki Matsumoto
- Department ofUrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Junji Kitamura
- Department ofUrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Naoki Ninomiya
- Department ofUrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Kazuki Masuda
- Department ofUrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Yu Nakamura
- Department ofUrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Tsuyoshi Yamaguchi
- Department ofUrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Manami Kinjo
- Department ofUrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Mitsuhiro Tambo
- Department ofUrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Takatsugu Okegawa
- Department ofUrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Eiji Higashihara
- Department ofADPKD ResearchKyorin University School of MedicineMitakaTokyoJapan
| | - Junji Shibahara
- Department ofPathologyKyorin University School of MedicineMitakaTokyoJapan
| | - Hiroshi Fukuhara
- Department ofUrologyKyorin University School of MedicineMitakaTokyoJapan
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Hong S, Maruyama K, Hatanaka R, Noguchi A, Shimoyamada H, Nagane M, Shiokawa Y. Frontotemporal dermoid cyst with incomplete dermal sinus tract in an adult: A case report. Surg Neurol Int 2020; 11:429. [PMID: 33365191 PMCID: PMC7749934 DOI: 10.25259/sni_504_2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022] Open
Abstract
Background Non-midline supratentorial dermoid cyst with dermal sinus tract has been rarely reported especially in adults. We recently experienced a noteworthy patient with frontotemporal dermoid cyst with incomplete dermal sinus tract. Case Description A 43-year-old female presented with recurrent subcutaneous mass in the left superolateral orbital region. She had a history of active bronchial asthma, which precluded her from contrast-enhanced imaging studies. Plain imaging studies showed a subcutaneous mass which was continuous with an intrasylvian fissure mass by a tract in the sphenoid ridge and the lesser wing of the sphenoid bone. Frontotemporal craniotomy was performed to reset the mass and the tract. Intraoperative finding showed no intradural tumor components. Extradural component was carefully removed focusing attention on the frontal branch of the facial nerve. The pathology was consistent with dermoid cyst and dermal sinus tract. Postoperatively, she had mild facial palsy of the corrugator supercilii (House and Brackmann Grade II). She was discharged home with modified Rankin scale 1. Conclusion Dermoid cyst needs to be included in the differential diagnosis of adult-onset subcutaneous mass in the frontotemporal regions. After thorough imaging studies for the presence and extent of the sinus tract, the symptomatic lesion should be excised completely once and for all.
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Affiliation(s)
- Sukwoo Hong
- Department of Neurosurgery, Kyorin University Hospital, Mitaka, Tokyo, Japan
| | - Keisuke Maruyama
- Department of Neurosurgery, Kyorin University Hospital, Mitaka, Tokyo, Japan
| | - Ryo Hatanaka
- Department of Neurosurgery, Kyorin University Hospital, Mitaka, Tokyo, Japan
| | - Akio Noguchi
- Department of Neurosurgery, Kyorin University Hospital, Mitaka, Tokyo, Japan
| | | | - Motoo Nagane
- Department of Neurosurgery, Kyorin University Hospital, Mitaka, Tokyo, Japan
| | - Yoshiaki Shiokawa
- Department of Neurosurgery, Kyorin University Hospital, Mitaka, Tokyo, Japan
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Ohno A, Miyoshi J, Tanabe H, Kusuhara M, Toki M, Chiba T, Shimoyamada H, Shibahara J, Hisamatsu T. Gastropathy associated with lanthanum phosphate deposition that was endoscopically tracked for 3 years. A case report. BMC Gastroenterol 2020; 20:292. [PMID: 32867713 PMCID: PMC7457500 DOI: 10.1186/s12876-020-01424-7] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 08/11/2020] [Indexed: 01/01/2023] Open
Abstract
Background With the recent increased use of lanthanum carbonate, several cases of lanthanum phosphate deposition to gastric mucosa in dialysis patients have been reported. However, the endoscopic appearance of the early-stage lesion and the over-time alterations of endoscopic findings due to the progression of lanthanum phosphate deposition remain unclear. Case presentation An 80-year-old man receiving dialysis and taking lanthanum carbonate as a phosphate binder over a 4-year period underwent upper gastrointestinal endoscopy four times beginning 1 year after initiation of treatment. The first endoscopic examination (after 1 year of exposure to lanthanum carbonate) revealed rough mucosa with a few areas of white granular mucosa. Over the 3 years of endoscopic follow-up, the white granular mucosa spread and multiple erosions appeared. Histopathological findings of biopsy specimens from an erosion showed extensive infiltration by histiocytes containing deposits. Scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDX) revealed that the presence of the deposits containing phosphorus and lanthanum in the gastric mucosa. On the basis of these results, the patient was diagnosed with gastropathy associated with lanthanum phosphate deposition. Conclusions Over a 3-year period, endoscopic findings associated with lanthanum deposition gradually changed and expanded from the early stage.
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Affiliation(s)
- Akiko Ohno
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Jun Miyoshi
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Hidesato Tanabe
- Department of Gastroenterology, Kosei Hospital, 2-25-1 Wada, Suginami-ku, Tokyo, Japan
| | - Mitsunori Kusuhara
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Masao Toki
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Tomohiro Chiba
- Department of Pathology, The Cancer Institute Of JFCR, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan
| | - Hiroaki Shimoyamada
- Department of Pathology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Junji Shibahara
- Department of Pathology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Tadakazu Hisamatsu
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan.
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Shibata Y, Fukuoka K, Yokota R, Lee H, Sayo H, Ikegaya N, Mori K, Yamamoto J, Isomura A, Nagahama K, Shimoyamada H, Kawakami T, Komagata Y, Kaname S. Nephrotic syndrome due to minimal-change disease superimposed on anti-glomerular basement membrane antibody positive glomerulonephritis; a case report. BMC Nephrol 2020; 21:283. [PMID: 32680573 PMCID: PMC7368767 DOI: 10.1186/s12882-020-01947-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/19/2020] [Accepted: 07/12/2020] [Indexed: 11/29/2022] Open
Abstract
Background The prognosis for renal function in anti-GBM glomerulonephritis (anti-GBM GN) is extremely poor, and when renal impairment progresses severely, it is difficult to expect improvement. In addition, it is also known that once the disease activity can be controlled by aggressive treatment, its recurrence is rare. We experienced an anti-GBM GN that improved from severe renal dysfunction and relapsed. A possible cause was the superimpose of nephrotic syndrome due to minimal change disease (MCD). Case presentation A 30-year-old man was admitted to our hospital because of general malaise, fever, oliguria and renal dysfunction. The patient’s laboratory data showed serum creatinine as high as 6.6 mg/dl, and severe inflammation (C-reactive protein 20.6 mg/dl). Anti-glomerular basement membrane antibody (anti-GBM Ab) was detected in his serum, which led to the diagnosis of anti-GBM GN. Treatment was initiated with high-dose glucocorticoid (GC) and plasma exchange therapy (PE), and the patient’s renal function and oliguria improved rapidly and he was discharged 40 days after admission. Renal biopsy findings showed cellular crescents associated with linear IgG depositions along the glomerular tufts compatible with anti-GBM GN, but only about one-third of the glomeruli was involved, suggesting that it still remains an early stage of the disease. However, 2 months after discharge, he had a relapse and was readmitted due to severe proteinuria with positive anti-GBM Ab. On the second admission, after high-dose GC and PE combined with intravenous cyclophosphamide, and remission was achieved. Despite the relatively minor renal biopsy findings, the patient showed rapid renal dysfunction and relatively rapid improvement with our treatment. Electron microscopy of the renal biopsy tissue showed significant foot process effacement on podocytes in the apparently normal glomeruli, without electron dense deposits. Conclusion On the basis of clinical course and renal pathology, it is suggested that the present case was a rare complication of an early stage of anti-GBM GN and minimal change nephrotic syndrome. Although the simultaneous development of anti-GBM GN and MCD with anti-GBM antibody is unclear, it might have been precipitated by influenza infection or some unknown factor.
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Affiliation(s)
- Yuko Shibata
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, 6-20-2, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Kazuhito Fukuoka
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, 6-20-2, Mitaka-shi, Tokyo, 181-8611, Japan.
| | - Riyo Yokota
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, 6-20-2, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Heryon Lee
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, 6-20-2, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Hikaru Sayo
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, 6-20-2, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Noriko Ikegaya
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, 6-20-2, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Kiyotaka Mori
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, 6-20-2, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Jin Yamamoto
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, 6-20-2, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Aya Isomura
- Department of Pathology, Kyorin University Hospital, Tokyo, Japan
| | | | | | - Takahisa Kawakami
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, 6-20-2, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Yoshinori Komagata
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, 6-20-2, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Shinya Kaname
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, 6-20-2, Mitaka-shi, Tokyo, 181-8611, Japan
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Kubota H, Endo H, Ishii H, Tsuchiya H, Inaba Y, Terakawa K, Takahashi Y, Noma M, Takemoto K, Taniai S, Sakata K, Soejima K, Shimoyamada H, Kamma H, Kawakami H, Kaneko Y, Hirono S, Izumi D, Ozaki K, Minamino T, Yoshino H, Sudo K. Adult ALCAPA: from histological picture to clinical features. J Cardiothorac Surg 2020; 15:14. [PMID: 31931842 PMCID: PMC6958604 DOI: 10.1186/s13019-020-1048-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 08/31/2019] [Accepted: 01/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary anomaly that results in high mortality if left untreated. Our aim was to extend our knowledge of the histological, angiographic, and clinical characteristics of ALCAPA in order to deepen our understanding of this rare entity. CASE PRESENTATION We were involved in the assessment, treatment, and pathological evaluation of two adult ALCAPA patients who were rescued from ventricular fibrillation and then surgically treated to establish a dual coronary artery system. Histological studies indicated various chronic ischemic changes in the myocardium, patchy fibrosis, and severely thickened arteriolar walls in both ventricles. The first patient is alive and well 11.5 years after surgical correction without any implantable cardioverter defibrillator (ICD) activations. The second patient required re-do surgery 9 months after the initial operation but subsequently died. Histologically, chronic ischemic alteration of the myocardium and thickened arteriolar walls persisted even after surgical correction, and coronary angiography (CAG) showed an extremely slow flow phenomenon even after surgical correction in both patients. The average postoperative opacification rate in the first case was 7.36 + 1.12 (n = 2) in the RCA, 3.81 + 0.51 (n = 3) in the left anterior descending (LAD) artery, and 4.08 + 0.27 (n = 4) in the left circumflex (LCx) artery. The slow flow phenomenon may represent persistent high arteriolar resistance in both ventricles. CONCLUSIONS Seldom reported or new findings in adult ALCAPA were identified in two cases. More frequent diagnosis of adult ALCAPA can be expected because of the widespread availability of resuscitation and more advanced diagnostic modalities. Accumulation of pathological and clinical findings and confirmation of the long-term follow-up results after treatment may contribute to expanding our knowledge of this rare entity and establishing optimal treatment.
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Affiliation(s)
- Hiroshi Kubota
- Department of Cardiovascular Surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
| | - Hidehito Endo
- Department of Cardiovascular Surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Hikaru Ishii
- Department of Cardiovascular Surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Hiroshi Tsuchiya
- Department of Cardiovascular Surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Yusuke Inaba
- Department of Cardiovascular Surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | | | - Yu Takahashi
- Department of Cardiovascular Surgery, National Disaster Medical Center, Tachikawa, Japan
| | - Mio Noma
- Department of Cardiovascular Surgery, Tokyo Metropolitan Children's Medical Center, Fuchu, Japan
| | - Kazuya Takemoto
- Department of Internal Medicine, Jyukoukai Hospital, Miyoshi, Japan
| | - Seiichi Taniai
- Department of Cardiology, Kyorin University, Mitaka, Japan
| | - Konomi Sakata
- Department of Cardiology, Kyorin University, Mitaka, Japan
| | - Kyoko Soejima
- Department of Cardiology, Kyorin University, Mitaka, Japan
| | | | - Hiroshi Kamma
- Department of Pathology, Kyorin University, Mitaka, Japan
| | | | - Yukihiro Kaneko
- Department of Cardiovascular Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Satoru Hirono
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Daisuke Izumi
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazuyuki Ozaki
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Samejima M, Taguchi S, Miyagawa S, Matsumoto R, Omura S, Ninomiya N, Nakamura Y, Yamaguchi T, Kinjo M, Tambo M, Okegawa T, Koba T, Matsuki R, Jimbo I, Motoyasu A, Tsumura T, Shimoyamada H, Shibahara J, Sakamoto Y, Fukuhara H. Acute hypotension induced by suction of cystic fluid containing extremely high concentrations of catecholamines during resection of giant pheochromocytoma. IJU Case Rep 2019; 2:218-220. [PMID: 32743418 PMCID: PMC7292151 DOI: 10.1002/iju5.12087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 03/13/2019] [Accepted: 05/08/2019] [Indexed: 01/01/2023] Open
Abstract
Introduction Since pheochromocytomas present with various complications due to catecholamine hypersecretion, their perioperative management needs special attention. Case presentation A 45‐year‐old man visited our hospital with a complaint of abdominal swelling. Radiological and endocrinological assessments determined the tumor as a giant (>20 cm) cystic pheochromocytoma. After administration of doxazosin, the patient underwent radical surgery. Since the tumor was extremely large and fixed to surrounding structures, we punctured it and aspirated cystic fluid to improve the tumor's mobility. However, during the aspiration, the patient developed acute hypotension, which could be reversed by suction withdrawal and vasopressor administration. A similar event occurred during a second aspiration. Eventually, the tumor was successfully excised with negative surgical margin. The cystic fluid proved to contain extremely high concentrations of catecholamines, which might result in the hypotension. Conclusion We report the first case who developed acute hypotension due to aspiration of cystic fluid from giant pheochromocytoma.
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Affiliation(s)
- Mio Samejima
- Department of Urology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Satoru Taguchi
- Department of Urology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Shogo Miyagawa
- Department of Urology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Ryuki Matsumoto
- Department of Urology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Shota Omura
- Department of Urology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Naoki Ninomiya
- Department of Urology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Yu Nakamura
- Department of Urology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Tsuyoshi Yamaguchi
- Department of Urology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Manami Kinjo
- Department of Urology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Mitsuhiro Tambo
- Department of Urology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Takatsugu Okegawa
- Department of Urology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Tsuyuha Koba
- Department of Surgery Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Ryota Matsuki
- Department of Surgery Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Ippei Jimbo
- Department of Anesthesiology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Akira Motoyasu
- Department of Anesthesiology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Tetsuro Tsumura
- Third Department of Internal Medicine Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Hiroaki Shimoyamada
- Department of Pathology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Junji Shibahara
- Department of Pathology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Yoshihiro Sakamoto
- Department of Surgery Kyorin University Faculty of Medicine Mitaka Tokyo Japan
| | - Hiroshi Fukuhara
- Department of Urology Kyorin University Faculty of Medicine Mitaka Tokyo Japan
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Shimoda-Komatsu Y, Kinoshita-Ise M, Shimoyamada H, Ohyama M. Chronological observation of surgically-treated granuloma faciale implies the necessity of circumspect management for perinasal nodular subset. J Dermatol 2018; 45:1122-1125. [PMID: 29905388 DOI: 10.1111/1346-8138.14507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 04/09/2018] [Accepted: 05/10/2018] [Indexed: 11/30/2022]
Abstract
Granuloma faciale (GF) is a rare chronic dermatosis with still unknown etiopathology, which usually presents a solitary, asymptomatic, smooth reddish-brown to violaceous plaques or nodules on the face. Various therapeutic approaches, including topical application of corticosteroid or tacrolimus and removal with laser, cryotherapy and surgery have been attempted; however, the outcome has been inconsistent. Herein, we report a case of perinasal nodular GF who repeatedly underwent surgical excisions after the failure of laser treatment. Despite its nomenclature, GF does not manifest granulomatous tissue and the lesion is histopathologically characterized by dense dermal cell infiltration devoid of granulomatous changes and not distinguished by a clear border, which partially explains the difficulty of complete removal in our case. Review of the published work delineated that GF could be largely divided into two clinical subsets: plaque and nodular types. The plaque type GF could be responsive to topical tacrolimus, an approach preferentially adopted nowadays, while nodular type GF was often resistant to topical therapies and required surgical or laser removal. The latter subset often arose around the nose. For this location, surgical excision with sufficient removal margin is sometimes technically difficult when an aesthetically acceptable outcome is expected, explaining the basis for local recurrence. Postoperative recurrence could be observed after years of disease-free period. These observations indicated that the need for respective treatment strategies for the management of distinctive GF subsets. Of note, a multidisciplinary approach combining radical resection and additional supportive intervention with long-term follow up may be required for perinasal and nodular GF.
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Affiliation(s)
| | | | | | - Manabu Ohyama
- Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan
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Kigasawa H, Fujiwara M, Ishii J, Chiba T, Terado Y, Shimoyamada H, Mochizuki M, Kitamura O, Kamma H, Ohkura Y. Altered expression of cytokeratin 7 and CD117 in transitional mucosa adjacent to human colorectal cancer. Oncol Lett 2017; 14:119-126. [PMID: 28693143 PMCID: PMC5494860 DOI: 10.3892/ol.2017.6156] [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: 01/08/2016] [Accepted: 03/09/2017] [Indexed: 01/31/2023] Open
Abstract
The multi-step progression of colorectal cancer through precancerous lesions (adenoma and dysplasia) is associated with cumulative molecular alterations, a number of which have also been demonstrated to be present in morphologically normal transitional mucosa adjacent to colorectal cancer. The cytoskeletal protein cytokeratin 7 (CK7) and the receptor tyrosine kinase, KIT proto-oncogene receptor tyrosine kinase (CD117), encoded by the proto-oncogene c-Kit, are lacking in normal colorectal crypt epithelium and are aberrantly expressed in a subset of colorectal cancer. The aim of the present study was to evaluate the expression of CK7 and CD117 in morphologically normal transitional mucosa adjacent to colorectal cancer. Immunohistochemical staining for CK7 and CD117 was performed in the mucosa adjacent to five groups of surgically resected colorectal tumors [low-grade adenoma, high-grade adenoma, mucosal adenocarcinoma, small-sized invasive adenocarcinoma (≤2 cm) and large-sized invasive adenocarcinoma (>2 cm)]. CK7 was expressed in the mucosa adjacent to a subset of colorectal tumors, and the positivity ratio increased according to tumor grade from low-grade adenoma up to small-sized invasive adenocarcinoma (61.2%). However, the positivity ratio of CK7 in the mucosa adjacent to the large-sized invasive adenocarcinoma (25.0%) was significantly lower compared with that of the next lower grade. CD117 was also expressed in the mucosa adjacent to a subset of colorectal tumors. In contrast to CK7, the positivity ratio of CD117 increased according to tumor grade from low-grade adenoma all the way through to the large-sized invasive adenocarcinoma (45.0%). Based on these results, the mechanism of CK7 and CD117 expression in the transitional mucosa adjacent to colorectal cancer may be different, and analysis of their individual expression may provide novel insights into the development and progression of colorectal cancer.
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Affiliation(s)
- Hideaki Kigasawa
- Department of Pathology, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan.,Department of Forensic Medicine, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan
| | - Masachika Fujiwara
- Department of Pathology, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan
| | - Jun Ishii
- Department of Pathology, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan
| | - Tomohiro Chiba
- Department of Pathology, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan
| | - Yuichi Terado
- Department of Pathology, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan
| | - Hiroaki Shimoyamada
- Department of Pathology, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan
| | - Makoto Mochizuki
- Department of Pathology, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan
| | - Osamu Kitamura
- Department of Forensic Medicine, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan
| | - Hiroshi Kamma
- Department of Pathology, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan
| | - Yasuo Ohkura
- Department of Pathology, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan
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14
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Endo H, Ishii H, Tsuchiya H, Takahashi Y, Shimoyamada H, Isomura A, Nakajima M, Hirano T, Ohkura Y, Kubota H. Pathologic Features of Lone Aortic Mobile Thrombus in the Ascending Aorta. Ann Thorac Surg 2016; 102:e313-5. [DOI: 10.1016/j.athoracsur.2016.03.107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 03/16/2016] [Accepted: 03/31/2016] [Indexed: 11/28/2022]
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15
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Endo T, Yazawa T, Shishido-Hara Y, Fujiwara M, Shimoyamada H, Ishii J, Sato H, Tachibana K, Takei H, Kondo H, Goya T, Endo S, Kamma H. Expression of developing neural transcription factors in lung carcinoid tumors. Pathol Int 2014; 64:365-74. [DOI: 10.1111/pin.12183] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 06/22/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Tetsuya Endo
- Department of Pathology; Kyorin University School of Medicine; Mitaka Japan
- Department of General Thoracic Surgery; Jichi Medical University; Shimotsuke Japan
| | - Takuya Yazawa
- Department of Pathology; Kyorin University School of Medicine; Mitaka Japan
| | | | - Masachika Fujiwara
- Department of Pathology; Kyorin University School of Medicine; Mitaka Japan
| | | | - Jun Ishii
- Department of Pathology; Kyorin University School of Medicine; Mitaka Japan
| | - Hanako Sato
- Department of Anatomy; St. Marianna University School of Medicine; Kawasaki Japan
| | - Keisei Tachibana
- Department of Surgery; Kyorin University School of Medicine; Mitaka Japan
| | - Hidefumi Takei
- Department of Surgery; Kyorin University School of Medicine; Mitaka Japan
| | - Haruhiko Kondo
- Department of Surgery; Kyorin University School of Medicine; Mitaka Japan
| | - Tomoyuki Goya
- Department of Surgery; Kyorin University School of Medicine; Mitaka Japan
| | - Shunsuke Endo
- Department of General Thoracic Surgery; Jichi Medical University; Shimotsuke Japan
| | - Hiroshi Kamma
- Department of Pathology; Kyorin University School of Medicine; Mitaka Japan
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16
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Oda M, Saraya T, Wakayama M, Shibuya K, Ogawa Y, Inui T, Yokoyama E, Inoue M, Shimoyamada H, Fujiwara M, Ota T, Takizawa H, Goto H. Calcium oxalate crystal deposition in a patient with Aspergilloma due to Aspergillus niger. J Thorac Dis 2013; 5:E174-8. [PMID: 23991333 DOI: 10.3978/j.issn.2072-1439.2013.08.45] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 08/19/2013] [Indexed: 11/14/2022]
Abstract
Discrimination between aspergilloma and chronic necrotizing pulmonary aspergillosis (CNPA) based on radiological findings can difficult. We describe a patient with aspergilloma and organizing pneumonia that was possibly caused by Aspergillus niger infection and radiologically mimicked CNPA. A postmortem histological analysis showed diffuse alveolar damage that had originated in peri-cavitary lung parenchyma. Calcium oxalate or Aspergillus niger was located inside, but not outside the cavity in the right upper lobe. Calcium oxalate or other unknown hyphal bioactive components might provoke severe lung inflammation not only adjacent to the cavity, but also on the contralateral side.
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Affiliation(s)
- Miku Oda
- Department of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan
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17
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Sakaeda M, Sato H, Ishii J, Miyata C, Kamma H, Shishido-Hara Y, Shimoyamada H, Fujiwara M, Endo T, Tanaka R, Kondo H, Goya T, Aoki I, Yazawa T. Neural lineage-specific homeoprotein BRN2 is directly involved in TTF1 expression in small-cell lung cancer. J Transl Med 2013; 93:408-21. [PMID: 23358112 DOI: 10.1038/labinvest.2013.2] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Thyroid transcription factor 1 (TTF1) plays crucial roles in thyroid, lung, and developing brain morphogenesis. Because TTF1-expressing neoplasms are generated from organs and tissues that normally express TTF1, such as the thyroid follicular epithelium and peripheral lung airway epithelium, TTF1 is widely used as a cell lineage-specific and diagnostic marker for thyroid carcinomas and for lung adenocarcinomas with terminal respiratory unit (TRU) differentiation. However, among lung neuroendocrine tumors, small-cell carcinomas (small-cell lung cancers (SCLCs)), most of which are generated from the central airway, also frequently express TTF1 at high levels. To clarify how SCLCs express TTF1, we investigated the molecular mechanisms of its expression using cultivated lung cancer cells and focusing upon neural cell-specific transcription factors. Both SCLC cells and lung adenocarcinoma cells predominantly expressed isoform 2 of TTF1, and TTF1 promoter assays in SCLC cells revealed that the crucial region for activation of the promoter, which is adjacent to the transcription start site of TTF1 isoform 2, has potent FOX-, LHX-, and BRN2-binding sites. Transfection experiments using expression vectors for FOXA1, FOXA2, LHX2, LHX6, and BRN2 showed that BRN2 substantially upregulated TTF1 expression, whereas FOXA1/2 weakly upregulated TTF1 expression. BRN2 and FOXA1/2 binding to the TTF1 promoter was confirmed through chromatin immunoprecipitation experiments, and TTF1 expression in SCLC cells was considerably downregulated after BRN2 knockdown. Furthermore, the TTF1 promoter in SCLC cells was scarcely methylated, and immunohistochemical examinations using a series of primary lung tumors indicated that TTF1 and BRN2 were coexpressed only in SCLC cells. These findings suggest that TTF1 expression in SCLC is a cell lineage-specific phenomenon that involves the developing neural cell-specific homeoprotein BRN2.
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Affiliation(s)
- Masashi Sakaeda
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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18
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Ishii J, Sato H, Sakaeda M, Shishido-Hara Y, Hiramatsu C, Kamma H, Shimoyamada H, Fujiwara M, Endo T, Aoki I, Yazawa T. POU domain transcription factor BRN2 is crucial for expression of ASCL1, ND1 and neuroendocrine marker molecules and cell growth in small cell lung cancer. Pathol Int 2013; 63:158-68. [DOI: 10.1111/pin.12042] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 02/09/2013] [Indexed: 11/30/2022]
Affiliation(s)
| | - Hanako Sato
- Department of Anatomy; St. Marianna University School of Medicine; Kawasaki
| | | | | | - Chie Hiramatsu
- Department of Anatomy; St. Marianna University School of Medicine; Kawasaki
| | - Hiroshi Kamma
- Department of Pathology; Kyorin University School of Medicine; Mitaka
| | | | | | | | - Ichiro Aoki
- Department of Pathology; Yokohama City University Graduate School of Medicine; Yokohama
| | - Takuya Yazawa
- Department of Pathology; Kyorin University School of Medicine; Mitaka
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Abstract
Primary leiomyosarcoma of the kidney is rare. Here we report a case of metastasis of this tumor to the stomach. A 73-year-old man visited our hospital suffering from general weakness and intermittent tarry stools. He had undergone right nephrectomy for renal leiomyosarcoma 2 years previously. There had been no local recurrence or distant metastasis in the 2-year follow-up period. Endoscopy revealed two submucosal tumors in the stomach. These tumors were diagnosed histologically as leiomyosarcoma and distal gastrectomy was performed. Subsequent histochemical staining confirmed the diagnosis of gastric metastasis from renal leiomyosarcoma. The patient died due to metastases to the liver and bone 9 months after the operation. To the best of our knowledge, this is the first report of gastric metastasis from primary renal leiomyosarcoma.
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Affiliation(s)
- Satoshi Yodonawa
- Department of Surgery, Ibaraki Seinan Medical Center Hospital, Sakai, Japan
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20
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Kashiwagi K, Ishii J, Sakaeda M, Arimasu Y, Shimoyamada H, Sato H, Miyata C, Kamma H, Aoki I, Yazawa T. Differences of molecular expression mechanisms among neural cell adhesion molecule 1, synaptophysin, and chromogranin A in lung cancer cells. Pathol Int 2012; 62:232-45. [DOI: 10.1111/j.1440-1827.2011.02781.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Sato H, Sakaeda M, Ishii J, Kashiwagi K, Shimoyamada H, Okudela K, Tajiri M, Ohmori T, Ogura T, Woo T, Masuda M, Hirata K, Kitamura H, Yazawa T. Insulin-like growth factor binding protein-4 gene silencing in lung adenocarcinomas. Pathol Int 2010; 61:19-27. [PMID: 21166939 DOI: 10.1111/j.1440-1827.2010.02612.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Gene silencing by promoter hypermethylation plays an important role in molecular pathogenesis. We previously reported that insulin-like growth factor (IGF) binding protein-4 (IGFBP-4), which inhibits IGF-dependent growth, is expressed via early growth response-1 (EGR-1) and is often silenced in cultivated lung cancer cells. The purpose of the present study was to clarify clinicopathological factors associated with IGFBP-4 gene silencing in lung adenocarcinomas. Seventy-six surgically resected adenocarcinomas (20 well-, 35 moderately-, and 21 poorly-differentiated) were subjected to methylation-specific polymerase chain reaction (PCR) analysis for EGR-1-binding sites located in the IGFBP-4 promoter and immunohistochemistry for IGFBP-4, EGR-1, and Ki-67. Thirty-two adenocarcinomas (42%) revealed IGFBP-4 promoter hypermethylation, and the severity inversely correlated with the level of IGFBP-4 expression (P < 0.0001) and tumor differentiation (well versus poor, P = 0.0278; well/moderate versus poor, P = 0.0395). Furthermore, there was a negative correlation between Ki-67 labeling index and IGFBP-4 expression (P = 0.0361). These findings suggest that the expression of IGFBP-4 in adenocarcinoma cells in vivo is downregulated by epigenetic silencing in association with tumor differentiation, resulting in disruption of the mechanism of IGFBP-4-mediated growth inhibition.
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Affiliation(s)
- Hanako Sato
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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22
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Shimoyamada H, Yazawa T, Sato H, Okudela K, Ishii J, Sakaeda M, Kashiwagi K, Suzuki T, Mitsui H, Woo T, Tajiri M, Ohmori T, Ogura T, Masuda M, Oshiro H, Kitamura H. Early growth response-1 induces and enhances vascular endothelial growth factor-A expression in lung cancer cells. Am J Pathol 2010; 177:70-83. [PMID: 20489156 DOI: 10.2353/ajpath.2010.091164] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Vascular endothelial growth factor-A (VEGF-A) is crucial for angiogenesis, vascular permeability, and metastasis during tumor development. We demonstrate here that early growth response-1 (EGR-1), which is induced by the extracellular signal-regulated kinase (ERK) pathway activation, activates VEGF-A in lung cancer cells. Increased EGR-1 expression was found in adenocarcinoma cells carrying mutant K-RAS or EGFR genes. Hypoxic culture, siRNA experiment, luciferase assays, chromatin immunoprecipitation, electrophoretic mobility shift assays, and quantitative RT-PCR using EGR-1-inducible lung cancer cells demonstrated that EGR-1 binds to the proximal region of the VEGF-A promoter, activates VEGF-A expression, and enhances hypoxia inducible factor 1alpha (HIF-1alpha)-mediated VEGF-A expression. The EGR-1 modulator, NAB-2, was rapidly induced by increased levels of EGR-1. Pathology samples of human lung adenocarcinomas revealed correlations between EGR-1/HIF-1alpha and VEGF-A expressions and relative elevation of EGR-1 and VEGF-A expression in mutant K-RAS- or EGFR-carrying adenocarcinomas. Both EGR-1 and VEGF-A expression increased as tumors dedifferentiated, whereas HIF-1alpha expression did not. Although weak correlation was found between EGR-1 and NAB-2 expressions on the whole, NAB-2 expression decreased as tumors dedifferentiated, and inhibition of DNA methyltransferase/histone deacetylase increased NAB-2 expression in lung cancer cells despite no epigenetic alteration in the NAB-2 promoter. These findings suggest that EGR-1 plays important roles on VEGF-A expression in lung cancer cells, and epigenetic silencing of transactivator(s) associated with NAB-2 expression might also contribute to upregulate VEGF-A expression.
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Affiliation(s)
- Hiroaki Shimoyamada
- Department of Pathology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
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23
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Okudela K, Woo T, Mitsui H, Yazawa T, Shimoyamada H, Tajiri M, Ogawa N, Masuda M, Kitamura H. Proposal of an improved histological sub-typing system for lung adenocarcinoma - significant prognostic values for stage I disease. Int J Clin Exp Pathol 2010; 3:348-366. [PMID: 20490327 PMCID: PMC2872743] [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] [Subscribe] [Scholar Register] [Received: 03/19/2010] [Accepted: 03/21/2010] [Indexed: 05/29/2023]
Abstract
We have established a concise sub-typing system suitable for predicting the postoperative outcome in cases of stage I lung adenocarcinoma (ADC), using morphometric profiling. The association between postoperative disease recurrence and a variety of morphological features including histological architecture, cell type, cytoplasmic color/internal structure, nuclear shape/size, chromatin pattern, and nucleoli count/remarkableness, was analyzed. Histological architecture had the most prognostic value and could be subdivided into low-grade (bronchioloalveolar, papillary and tubular: "tubular" in this paper is defined as a tubular or glandular structure lined with single-layered neoplastic cells) and high-grade (acinar and solid: "acinar" is defined as a tubular or glandular structure lined with poly-layered neoplastic cells or as a fused glandular structure such as the cribriform pattern) components. The subgroups separated based on a cut-off value, 71.5% of the high-grade component comprised by a tumor, which was calculated according to a relative operating characteristic curve, exhibited a significant difference in disease recurrence [estimated 5-year disease-free survival rate, 95.3% in the low-grade group versus 66.7% in the high-grade group, hazard ratio 7.35, Log-rank test p = 0.002]. The sub-grouping system is concise and suitable for practical use. It will improve the histological classification of ADC.
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Affiliation(s)
- Koji Okudela
- Department of Pathology, Yokohama City University Graduate School of MedicineYokohama, Japan
| | - Tetsukan Woo
- Department of Surgery, Yokohama City University Graduate School of MedicineYokohama, Japan
| | - Hideaki Mitsui
- Department of Pathology, Yokohama City University Graduate School of MedicineYokohama, Japan
| | - Takuya Yazawa
- Department of Pathology, Yokohama City University Graduate School of MedicineYokohama, Japan
| | - Hiroaki Shimoyamada
- Department of Pathology, Yokohama City University Graduate School of MedicineYokohama, Japan
| | - Michihiko Tajiri
- Division of General Thoracic Surgery, Kanagawa Prefectural Cardiovascular and Respiratory Center HospitalYokohama, Japan
| | - Nobuo Ogawa
- Division of General Thoracic Surgery, Kanagawa Prefectural Cardiovascular and Respiratory Center HospitalYokohama, Japan
| | - Munetaka Masuda
- Department of Surgery, Yokohama City University Graduate School of MedicineYokohama, Japan
| | - Hitoshi Kitamura
- Department of Pathology, Yokohama City University Graduate School of MedicineYokohama, Japan
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Okudela K, Yazawa T, Ishii J, Woo T, Mitsui H, Bunai T, Sakaeda M, Shimoyamada H, Sato H, Tajiri M, Ogawa N, Masuda M, Sugimura H, Kitamura H. Down-regulation of FXYD3 expression in human lung cancers: its mechanism and potential role in carcinogenesis. Am J Pathol 2009; 175:2646-56. [PMID: 19893046 DOI: 10.2353/ajpath.2009.080571] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
FXYD3 is a FXYD-containing Na,K-ATPase ion channel regulator first identified as a protein overexpressed in murine breast tumors initiated by oncogenic ras or neu. However, our preliminary study revealed that FXYD3 expression was down-regulated in oncogenic KRAS-transduced airway epithelial cells. This contradiction led us to investigate the role of FXYD3 in carcinogenesis of the lung. FXYD3 mRNA and protein levels were lower in most of the lung cancer cell lines than in either the noncancerous lung tissue or airway epithelial cells. Protein levels were also lower in a considerable proportion of primary lung cancers than in nontumoral airway epithelia; FXYD3 expression levels decreased in parallel with the dedifferentiation process. Also, a somatic point mutation, g55c (D19H), was found in one cell line. Forced expression of the wild-type FXYD3, but not the mutant, restored the well-demarcated distribution of cortical actin in cancer cells that had lost FXYD3 expression, suggesting FXYD3 plays a role in the maintenance of cytoskeletal integrity. However, no association between FXYD3 expression and its promoter's methylation status was observed. Therefore, inactivation of FXYD3 through a gene mutation or unknown mechanism could be one cause of the atypical shapes of cancer cells and play a potential role in the progression of lung cancer.
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Affiliation(s)
- Koji Okudela
- Department of Pathology, Yokohama City University Graduate School of Medicine, Kanazawa-Ku, Yokohama, Japan
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Kitamura H, Okudela K, Yazawa T, Sato H, Shimoyamada H. Cancer stem cell: implications in cancer biology and therapy with special reference to lung cancer. Lung Cancer 2009; 66:275-81. [PMID: 19716622 DOI: 10.1016/j.lungcan.2009.07.019] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Revised: 07/23/2009] [Accepted: 07/28/2009] [Indexed: 12/11/2022]
Abstract
The cancer stem cell (CSC) theory is currently central to the field of cancer research, because it is not only a matter of academic interest but also crucial in cancer therapy. CSCs share a variety of biological properties with normal somatic stem cells in terms of self-renewal, the propagation of differentiated progeny, the expression of specific cell markers and stem cell genes, and the utilization of common signaling pathways and the stem cell niche. However, CSCs differ from normal stem cells in their tumorigenic activity. Thus, CSCs are also termed cancer initiating cells. In this paper, we briefly review hitherto described study results and refer to some excellent review articles to understand the basic properties of CSCs. In addition, we focus upon CSCs of lung cancers, since lung cancer is still increasing in incidence worldwide and remains the leading cause of cancer deaths. Understanding the properties of, and exploring cell markers and signaling pathways specific to, CSCs of lung cancers, will lead to progress in therapy, intervention, and improvement of the prognosis of patients with lung cancer. In the near future, the evaluation of CSCs may be a routine part of practical diagnostic pathology.
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Affiliation(s)
- Hitoshi Kitamura
- Department of Pathology, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
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Yazawa T, Sato H, Shimoyamada H, Okudela K, Woo T, Tajiri M, Ogura T, Ogawa N, Suzuki T, Mitsui H, Ishii J, Miyata C, Sakaeda M, Goto K, Kashiwagi K, Masuda M, Takahashi T, Kitamura H. Neuroendocrine cancer-specific up-regulating mechanism of insulin-like growth factor binding protein-2 in small cell lung cancer. Am J Pathol 2009; 175:976-87. [PMID: 19679880 DOI: 10.2353/ajpath.2009.081004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Small cell lung cancer (SCLC) exhibits insulin-like growth factor-dependent growth. SCLC is the most aggressive among known in vivo lung cancers, whereas in vitro growth of SCLC is paradoxically slow as compared with that of non-SCLC (NSCLC). In this study, we demonstrate that SCLC cells overexpress insulin-like growth factor binding protein (IGFBP)-2 via NeuroD, a neuroendocrine cell-specific transcription factor. Chromatin immunoprecipitation, electrophoretic mobility shift, and IGFBP-2 promoter assays all revealed that NeuroD binds to the E-box in the 5'-untranslated region of IGFBP-2. A NeuroD transgene in both airway epithelial and NSCLC cells up-regulated the transcription of IGFBP-2 and retarded cell growth. Recombinant IGFBP-2 repressed the growth of both airway epithelial and NSCLC cells in a dose-dependent manner. A NeuroD-specific small interfering RNA repressed IGFBP-2 expression in SCLC, and neutralization of IGFBP-2 and an IGFBP-2-specific small interfering RNA increased SCLC cell growth. Pathological samples of SCLC also expressed IGFBP-2 abundantly, as compared with NSCLC, and showed only rare (8%) IGFBP-2 promoter methylation, whereas the IGFBP-2 promoter was methylated in 71% of adenocarcinomas and 29% of squamous cell carcinomas. These findings suggest that 1) SCLC has an IGFBP-2 overexpression mechanism distinct from NSCLC, 2) secreted IGFBP-2 contributes to the slow growth of SCLC in vitro, and 3) the epigenetic alterations in the IGFBP-2 promoter contribute to the striking differences in IGFBP-2 expression between SCLC and NSCLC in vivo.
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Affiliation(s)
- Takuya Yazawa
- Department of Pathology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan.
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Okudela K, Yazawa T, Woo T, Sakaeda M, Ishii J, Mitsui H, Shimoyamada H, Sato H, Tajiri M, Ogawa N, Masuda M, Takahashi T, Sugimura H, Kitamura H. Down-regulation of DUSP6 expression in lung cancer: its mechanism and potential role in carcinogenesis. Am J Pathol 2009; 175:867-81. [PMID: 19608870 DOI: 10.2353/ajpath.2009.080489] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Our preliminary studies revealed that oncogenic KRAS (KRAS/V12) dramatically suppressed the growth of immortalized airway epithelial cells (NHBE-T, with viral antigen-inactivated p53 and RB proteins). This process appeared to be a novel event, different from the so-called premature senescence that is induced by either p53 or RB, suggesting the existence of a novel tumor suppressor that functions downstream of oncogenic KRAS. After a comprehensive search for genes whose expression levels were modulated by KRAS/V12, we focused on DUSP6, a pivotal negative feedback regulator of the RAS-ERK pathway. A dominant-negative DUSP6 mutant, however, failed to rescue KRAS/V12-induced growth suppression, but conferred a stronger anchorage-independent growth activity to the surviving subpopulation of cells generated from KRAS/V12-transduced NHBE-T. DUSP6 expression levels were found to be weaker in most lung cancer cell lines than in NHBE-T, and DUSP6 restoration suppressed cellular growth. In primary lung cancers, DUSP6 expression levels decreased as both growth activity and histological grade of the tumor increased. Loss of heterozygosity of the DUSP6 locus was found in 17.7% of cases and was associated with reduced expression levels. These results suggest that DUSP6 is a growth suppressor whose inactivation could promote the progression of lung cancer. We have here identified an important factor involved in carcinogenesis through a comprehensive search for downstream targets of oncogenic KRAS.
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Affiliation(s)
- Koji Okudela
- Department of Pathology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-Ku, 236-0004 Yokohama, Japan
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Kitamura H, Yazawa T, Sato H, Okudela K, Shimoyamada H. Small cell lung cancer: significance of RB alterations and TTF-1 expression in its carcinogenesis, phenotype, and biology. Endocr Pathol 2009; 20:101-7. [PMID: 19390995 DOI: 10.1007/s12022-009-9072-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Small cell lung cancer (SCLC) exhibits highly aggressive behavior and has a poor prognosis. While numerous investigations have been carried out, the exact mechanism of its carcinogenesis and aggressiveness is still unclear. SCLC is categorized as a neuroendocrine neoplasia and has a genetic profile characterized by universal alterations of the RB and TP53 genes. Epidemiological studies indicate the majority of SCLCs to be caused by smoking and the TP53 mutational pattern to be consistent with that evoked by smoke carcinogens; however, there is no direct evidence that such carcinogens induce alterations to RB in SCLC. While the importance of these alterations in the carcinogenesis of SCLC is strongly suggested, the exact molecular mechanism has been only little elucidated. SCLC cells almost always express mammalian achaete-scute homolog-1 (MASH1) and thyroid transcription factor-1 (TTF-1). MASH1 plays a critical role in neuroendocrine differentiation. TTF-1 is a characteristic marker of distal airway cells and pulmonary adenocarcinomas, but is also expressed in extrapulmonary neuroendocrine cancers. Thus, TTF-1 may well play a significant role in the development of neuroendocrine cancers. Recent studies indicate that the airway stem cell is committed to the neuroendocrine lineage through MASH1 and Notch signaling and that only RB-deleted neuroendocrine cells selectively proliferate in response to E2F3, eventually undergoing transformation to neuroendocrine cancer cells, probably in concert with TP53 gene aberrations. Thus, alterations of both the RB and TP53 genes are central to the carcinogenesis of SCLC, while many other factors including MASH1 and TTF-1 contribute to the development and biological behavior of SCLC.
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Affiliation(s)
- Hitoshi Kitamura
- Department of Pathology, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
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Kitamura H, Yazawa T, Okudela K, Shimoyamada H, Sato H. Molecular and Genetic Pathogenesis of Lung Cancer: Differences Between Small-Cell and Non-Small-Cell Carcinomas. ACTA ACUST UNITED AC 2008. [DOI: 10.2174/1874375700802010106] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Hashimoto T, Kihara M, Imai N, Yoshida SI, Shimoyamada H, Yasuzaki H, Ishida J, Toya Y, Kiuchi Y, Hirawa N, Tamura K, Yazawa T, Kitamura H, Fukamizu A, Umemura S. Requirement of apelin-apelin receptor system for oxidative stress-linked atherosclerosis. Am J Pathol 2007; 171:1705-12. [PMID: 17884970 PMCID: PMC2043530 DOI: 10.2353/ajpath.2007.070471] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The recently identified endogenous peptide apelin and its specific apelin receptor (APJ) are currently being considered as potential regulators in vascular tissue. Previously, we reported apelin mediates phosphorylation of myosin light chain and elicits vasoconstriction in vascular smooth muscle. In this study, physiological roles of the apelin-APJ system were investigated on atherosclerosis. In APJ and apolipoprotein E double-knockout (APJ(-/-)ApoE(-/-)) mice fed a high-cholesterol diet, atherosclerotic lesions were dramatically reduced when compared with APJ(+/+) ApoE(-/-) mice, in the absence of an effect of cholesterol levels. Immunohistochemical detection of smooth muscle cells, using a smooth muscle alpha-actin antibody, showed greatly reduced staining for these cells in lesions of APJ(-/-)ApoE(-/-) mice fed a high-cholesterol diet. Vascular production of superoxide radicals and the expression of nicotinamide-adenine dinucleotide phosphate oxidase subunits were decreased in APJ(-/-)ApoE(-/-) mice compared with APJ(+/+)ApoE(-/-) mice fed a standard normal diet. In vascular smooth muscle cells, apelin induced nicotinamide-adenine dinucleotide phosphate oxidase subunit expression. Apelin also induced vascular smooth muscle cell proliferation, which was inhibited by superoxide dismutase or diphenylene iodonium. The apelin-APJ system is a mediator of oxidative stress in vascular tissue, and thus we propose it to be a critical factor in atherogenesis under high-cholesterol dietary conditions. APJ deficiency is preventative against oxidative stress-linked atherosclerosis.
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Affiliation(s)
- Tatsuo Hashimoto
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine and School of Medicine, Kanazawa-ku, Yokohama, Japan
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31
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Yanagawa T, Yoshida H, Yamagata K, Onizawa K, Tabuchi K, Koyama Y, Iwasa S, Shimoyamada H, Harada H, Omura K. Loss of cytokeratin 13 expression in squamous cell carcinoma of the tongue is a possible sign for local recurrence. J Exp Clin Cancer Res 2007; 26:215-20. [PMID: 17725101] [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] [Indexed: 05/16/2023]
Abstract
Cytokeratin (CK) 13 is an intermediate filament protein that is expressed in a cell-type-specific manner, in the tongue and occasionally in tongue squamous cell carcinoma (SCC). Correlations between the clinical features of patients with SCC and CK13 expression in the tumor are here investigated along with CK13's utility as a marker for tongue cancer status. Samples from 121 patients with SCC of the tongue were examined by immunohistochemistry with antibodies against CK13. Correlations between the expression level of CK13 in the tumor and the patients' clinical features were statistically analyzed by univariate and multivariate methods. Univariate analysis showed a more relevant number of local recurrence (P = 0.04) in CK13-negative staining patients. In addition, CK13-negative cases were associated with local recurrence by multiple logistic regression analysis (OR: 3.36; 95% CI: 1.044-10.78; P = 0.04). Our results suggest that the loss of CK13 expression indicates tumors with a high potential for recurrence, and thus CK13 could be useful for determining the best course of treatment.
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Affiliation(s)
- T Yanagawa
- Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
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Sato H, Yazawa T, Suzuki T, Shimoyamada H, Okudela K, Ikeda M, Hamada K, Yamada-Okabe H, Yao M, Kubota Y, Takahashi T, Kamma H, Kitamura H. Growth regulation via insulin-like growth factor binding protein-4 and -2 in association with mutant K-ras in lung epithelia. Am J Pathol 2006; 169:1550-66. [PMID: 17071580 PMCID: PMC1780191 DOI: 10.2353/ajpath.2006.051068] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Gain-of-function point mutations in K-ras affect early events in pulmonary bronchioloalveolar carcinoma. We investigated altered mRNA expression on K-Ras activation in human peripheral lung epithelial cells (HPL1A) using oligonucleotide microarrays. Mutated K-Ras stably expressed in HPL1A accelerated cell growth and induced the expression of insulin-like growth factor (IGF)-binding protein (IGFBP)-4 and IGFBP-2, which modulate cell growth via IGF. Other lung epithelial cell lines (NHBE and HPL1D) revealed the same phenomena as HPL1A by mutated K-ras transgene. Lung cancer cell growth was also accelerated by mutated K-ras gene transduction, whereas IGFBP-4/2 induction was weaker compared with mutated K-Ras-expressing lung epithelial cells. To understand the differences in IGFBP-4/2 inducibility via K-Ras-activated signaling between nonneoplastic lung epithelia and lung carcinoma, we addressed the mechanisms of IGFBP-4/2 transcriptional activation. Our results revealed that Egr-1, which is induced on activation of Ras-mitogen-activated protein kinase signaling, is crucial for transactivation of IGFBP-4/2. Furthermore, IGFBP-4 and IGFBP-2 promoters were often hypermethylated in lung carcinoma, yielding low basal expression/weak induction of IGFBP-4/2. These findings suggest that continuous K-Ras activation accelerates cell growth and evokes a feedback system through IGFBP-4/2 to prevent excessive growth. Moreover, this growth regulation is disrupted in lung cancers because of promoter hypermethylation of IGFBP-4/2 genes.
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Affiliation(s)
- Hanako Sato
- Department of Pathobiology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanagawa, Japan
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Tabuchi K, Okubo H, Takahashi K, Uemaetomari I, Shimoyamada H, Nakayama Y, Hara A. Nevoid basal cell carcinoma syndrome: report of an aggressive case with ethmoid sinus invasion. Auris Nasus Larynx 2004; 30:421-3. [PMID: 14656570 DOI: 10.1016/s0385-8146(03)00092-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 10/27/2022]
Abstract
Nevoid basal cell carcinoma syndrome, also referred to as Gorlin-Goltz syndrome, is a rare autosomal dominant disorder characterized by multiple basal cell carcinomas, jaw cysts, palmar or plantar pits, ectopic calcification of the falx cerebri, and various skeletal developmental abnormalities. A minority of basal cell carcinomas demonstrate aggressive behavior and involve the craniofacial bones in nevoid basal cell carcinoma syndrome. A non-familial case of nevoid basal cell carcinoma syndrome with a basal cell carcinoma of the eyelid invading to the ethmoid sinus is reported.
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Affiliation(s)
- Keiji Tabuchi
- Department of Otolaryngology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, 305-8575, Tsukuba, Japan
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Shimoyamada H, Fan J, Watanabe T, Nagata M. Accelerated atherosclerosis with apolipoprotein(a) and oxidized low-density lipoprotein deposition in acute rejection of transplanted kidney: analogous to atherosclerosis. Clin Transplant 2003; 16 Suppl 8:35-9. [PMID: 12464130 DOI: 10.1034/j.1399-0012.16.s8.7.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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: 11/23/2022]
Abstract
Atherosclerosis is a chronic inflammatory process affecting mainly elastic and muscular arteries. Although small arteries and arterioles are usually spared, atherosclerosis can occur in these small vasculatures for a very short period. Here we report a case of atherosclerosis-like lesions that occurred in a transplanted kidney showing acute accelerated rejection in a 43-year-old man. Histologically, biopsy specimens at 14 and 28 days and nephrectomy material at 52 days post-transplantation showed atherosclerosis-like lesions in various-sized arteries. The lesions were characterized by the intimal infiltration of inflammatory cells, including foamy macrophages and a variable number of T-lymphocytes, with smooth muscle cell proliferation. Immunohistochemistry disclosed that the foam cells expressing CD68 contained oxidized LDL. In addition, apolipoprotein(a) (Lp(a)), another major atherogenic lipoprotein, was found in the intimal smooth muscle layer, suggesting that Lp(a) induced smooth muscle cell proliferation in the rejected kidney as a mechanism of atherosclerosis. This case shows that immunoinflammatory reactions during a relatively short period can mimic the chronic atherosclerotic process even in small arteries and arterioles. Furthermore, the deposition of atherogenic lipoproteins, Lp(a) and oxidized LDL in lesions of rejected tissue present an analogy between vascular rejection in transplanted kidney and atherosclerosis.
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Ichikawa T, Unoki H, Sun H, Shimoyamada H, Marcovina S, Shikama H, Watanabe T, Fan J. Lipoprotein(a) promotes smooth muscle cell proliferation and dedifferentiation in atherosclerotic lesions of human apo(a) transgenic rabbits. Am J Pathol 2002; 160:227-36. [PMID: 11786416 PMCID: PMC1867144 DOI: 10.1016/s0002-9440(10)64366-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Elevated plasma lipoprotein(a) [Lp(a)] levels constitute an independent risk factor for the development of atherosclerosis. However, the mechanism underlying Lp(a) atherogenicity is unclear. Recently, we demonstrated that Lp(a) may potentially be proatherogenic in transgenic rabbits expressing human apolipoprotein(a) [apo(a)]. In this study, we further investigated atherosclerotic lesions of transgenic rabbits by morphometry and immunohistochemistry. On a cholesterol diet, human apo(a) transgenic rabbits had more extensive atherosclerotic lesions of the aorta, carotid artery, iliac artery, and coronary artery than did nontransgenic littermate rabbits as defined by increased intimal lesion area. Enhanced lesion development in transgenic rabbits was characterized by increased accumulation of smooth muscle cells, that was often associated with the Lp(a) deposition. To explore the possibility that Lp(a) may be involved in the smooth-muscle cell phenotypic modulation, we stained the lesions using a panel of monoclonal antibodies against smooth-muscle myosin heavy-chain isoforms (SM1, SM2, and SMemb) and basic transcriptional element binding protein-2 (BTEB2). We found that a large number of smooth muscle cells located in the apo(a)-containing areas of transgenic rabbits were positive for SMemb and BTEB2, suggesting that these smooth muscle cells were either immature or in the state of activation. In addition, transgenic rabbits showed delayed fibrinolytic activity accompanied by increased plasma plasminogen activator inhibitor-1. We conclude that Lp(a) may enhance the lesion development by mediating smooth muscle cell proliferation and dedifferentiation possibly because of impaired fibrinolytic activity.
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Affiliation(s)
- Tomonaga Ichikawa
- Department of Pathology, Institute of Basic Medical Sciences, University of Tsukuba, Tsukuba, Japan
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Fan J, Unoki H, Kojima N, Sun H, Shimoyamada H, Deng H, Okazaki M, Shikama H, Yamada N, Watanabe T. Overexpression of lipoprotein lipase in transgenic rabbits inhibits diet-induced hypercholesterolemia and atherosclerosis. J Biol Chem 2001; 276:40071-9. [PMID: 11477088 DOI: 10.1074/jbc.m105456200] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.0] [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: 11/06/2022] Open
Abstract
Lipoprotein lipase (LPL) is a key enzyme in the hydrolysis of TG-rich lipoproteins. To elucidate the physiological roles of LPL in lipid and lipoprotein metabolism, we generated transgenic rabbits expressing human LPL. In postheparinized plasma of transgenic rabbits, the human LPL protein levels were about 650 ng/ml, and LPL enzymatic activity was found at levels up to 4-fold greater than that in nontransgenic littermates. Increased LPL activity in transgenic rabbits was associated with as much as an 80% decrease in plasma triglycerides and a 59% decrease in high density lipoprotein-cholesterol. Analysis of the lipoprotein density fractions revealed that increased expression of the LPL transgene resulted in a remarkable reduction in the level of very low density lipoproteins as well as in the level of intermediate density lipoproteins. In addition, LDL cholesterol levels in transgenic rabbits were significantly increased. When transgenic rabbits were fed a cholesterol-rich diet, the development of hypercholesterolemia and aortic atherosclerosis was dramatically suppressed in transgenic rabbits. These results demonstrate that systemically increased LPL activity functions in the metabolism of all classes of lipoproteins, thereby playing a crucial role in plasma triglyceride hydrolysis and lipoprotein conversion, and that overexpression of LPL protects against diet-induced hypercholesterolemia and atherosclerosis.
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Affiliation(s)
- J Fan
- Department of Pathology, Institute of Basic Medical Sciences, University of Tsukuba, Tsukuba 305-8575, Japan.
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Fan J, Shimoyamada H, Sun H, Marcovina S, Honda K, Watanabe T. Transgenic rabbits expressing human apolipoprotein(a) develop more extensive atherosclerotic lesions in response to a cholesterol-rich diet. Arterioscler Thromb Vasc Biol 2001; 21:88-94. [PMID: 11145938 DOI: 10.1161/01.atv.21.1.88] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.9] [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: 11/16/2022]
Abstract
High lipoprotein(a) [Lp(a)] levels constitute an independent risk factor for the development of atherosclerosis. However, the relationship between Lp(a) and atherosclerosis is not fully understood. To examine the effect of Lp(a) on the development of atherosclerosis, we studied transgenic rabbits expressing human apolipoprotein(a) [apo(a)], which was assembled into Lp(a) in the plasma. Human apo(a) transgenic rabbits fed a 0.3% cholesterol diet for 16 weeks had more extensive atherosclerotic lesions than did nontransgenic rabbits, although the cholesterol levels in the plasma of both groups were similarly elevated. Compared with the lesions in control rabbits, the areas of the atherosclerotic lesions in human apo(a) transgenic rabbits were significantly increased in the aorta, the iliac artery, and the carotid artery. Furthermore, human apo(a) transgenic rabbits on a cholesterol-rich diet had a greater degree of coronary atherosclerosis than did control rabbits. Immunohistochemical analysis revealed that human apo(a) was frequently deposited in the atherosclerotic lesions of transgenic rabbits. We conclude that Lp(a) may have proatherogenic effects in the setting of a cholesterol-rich diet in transgenic rabbits.
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Affiliation(s)
- J Fan
- Department of Pathology, Institute of Basic Medical Sciences, University of Tsukuba, Tsukuba, Japan.
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Brown ML, Ramprasad MP, Umeda PK, Tanaka A, Kobayashi Y, Watanabe T, Shimoyamada H, Kuo WL, Li R, Song R, Bradley WA, Gianturco SH. A macrophage receptor for apolipoprotein B48: cloning, expression, and atherosclerosis. Proc Natl Acad Sci U S A 2000; 97:7488-93. [PMID: 10852956 PMCID: PMC16572 DOI: 10.1073/pnas.120184097] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We have cloned a human macrophage receptor that binds to apolipoprotein (apo)B48 of dietary triglyceride (TG)-rich lipoproteins. TG-rich lipoprotein uptake by the apoB48R rapidly converts macrophages and apoB48R-transfected Chinese hamster ovary cells in vitro into lipid-filled foam cells, as seen in atherosclerotic lesions. The apoB48R cDNA (3,744 bp) encodes a protein with no known homologs. Its approximately 3.8-kb mRNA is expressed primarily by reticuloendothelial cells: monocytes, macrophages, and endothelial cells. Immunohistochemistry shows the apoB48R is in human atherosclerotic lesion foam cells. Normally, the apoB48R may provide essential lipids to reticuloendothelial cells. If overwhelmed, foam cell formation, endothelial dysfunction, and atherothrombogenesis may ensue, a mechanism for cardiovascular disease risk of elevated TG.
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Affiliation(s)
- M L Brown
- Department of Medicine, Division of Gerontology and Geriatrics, University of Alabama, Birmingham, AL 35294-0012, USA
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Fan J, Challah M, Shimoyamada H, Shiomi M, Marcovina S, Watanabe T. Defects of the LDL receptor in WHHL transgenic rabbits lead to a marked accumulation of plasma lipoprotein[a]. J Lipid Res 2000; 41:1004-12. [PMID: 10828093] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
In this study, we created LDL receptor (LDLr) defective (WHHL) transgenic rabbits expressing human apo[a] to examine whether LDLr mediates the Lp[a] clearance from the plasma. By crossbreeding WHHL rabbits with human apo[a] transgenic rabbits, we obtained two groups of human apo[a] transgenic rabbits with defective LDLr functions: apo[a](1/0) WHHL heterozygous (LDLr(+/-) and apo[a](+/0) WHHL homozygous (LDLr(-/-) rabbits. The lipid and lipoprotein levels of human apo[a] WHHL rabbits were compared to those of human apo[a] transgenic rabbits with normal LDLr functions (LDLr(+/+). The apo[a] production rate was evaluated by analyzing apo[a] mRNA expression in the liver, the major site for apo[a] synthesis in transgenic rabbits. We found that pre-beta lipoproteins were markedly increased accompanied by a 2-fold increase in the plasma Lp[a] in apo[a](+/0)/LDLr(+/-) rabbits and a 4.2-fold increase in apo[a](+/0)/LDLr(-/-) rabbits compared with that in apo[a](+/0) rabbits with normal LDLr function. In apo[a](+/0)/LDLr(-/-) rabbits, there was a marked increase in plasma total cholesterol and triglycerides, as was found in their counterpart non-transgenic WHHL rabbits. Northern blot analysis revealed that hepatic apo[a] expression in WHHL transgenic rabbits was similar to that in LDLr(+/+) transgenic rabbits, suggesting the accumulation of plasma Lp[a] in WHHL transgenic rabbits was not due to increased apo[a] synthesis. In conclusion, absence of a functional LDLr leads to a marked accumulation of plasma Lp[a] in human apo[a] transgenic WHHL rabbits and LDLr may participate in the catabolism of Lp[a] in rabbits.
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Affiliation(s)
- J Fan
- Department of Pathology, Institute of Basic Medical Sciences, University of Tsukuba, Tsukuba, 305-8575 Japan
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40
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Fan J, Challah M, Shimoyamada H, Watanabe T. Transgenic rabbits expressing human apolipoprotein(a) as a useful model for the study of lipoprotein(a). Ann N Y Acad Sci 2000; 902:347-51. [PMID: 10865861 DOI: 10.1111/j.1749-6632.2000.tb06336.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J Fan
- Department of Pathology, University of Tsukuba, Japan.
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Fan J, Araki M, Wu L, Challah M, Shimoyamada H, Lawn RM, Kakuta H, Shikama H, Watanabe T. Assembly of lipoprotein (a) in transgenic rabbits expressing human apolipoprotein (a). Biochem Biophys Res Commun 1999; 255:639-44. [PMID: 10049763 DOI: 10.1006/bbrc.1999.0242] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [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: 11/22/2022]
Abstract
The study of human lipoprotein (a) [Lp(a)] has been hampered due to the lack of appropriate animal models since apolipoprotein (a) [apo(a)] is found only in primates and humans. In addition, human apo(a) in transgenic mice can not bind to murine apoB to form Lp(a) particles. In this study, we generated three independent transgenic rabbits expressing human apo(a) in their plasma at 1.8-4.5 mg/dl. In the plasma of transgenic rabbits, unlike the plasma of transgenic mice, about 80% of the apo(a) was covalently associated with rabbit apo-B and was contained in the fractions with density 1.02-1.10 g/ml, indicating the formation of Lp(a). These results suggest that transgenic rabbits expressing human apo(a) exhibit efficient assembly of Lp(a) and can be used as an animal model for the study of human Lp(a).
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Affiliation(s)
- J Fan
- Department of Pathology, Institute of Basic Medical Sciences, University of Tsukuba, Tsukuba, 305-8575, Japan
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42
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Shigeta M, Nagata M, Shimoyamada H, Shibata S, Okuno S, Hamada H, Watanabe T. Prune-belly syndrome diagnosed at 14 weeks' gestation with severe urethral obstruction but normal kidneys. Pediatr Nephrol 1999; 13:135-7. [PMID: 10229001 DOI: 10.1007/s004670050580] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A fetus was diagnosed with prune-belly syndrome (PBS) found by ultrasound demonstration of cystomegaly at 12 weeks' gestation. Fetal urinary electrolyte and beta2-microglobulin concentrations at 14 weeks' gestation indicated a poor renal prognosis. The pregnancy was therefore terminated. An autopsy showed defects of the abdominal wall muscles and megalocystis caused by severe urethral obstruction. However, the kidneys were histologically normal. Together with previous reports, the present case suggests that renal dysplasia in PBS with severe uretheral obstruction may develop after 14 weeks' gestation. We discuss the possibility of preventing the development of renal dysplasia in PBS by early prenatal decompression of the obstructed fetal urinary tract.
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Affiliation(s)
- M Shigeta
- Department of Pediatrics, Tsukuba Soai Hospital, Japan
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Fujioka T, Nakada K, Osada H, Shimoyamada H, Noguchi T, Yamato M. [Case of right-sided traumatic diaphragmatic hernia in child]. Nihon Kyobu Geka Gakkai Zasshi 1983; 31:962-8. [PMID: 6619606] [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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44
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Hiekata T, Shimoyamada H, Ogata M, Soneda Y, Nakada K. [Multiple aneurysms of the left subclavian artery]. Kyobu Geka 1975; 28:787-90. [PMID: 1238823] [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: 12/26/2022]
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45
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Hiekata T, Kawada T, Shimoyamada H, Nakada K, Soneda Y. [Thoracoabdominal aortic aneurysm]. Kyobu Geka 1975; 29:197-201. [PMID: 1241418] [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: 12/26/2022]
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