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Asahina Y, Hinata M, Tanaka A, Oshio K, Ogawa H, Aihara M, Onodera H, Ushiku T. Transparency-enhancing technology allows the three-dimensional assessment of esophageal carcinoma obtained by endoscopic submucosal dissection. Esophagus 2024:10.1007/s10388-024-01055-x. [PMID: 38498095 DOI: 10.1007/s10388-024-01055-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/01/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Although much progress has been made in diagnosis of carcinomas, no established methods have been confirmed to elucidate their morphological features. METHODS Three-dimensional structure of esophageal carcinomas was assessed using transparency-enhancing technology. Endoscopically resected esophageal squamous cell carcinoma was fluorescently stained, optically cleared using a transparency-enhancing reagent called LUCID, and visualized using laser scanning microscopy. The resulting microscope images were converted to virtual HE images for observation using ImageJ software. RESULTS Microscopic observation and image editing enabled three-dimensional image reconstruction and conversion to virtual HE images. The structure of abnormal blood vessels in esophageal carcinoma recognized by endoscopy could be observed in the 3 dimensions. Squamous cell carcinoma and normal squamous epithelium could be distinguished in the virtual HE images. CONCLUSIONS The results suggested that transparency-enhancing technology and virtual HE images may be feasible for clinical application and represent a novel histopathological method for evaluating endoscopically resected specimens.
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Affiliation(s)
- Yuichi Asahina
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Munetoshi Hinata
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Asami Tanaka
- Photon Science Center, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan
| | - Kaori Oshio
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
- Department of Gastroenterology, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Haruki Ogawa
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
- Department of Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Makoto Aihara
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroshi Onodera
- Institute for Photon Science and Technology, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
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2
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Sato D, Tanaka S, Takami H, Takayanagi S, Rai Y, Hinata M, Katano A, Saito N. Histopathological, Demographic, and Clinical Signatures of Medulla Oblongata Germ Cell Tumors: A Case Report With the Review of Literature. Cureus 2024; 16:e51861. [PMID: 38327946 PMCID: PMC10848086 DOI: 10.7759/cureus.51861] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
The medulla oblongata is one of the rarest sites of occurrence for germ cell tumors (GCTs) of the central nervous system. As there is scant data regarding epidemiology, clinical presentations, optimal intervention, and long-term prognosis, we aimed to delineate the features of this rare entity by presenting our representative case and performing a quantitative review of the literature. A 24-year-old woman presented to our department with vertigo and swallowing difficulties. Magnetic resonance imaging revealed a homogenously enhanced exophytic lesion arising from the medulla oblongata and extending to the fourth ventricle. Surgical resection was performed and a histological diagnosis of pure germinoma was made. The patient underwent chemotherapy and whole-ventricular irradiation. No recurrence has been experienced for 4 months after the surgery. According to the literature, the prognosis of GCTs at the medulla oblongata seems no worse than those at typical sites. Striking features including occurrence at an older age, female preponderance, and a predominance of germinoma were noteworthy. The pattern of local recurrence suggests extensive radiation coverage is not a prerequisite. Special attention is needed for cardiac and respiratory functions as the main factors eliciting mortality.
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Affiliation(s)
- Daisuke Sato
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, JPN
| | - Shota Tanaka
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, JPN
| | - Hirokazu Takami
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, JPN
| | | | - Yurie Rai
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, JPN
| | - Munetoshi Hinata
- Department of Pathology and Diagnostic Pathology, The University of Tokyo Hospital, Tokyo, JPN
| | - Atsuto Katano
- Department of Radiology, The University of Tokyo Hospital, Tokyo, JPN
| | - Nobuhito Saito
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, JPN
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3
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Takeyasu S, Morita K, Saito S, Toho M, Oyama T, Obo T, Taoka K, Shimura A, Maki H, Shibata E, Watanabe Y, Suzuki F, Zhang L, Kobayashi H, Hinata M, Kurokawa M. Myeloid sarcoma and pathological fracture: a case report and review of literature. Int J Hematol 2023; 118:745-750. [PMID: 37707761 PMCID: PMC10673718 DOI: 10.1007/s12185-023-03656-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 08/17/2023] [Accepted: 08/23/2023] [Indexed: 09/15/2023]
Abstract
Myeloid sarcoma is a rare clinical entity that presents as an isolated proliferation of leukemic cells, concurrently with or at relapse of acute myeloid leukemia (AML), myelodysplastic syndromes/neoplasms (MDS), chronic myeloid leukemia (CML), and myeloproliferative neoplasm (MPN). Myeloid sarcoma disrupts the normal architecture of its surrounding tissues. When it forms in long bones, it can cause their pathological fracture. We recently experienced a rare case of MDS presenting with myeloid sarcoma in the femur that eventually resulted in its pathological fracture. Detailed chromosomal analysis of the bone marrow cells suggested emergence of myeloid sarcoma during the fast-paced progression of MDS just after acquiring trisomy 22. A comprehensive review of previous cases of myeloid sarcoma-associated pathological fracture indicated possible involvement of structural rearrangements of chromosomes 9 and 22. Management of myeloid sarcoma should continue to improve, and clinicians should note that myeloid sarcoma with specific chromosomal alterations needs extra medical attention to prevent pathological fracture.
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Affiliation(s)
- Sho Takeyasu
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Ken Morita
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Seitaro Saito
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Masanori Toho
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Takashi Oyama
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Takafumi Obo
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Kazuki Taoka
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Arika Shimura
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Hiroaki Maki
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Eisuke Shibata
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yusuke Watanabe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Fumio Suzuki
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Liuzhe Zhang
- Department of Orthopedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Kobayashi
- Department of Orthopedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Munetoshi Hinata
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
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4
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Hirata Y, Makino Y, Iida S, Katano H, Nagasawa S, Rokutan H, Hinata M, Iwasaki A, Yasunaga Y, Abe H, Ikemura M, Motomura A, Kira K, Kobayashi S, Tsuneya S, Torimitsu S, Yamamoto I, Nakagawa K, Hasegawa I, Akitomi S, Yajima D, Ushiku T, Saitoh H, Suzuki T, Iwase H. COVID-19 Analysis in Tissue Samples Acquired by Minimally Invasive Autopsy in Out-of-Hospital Deaths with Postmortem Degeneration. Jpn J Infect Dis 2023; 76:302-309. [PMID: 37394459 DOI: 10.7883/yoken.jjid.2023.140] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Minimally invasive autopsy (MIA) is an alternative to a full autopsy for the collection of tissue samples from patients' bodies using instruments such as a biopsy needle. MIA has been conducted in many cases of coronavirus disease 2019 (COVID-19) and has contributed to the elucidation of the disease pathogenesis. However, most cases analyzed are hospital deaths, and there are few reports on the application of MIA in out-of-hospital deaths with varying extents of post-mortem changes. In this study, MIA and autopsies were performed in 15 patients with COVID-19 2-30 days after death, including 11 out-of-hospital deaths. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome detection by reverse transcriptase quantitative polymerase chain reaction using MIA samples was mostly consistent with autopsy samples, particularly lung tissue, even in out-of-hospital cases. MIA had high sensitivity and specificity (> 0.80). Histological examination of lung tissue obtained by MIA showed characteristics of COVID-19 pneumonia, with 91% agreement with autopsy samples, whereas localization of SARS-CoV-2 protein in lung tissue was indicated by immunohistochemistry, with 75% agreement. In conclusion, these results suggest that MIA is applicable to out-of-hospital deaths due to COVID-19 with various postmortem changes, especially when autopsies are not available.
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Affiliation(s)
- Yuichiro Hirata
- Department of Pathology, National Institute of Infectious Diseases, Japan
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Japan
| | - Yohsuke Makino
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Japan
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Japan
| | - Shun Iida
- Department of Pathology, National Institute of Infectious Diseases, Japan
| | - Harutaka Katano
- Department of Pathology, National Institute of Infectious Diseases, Japan
| | - Sayaka Nagasawa
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Japan
| | - Hirofumi Rokutan
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Munetoshi Hinata
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Akiko Iwasaki
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Yoichi Yasunaga
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Hiroyuki Abe
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Masako Ikemura
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Ayumi Motomura
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Japan
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Japan
- Department of Forensic Medicine, International University of Health and Welfare, Japan
| | - Kei Kira
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Japan
| | - Susumu Kobayashi
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Japan
| | - Shigeki Tsuneya
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Japan
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Japan
| | - Suguru Torimitsu
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Japan
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Japan
| | - Isao Yamamoto
- Department of Forensic Medicine, Kanagawa Dental University, Japan
| | - Kimiko Nakagawa
- Department of Forensic Medicine, Kanagawa Dental University, Japan
| | - Iwao Hasegawa
- Department of Forensic Medicine, Kanagawa Dental University, Japan
| | - Shinji Akitomi
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Japan
- Japan Medical Association Research Institute, Japan
| | - Daisuke Yajima
- Department of Forensic Medicine, International University of Health and Welfare, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Hisako Saitoh
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Japan
- Department of Forensic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Tadaki Suzuki
- Department of Pathology, National Institute of Infectious Diseases, Japan
| | - Hirotaro Iwase
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Japan
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Japan
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5
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Kanemaru N, Nakai Y, Watadani T, Nakao T, Hinata M, Nakazawa A, Akamatsu N, Ushiku T, Hasegawa K, Abe O. Multimodal imaging findings of intrahepatic cholangiocarcinoma arising from a biliary adenofibroma: a case report with radiological-pathological correlation. Abdom Radiol (NY) 2023; 48:2469-2476. [PMID: 37074475 PMCID: PMC10333138 DOI: 10.1007/s00261-023-03908-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/30/2023] [Accepted: 03/30/2023] [Indexed: 04/20/2023]
Abstract
PURPOSE Biliary adenofibroma is a solid microcystic epithelial neoplasm in the liver, comprising microcystic and tubuloacinar glandular tissues lined by a non-mucin secreting biliary epithelium and supported by a fibrous stroma. It is an extremely rare benign tumor with potential for malignant transformation. Herein, we report the case of a 64-year-old woman diagnosed with intrahepatic cholangiocarcinoma arising from biliary adenofibroma. METHODS Imaging studies revealed a tumor of 50 mm diameter, consisting of two components in S1 of the liver. The ventral portion of the tumor showed an ill-defined mass with early peripheral and gradual centripetal enhancement invading to the middle hepatic vein on computed tomography (CT), diffusion restriction on magnetic resonance images, and high fluorine-18-2-deoxy-D-glucose (FDG) uptake on positron emission tomography, like conventional intrahepatic cholangiocarcinoma. The dorsal portion showed a well-defined and low-attenuated mass with heterogeneous early enhancement and partial wash-out on CT, marked hyperintensity on heavily T2-weighted images, and low FDG uptake. The patient subsequently underwent extended left hepatectomy. RESULTS Pathologically, the former was diagnosed as cholangiocarcinoma and the latter as biliary adenofibroma. We discuss the radiological-pathological correlation of the tumor with a literature review. CONCLUSION Preoperative diagnosis of biliary adenofibroma is extremely challenging; however, clinically, it is crucial not to miss the presence of malignant findings.
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Affiliation(s)
- Noriko Kanemaru
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yudai Nakai
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Takeyuki Watadani
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takahiro Nakao
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Munetoshi Hinata
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Akiko Nakazawa
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Nobuhisa Akamatsu
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tetsuo Ushiku
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kiyoshi Hasegawa
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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6
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Matsumoto H, Shinya Y, Miyawaki S, Shin M, Koizumi S, Sato D, Hinata M, Ikemura M, Kiyofuji S, Kin T, Iwanaga M, Shimizu M, Nakatomi H, Saito N. White epidermoid cyst transformation after stereotactic radiosurgery: illustrative case. J Neurosurg Case Lessons 2023; 5:CASE2376. [PMID: 37334973 PMCID: PMC10550655 DOI: 10.3171/case2376] [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] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/04/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND White epidermoid cysts (WECs) are a rare type of epidermoid cyst with atypical radiological features. The epidemiological aspects and mechanisms of their onset remain unknown. Herein, the authors report a unique case of WEC transformation from a typical epidermoid cyst after stereotactic radiosurgery (SRS), confirmed by radiological and pathological findings. OBSERVATIONS The case involved a 78-year-old man with a history of 2 surgeries for a left cerebellopontine angle typical epidermoid cyst 23 years earlier and SRS using the CyberKnife for recurrent trigeminal neuralgia (TN) 14 years earlier. The tumor with high intensity on T1-weighted imaging, low intensity on T2-weighted imaging, without restriction on diffusion-weighted imaging had gradually enlarged after SRS. Therefore, a salvage surgery was performed via a left suboccipital craniotomy, and the intraoperative findings showed a cyst with a brown, viscous liquid component, consistent with those of WECs. Histopathologically, keratin calcification and hemorrhage were identified, leading to a diagnosis of WEC. The postoperative course was uneventful, and the TN resolved. No tumor recurrence was recorded at 2 years postoperatively. LESSONS To the best of the authors' knowledge, this is the first world case of WEC transformation from a typical epidermoid cyst after SRS, confirmed by radiological and pathological findings. Radiation effects could have been involved in this transformation.
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Affiliation(s)
| | | | | | - Masahiro Shin
- Departments of Neurosurgery and
- Department of Neurosurgery, Teikyo University Hospital, Tokyo, Japan
| | | | | | | | - Masako Ikemura
- Pathology, The University of Tokyo Hospital, Tokyo, Japan
| | | | | | - Mototaro Iwanaga
- Department of Neurosurgery, Kanto Neurosurgical Hospital, Kumagaya, Japan; and
| | - Masahiro Shimizu
- Department of Neurosurgery, Kanto Neurosurgical Hospital, Kumagaya, Japan; and
| | - Hirofumi Nakatomi
- Departments of Neurosurgery and
- Department of Neurosurgery, Kyorin University Hospital, Tokyo, Japan
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Masuzawa H, Suzuki F, Amemiya S, Orimo K, Ishiura H, Hara R, Toda T, Nakazawa T, Honda A, Tanaka M, Hinata M, Abe O. A case of intravascular lymphoma presenting with a lesion in the splenium of the corpus callosum. Radiol Case Rep 2023; 18:1929-1932. [PMID: 36970234 PMCID: PMC10030823 DOI: 10.1016/j.radcr.2023.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/09/2023] [Accepted: 02/12/2023] [Indexed: 03/18/2023] Open
Abstract
Intravascular lymphoma (IVL) is difficult to diagnose because its clinical presentation and laboratory and imaging findings are nonspecific. Herein, we report a case of IVL presenting as a lesion in the splenium of the corpus callosum. A 52-year-old man attended the emergency department with a 2-week history of progressively worsening abnormal behavior and gait disturbance. Magnetic resonance imaging on admission revealed an oval lesion in the splenium of the corpus callosum. The follow-up magnetic resonance imaging performed 2 months after disease onset revealed multiple high-signal areas in the bilateral cerebral white matter on T2-weighted images and diffusion-weighted images. The blood test results showed an elevated level of lactate dehydrogenase and serum-soluble interleukin-2 receptor. These findings were compatible with the diagnosis of IVL. IVL is often difficult to diagnose due to a wide variety of clinical presentations and imaging findings.
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Affiliation(s)
- Haruka Masuzawa
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo City, Tokyo, 113-8655, Japan
- Corresponding author.
| | - Fumio Suzuki
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo City, Tokyo, 113-8655, Japan
| | - Shiori Amemiya
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo City, Tokyo, 113-8655, Japan
| | - Kenta Orimo
- Department of Neurology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, BunkyoCity, Tokyo, 113-8655, Japan
| | - Hiroyuki Ishiura
- Department of Neurology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, BunkyoCity, Tokyo, 113-8655, Japan
| | - Ryo Hara
- Department of Neurology, Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Tatsushi Toda
- Department of Neurology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, BunkyoCity, Tokyo, 113-8655, Japan
| | - Teruo Nakazawa
- Department of Neurology, Kashiwa Kousei General Hospital, 617 Shikoda, Kashiwa-shi, Chiba-ken 277-8551, Japan
| | - Akira Honda
- Department of Hematology and Oncology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo City, Tokyo, 113-8655, Japan
| | - Mariko Tanaka
- Department of Pathology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo City, Tokyo, 113-8655, Japan
| | - Munetoshi Hinata
- Department of Pathology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo City, Tokyo, 113-8655, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo City, Tokyo, 113-8655, Japan
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8
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Saitoh H, Sakai-Tagawa Y, Nagasawa S, Torimitsu S, Kubota K, Hirata Y, Iwatsuki-Horimoto K, Motomura A, Ishii N, Okaba K, Horioka K, Abe H, Ikemura M, Rokutan H, Hinata M, Iwasaki A, Yasunaga Y, Nakajima M, Yamaguchi R, Tsuneya S, Kira K, Kobayashi S, Inokuchi G, Chiba F, Hoshioka Y, Mori A, Yamamoto I, Nakagawa K, Katano H, Iida S, Suzuki T, Akitomi S, Hasegawa I, Ushiku T, Yajima D, Iwase H, Makino Y, Kawaoka Y. High titers of infectious SARS-CoV-2 in corpses of patients with COVID-19. Int J Infect Dis 2023; 129:103-109. [PMID: 36754229 PMCID: PMC9902281 DOI: 10.1016/j.ijid.2023.01.046] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/08/2022] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVES The prolonged presence of infectious SARS-CoV-2 in deceased patients with COVID-19 has been reported. However, infectious virus titers have not been determined. Such information is important for public health, death investigation, and handling corpses. The aim of this study was to assess the level of SARS-CoV-2 infectivity in the corpses of patients with COVID-19. METHODS We collected 11 nasopharyngeal swabs and 19 lung tissue specimens from 11 autopsy cases with COVID-19 in 2021. We then investigated the viral genomic copy number by real-time reverse transcription-polymerase chain reaction and infectious titers by cell culture and virus isolation. RESULTS Infectious virus was present in six of 11 (55%) cases, four of 11 (36%) nasopharyngeal swabs, and nine of 19 (47%) lung specimens. The virus titers ranged from 6.00E + 01 plaque-forming units/ml to 2.09E + 06 plaque-forming units/g. In all cases in which an infectious virus was found, the time from death to discovery was within 1 day and the longest postmortem interval was 13 days. CONCLUSION The corpses of patients with COVID-19 may have high titers of infectious virus after a long postmortem interval (up to 13 days). Therefore, appropriate infection control measures must be taken when handling corpses.
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Affiliation(s)
- Hisako Saitoh
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - Yuko Sakai-Tagawa
- Division of Virology, Department of Microbiology and Immunology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Sayaka Nagasawa
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Suguru Torimitsu
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazumi Kubota
- Department of Healthcare Information Management, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuichiro Hirata
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kiyoko Iwatsuki-Horimoto
- Division of Virology, Department of Microbiology and Immunology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Ayumi Motomura
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Legal Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Namiko Ishii
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Legal Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Keisuke Okaba
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Legal Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Kie Horioka
- Department of Legal Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Hiroyuki Abe
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masako Ikemura
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hirofumi Rokutan
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Munetoshi Hinata
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akiko Iwasaki
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoichi Yasunaga
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Makoto Nakajima
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Rutsuko Yamaguchi
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shigeki Tsuneya
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kei Kira
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Susumu Kobayashi
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Go Inokuchi
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Fumiko Chiba
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yumi Hoshioka
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Aika Mori
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Isao Yamamoto
- Department of Forensic Medicine, Kanagawa Dental University, Yokosuka, Japan; Public Interest Incorporated Association Nihon Kousei-Kyoukai, Yokosuka, Japan
| | - Kimiko Nakagawa
- Department of Forensic Medicine, Kanagawa Dental University, Yokosuka, Japan; Public Interest Incorporated Association Nihon Kousei-Kyoukai, Yokosuka, Japan
| | - Harutaka Katano
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shun Iida
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tadaki Suzuki
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shinji Akitomi
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Japan Medical Association Research Institute, Tokyo, Japan
| | - Iwao Hasegawa
- Department of Forensic Medicine, Kanagawa Dental University, Yokosuka, Japan; Public Interest Incorporated Association Nihon Kousei-Kyoukai, Yokosuka, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daisuke Yajima
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Legal Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Hirotaro Iwase
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yohsuke Makino
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihiro Kawaoka
- Division of Virology, Department of Microbiology and Immunology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan; Center for Global Viral Diseases, National Center for Global Health and Medicine, Tokyo, Japan; Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, USA
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9
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Nakamura M, Kanda S, Kajiho Y, Hinata M, Tomonaga K, Fujishiro J, Harita Y. A case of right hypodysplastic kidney and ectopic ureter associated with bicornuate uterus in a prepubertal girl. CEN Case Rep 2023; 12:122-129. [PMID: 36056295 PMCID: PMC9892399 DOI: 10.1007/s13730-022-00730-1] [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: 06/19/2022] [Accepted: 08/18/2022] [Indexed: 02/05/2023] Open
Abstract
Congenital anomalies of the kidney and urinary tract (CAKUT) are frequently associated with Mullerian anomalies. This can be explained by the fact that Mullerian duct elongation depends on the preformed Wolffian duct during embryogenesis. While CAKUT such as unilateral renal agenesis and multicystic dysplastic kidney are commonly identified prenatally by routine ultrasound, the diagnosis of Mullerian anomalies is often delayed, increasing the risk of complications such as endometriosis or pelvic inflammatory disease. Herein, we report a case of a premenarchal girl who had initially been diagnosed with right multicystic dysplastic kidney. She presented with continuous urinary incontinence at 4 years old and further evaluation by contrast-enhanced computed tomography, cystoscopy, colposcopy, ureterography, and hysterosalpingography led to the final diagnosis of right hypodysplastic kidney and ectopic ureter associated with bicornuate uterus. A strong family history of uterine malformations prompted the examination of the uterus. Genetic testing was suggested but the family declined. She is planned to be referred to a gynecologist at puberty for further assessment. The recognition and screening rate of concurrent Mullerian anomalies in CAKUT patients varies between institutions. Screening for Mullerian anomalies in prediagnosed CAKUT girls may enable to provide timely counseling and to prevent gynecological complications.
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Affiliation(s)
- Misako Nakamura
- Department of Pediatrics, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shoichiro Kanda
- Department of Pediatrics, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Yuko Kajiho
- Department of Pediatrics, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Munetoshi Hinata
- Department of Pathology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kotaro Tomonaga
- Department of Pediatric Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Jun Fujishiro
- Department of Pediatric Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yutaka Harita
- Department of Pediatrics, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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10
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Matsumoto Y, Kage H, Morota M, Zokumasu K, Ando T, Maemura K, Watanabe K, Kawakami M, Hinata M, Ushiku T, Nakajima J, Nagase T. Integrin alpha 2 is associated with tumor progression and postoperative recurrence in non-small cell lung cancer. Jpn J Clin Oncol 2023; 53:63-73. [PMID: 36151049 DOI: 10.1093/jjco/hyac148] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 08/29/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Integrins are transmembrane proteins that mediate cell adhesion to extracellular matrix. Whereas expression of integrin alpha 2 is associated with motility, invasiveness and cellular differentiation in various tumors, the role of integrin alpha 2 in lung cancer has not been studied in detail. The aim of this study was to determine whether and how aberrant integrin alpha 2 expression in non-small cell lung cancer leads to different outcomes. METHODS We measured expression of integrin alpha 2 by quantitative polymerase chain reaction in 100 samples collected from non-small cell lung cancer patients who had undergone surgical resection. We assigned patients to high and low expression groups and analyzed survival. Cellular morphology, adhesion, proliferation, migration and invasion were examined in human lung cancer cell lines. RESULTS Among 100 cases, 41 were female, with a median age of 71 years. High expression of integrin alpha 2 in non-small cell lung cancer was associated with lower recurrence-free survival (P = 0.004). Overexpression of integrin alpha 2 in cell lines had no effect on cell proliferation or invasion but resulted in increased cell size (1416 μm2 versus 470 μm2 in H522 cells, P < 0.001; 1822 μm2 versus 1029 μm2 in H661 cells, P = 0.02), adhesion (P < 0.001 in H522 and H661 cells) and migration (gap area filled was 71% versus 36% in H522 cells, P < 0.001; 57% versus 26% in H661 cells, P = 0.001). These changes were suppressed by E7820, an inhibitor of integrin alpha 2. CONCLUSIONS Integrin alpha 2 may play a significant role in lung cancer adhesion and migration, and may lead to a higher risk of recurrence.
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Affiliation(s)
- Yoko Matsumoto
- Department of Respiratory Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidenori Kage
- Next-Generation Precision Medicine Development Laboratory, The University of Tokyo, Tokyo, Japan
| | - Mizuki Morota
- Department of Thoracic Surgery, The University of Tokyo, Tokyo, Japan
| | - Koichi Zokumasu
- Department of Respiratory Medicine, The University of Tokyo, Tokyo, Japan
| | - Takahiro Ando
- Department of Respiratory Medicine, The University of Tokyo, Tokyo, Japan
| | - Keita Maemura
- Department of Respiratory Medicine, The University of Tokyo, Tokyo, Japan
| | - Kousuke Watanabe
- Department of Clinical Laboratory, The University of Tokyo, Tokyo, Japan
| | - Masanori Kawakami
- Department of Respiratory Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Tetsuo Ushiku
- Department of Pathology, The University of Tokyo, Tokyo, Japan
| | - Jun Nakajima
- Department of Thoracic Surgery, The University of Tokyo, Tokyo, Japan
| | - Takahide Nagase
- Department of Respiratory Medicine, The University of Tokyo, Tokyo, Japan
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11
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Kobayashi K, Sato M, Kawashima S, Yanagiya M, Nagano M, Konoeda C, Kitano K, Hinata M, Ikemura M, Shinozaki-Ushiku A, Nakajima J. Lung adenocarcinoma without stromal invasion accompanied by spread through alveolar spaces: A case report. Current Problems in Cancer: Case Reports 2022. [DOI: 10.1016/j.cpccr.2022.100204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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12
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Kakushima N, Hinata M, Ushiku T. White opaque substance in a non-neoplastic duodenal lesion. Dig Endosc 2022; 34:1495. [PMID: 35997616 DOI: 10.1111/den.14424] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 08/22/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Naomi Kakushima
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Munetoshi Hinata
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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13
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Hinata M, Ushiku T. Detecting immunotherapy-sensitive subtype in gastric cancer using histologic image-based deep learning. Sci Rep 2021; 11:22636. [PMID: 34811485 PMCID: PMC8608814 DOI: 10.1038/s41598-021-02168-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 11/09/2021] [Indexed: 12/16/2022] Open
Abstract
Immune checkpoint inhibitor (ICI) therapy is widely used but effective only in a subset of gastric cancers. Epstein–Barr virus (EBV)-positive and microsatellite instability (MSI) / mismatch repair deficient (dMMR) tumors have been reported to be highly responsive to ICIs. However, detecting these subtypes requires costly techniques, such as immunohistochemistry and molecular testing. In the present study, we constructed a histology-based deep learning model that aimed to screen this immunotherapy-sensitive subgroup efficiently. We processed whole slide images of 408 cases of gastric adenocarcinoma, including 108 EBV, 58 MSI/dMMR, and 242 other subtypes. Many images generated by data augmentation of the learning set were used for training convolutional neural networks to establish an automatic detection platform for EBV and MSI/dMMR subtypes, and the test sets of images were used to verify the learning outcome. Our model detected the subgroup (EBV + MSI/dMMR tumors) with high accuracy in test cases with an area under the curve of 0.947 (0.901–0.992). This result was slightly better than when EBV and MSI/dMMR tumors were detected separately. In an external validation cohort including 244 gastric cancers from The Cancer Genome Atlas database, our model showed a favorable result for detecting the “EBV + MSI/dMMR” subgroup with an AUC of 0.870 (0.809–0.931). In addition, a visualization of the trained neural network highlighted intraepithelial lymphocytosis as the ground for prediction, suggesting that this feature is a discriminative characteristic shared by EBV and MSI/dMMR tumors. Histology-based deep learning models are expected to be used for detecting EBV and MSI/dMMR gastric cancers as economical and less time-consuming alternatives, which may help to effectively stratify patients who respond to ICIs.
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Affiliation(s)
- Munetoshi Hinata
- Department of Pathology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Tetsuo Ushiku
- Department of Pathology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
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14
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Sone K, Inoue F, Taguchi A, Hinata M, Ikemura M, Miyamoto Y, Michihiro T, Ohno T, Iriyama T, Mori-Uchino M, Tsuruga T, Mishima M, Osuga Y. A case of difficult-to-diagnose non-invasive papillary squamous cell carcinoma of the uterine cervix infected with human papilloma virus 6: A diagnostic pitfall. Clin Case Rep 2021; 9:e04905. [PMID: 34631088 PMCID: PMC8489388 DOI: 10.1002/ccr3.4905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 02/06/2023] Open
Abstract
We encountered HPV6-positive cervical papillary squamous cancer (PSCC) that was difficult to diagnose. The case was initially diagnosed and treated for condyloma. To the best of our knowledge, this is the first report of HPV6 infection in PSCC.
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Affiliation(s)
- Kenbun Sone
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Futaba Inoue
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Ayumi Taguchi
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Munetoshi Hinata
- Department of pathology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Masako Ikemura
- Department of pathology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Yuichiro Miyamoto
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Tanikawa Michihiro
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | | | - Takayuki Iriyama
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Mayuyo Mori-Uchino
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Tetsushi Tsuruga
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Misako Mishima
- Department of pathology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
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15
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Murakami D, Maki H, Matsuda K, Masamoto Y, Suzuki F, Amemiya S, Osawa K, Hinata M, Ikemura M, Ushiku T, Kurokawa M. Cerebral toxoplasmosis complicating lymphoplasmacytic lymphoma in partial remission. J Infect Chemother 2021; 28:279-282. [PMID: 34580008 DOI: 10.1016/j.jiac.2021.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/20/2021] [Accepted: 09/05/2021] [Indexed: 10/20/2022]
Abstract
Toxoplasma gondii can develop toxoplasmic encephalitis (TE) in immunodeficient conditions such as AIDS and after organ transplantation. While some cases of TE with malignant lymphoma were reported, these cases occurred immediately after chemotherapy or when their diseases were active. Here we report the first Case of TE that occurred in patient who was in partial remission (PR) of lymphoplasmacytic lymphoma (LPL) for two years. A 76-year-old man was referred to our institute because of disturbance of consciousness, right arm weakness and paresthesia. A computed tomography (CT) scan detected multiple nodules in his brain. Magnetic resonance imaging (MRI) of the head detected multiple gadolinium-enhancing parenchymal lesions with hyperintense signals on T2-and diffusion-weighted images, located in both cerebral and cerebellar hemispheres. Blood test and cerebrospinal fluid (CSF) findings were unremarkable. His rapidly deteriorating consciousness precluded a chance of brain biopsy. Considering the limited efficacy of antimicrobials and the imaging findings that could be compatible with the diagnosis of malignant lymphoma, we suspected central nerve system (CNS) recurrence of LPL. Although chemotherapy was initiated, he died of respiratory failure just after chemotherapy. A pathological autopsy showed his cause of death was TE. To our knowledge, this is the first case of TE in long-term PR of malignant lymphoma. TE should be suspected when patients with malignant lymphoma present unexplained neurologic symptoms regardless of their treatment efficacy of lymphoma. (226/250 words).
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Affiliation(s)
- Daisuke Murakami
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Hiroaki Maki
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Kensuke Matsuda
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Yosuke Masamoto
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Fumio Suzuki
- Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Shiori Amemiya
- Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Kazuhiro Osawa
- Department of Pathology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Munetoshi Hinata
- Department of Pathology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Masako Ikemura
- Department of Pathology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Tetsuo Ushiku
- Department of Pathology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan; Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
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16
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Sakamoto A, Nozawa H, Sonoda H, Hinata M, Ishii H, Emoto S, Anzai H, Yokoyama Y, Murono K, Sasaki K, Kawai K, Ushiku T, Ishihara S. Rectal neuroendocrine tumor with extracapsular lymph node metastasis: a case report. Clin J Gastroenterol 2021; 14:1426-1430. [PMID: 34028785 DOI: 10.1007/s12328-021-01447-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/17/2021] [Indexed: 11/24/2022]
Abstract
The presence of extramural tumor deposits without lymph node structure (EX) is an important prognostic factor in patients with colorectal carcinoma. However, there is no English literature on neuroendocrine tumor (NET) with EX. We report a patient with rectal NET with extracapsular metastasis of a regional lymph node that was considered to be EX. A 51-year-old Japanese woman with diabetes was referred to our hospital for further examination of a submucosal tumor in the lower rectum. She was diagnosed as having rectal NET by immunohistochemical analysis of a biopsy, and underwent laparoscopic low anterior resection with lymph node dissection and covering ileostomy. Pathological findings of the resected specimen showed that the primary tumor was NET-G1 without any lymphatic or venous invasion. A single metastatic deposit was found near the capsule of a NET-negative regional lymph node. She has been free from recurrence for nine months without adjuvant treatments. Extracapsular metastasis of NET on a dissected lymph node in our case was considered to correspond to EX as defined for colorectal carcinoma. This rare case suggests that NET can disseminate to form EX in a similar manner to colorectal carcinoma.
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Affiliation(s)
- Akira Sakamoto
- Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Hiroaki Nozawa
- Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hirofumi Sonoda
- Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Munetoshi Hinata
- Department of Pathology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroaki Ishii
- Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shigenobu Emoto
- Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroyuki Anzai
- Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yuichiro Yokoyama
- Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Koji Murono
- Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kazuhito Sasaki
- Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kazushige Kawai
- Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tetsuo Ushiku
- Department of Pathology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Soichiro Ishihara
- Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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17
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Miyazawa R, Miyawaki S, Yamada K, Amemiya S, Ikemura M, Hinata M, Uchikawa H, Shiode T, Kin T, Takai K, Nakatomi H, Saito N. Retro-odontoid Pseudotumor: Two Cases of Intradural Ganglion Cysts Arising From the Odontoid Process with Syringobulbia. World Neurosurg 2020; 144:148-153. [PMID: 32827740 DOI: 10.1016/j.wneu.2020.08.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/16/2020] [Accepted: 08/16/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Ganglion cysts mostly occur in the knuckles and wrists, but they rarely present in the odontoid process and can cause neurological symptoms by compressing the spinal cord. They are mostly localized in the epidural space, but may very rarely appear in the intradural space. There are no reports of cases of intradural ganglion cyst involving syringobulbia. CASE DESCRIPTION We report the presentation and management of 2 cases of an intradural ganglion cyst of the odontoid process. Several treatment options for ganglion cysts of the odontoid process have been reported, such as rest and use of a neck collar, posterior decompression and fusion, and transoral anterior decompression. Because our 2 cases progressed rapidly and had severe neurological symptoms, surgical treatment was performed for rapid decompression and definitive pathological diagnosis. The mass was resected as much as possible using the lateral occipital fossa approach, and the operation was completed without dissection of the brain stem or manipulation of the syringobulbia. Postoperatively, neurological symptoms promptly improved, and the syringobulbia reduced. CONCLUSIONS For intradural ganglion cysts with syringobulbia, we suggest relief of the compression by resection of the mass and treatment of the syringobulbia in 2 stages, if necessary, to avoid the risk of damage to the brainstem.
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Affiliation(s)
- Ryota Miyazawa
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoru Miyawaki
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Keisuke Yamada
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shiori Amemiya
- Department of Radiology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masako Ikemura
- Department of Pathology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Munetoshi Hinata
- Department of Pathology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroki Uchikawa
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taketo Shiode
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taichi Kin
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keisuke Takai
- Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Hirofumi Nakatomi
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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Abstract
Immune checkpoint inhibitors (CPIs), including pembrolizumab, are becoming common oncological treatments. CPIs have been associated with a significant risk of developing immune-related adverse events (irAEs), such as nephritis and interstitial nephritis. However, the occurrence of glomerulonephritis has only rarely been reported. We herein present the case of a 75-year-old woman with non-small cell lung carcinoma (NSCLC) who developed proteinuria and microscopic hematuria during treatment with pembrolizumab. Renal biopsy revealed tubulointerstitial nephritis and IgA nephropathy. Considering that a urinalysis showed no abnormality before treatment, the condition might have been induced by pembrolizumab. In this report, we focus on the correct diagnosis and management of renal irAEs, which remain controversial.
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MESH Headings
- Aged
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antineoplastic Agents, Immunological/adverse effects
- Antineoplastic Agents, Immunological/therapeutic use
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Carcinoma, Non-Small-Cell Lung/physiopathology
- Clinical Protocols
- Female
- Glomerulonephritis, IGA/chemically induced
- Glomerulonephritis, IGA/physiopathology
- Humans
- Lung Neoplasms/drug therapy
- Lung Neoplasms/physiopathology
- Nephritis, Interstitial/chemically induced
- Nephritis, Interstitial/physiopathology
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Affiliation(s)
- Rikako Oki
- Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Japan
| | - Yosuke Hirakawa
- Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Japan
| | - Hitomi Kimura
- Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Japan
| | - Kenjiro Honda
- Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Japan
| | - Munetoshi Hinata
- Department of Pathology, The University of Tokyo Hospital, Japan
| | - Hiroyuki Abe
- Department of Pathology, The University of Tokyo Hospital, Japan
| | - Yukako Domoto
- Department of Pathology, The University of Tokyo Hospital, Japan
| | - Goh Tanaka
- Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Japan
| | - Takahide Nagase
- Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Japan
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, The University of Tokyo Hospital, Japan
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19
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Sasahara A, Tanabe M, Hayashi K, Konishi T, Oya M, Sakiyama K, Morizono A, Harada M, Otsuji K, Ishibashi Y, Sato A, Kikuchi Y, Niwa T, Hinata M, Nishioka K, Seto Y. A case of primary breast angiosarcoma with multiple discontinuous small lesions. Surg Case Rep 2019; 5:157. [PMID: 31654286 PMCID: PMC6814660 DOI: 10.1186/s40792-019-0704-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 09/11/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Angiosarcoma of the breast is rare. It carries a poor prognosis because of its high risk of local recurrence and distant metastases. Presently, there are still no established systemic therapies. Thus, the main treatment strategy for breast angiosarcoma is complete resection. This underscores the importance of closely monitoring the spread of the tumor lesion, particularly for multifocal angiosarcoma, and to plan an optimal operative procedure. We herein present the successful surgical treatment of a rare case of multifocal primary breast angiosarcoma. CASE PRESENTATION A 43-year-old woman visited our hospital with a growing lump on her right breast accompanied by pain. Clinical and radiological examinations revealed a well-circumscribed 40-mm-diameter tumor at the inner lower quadrant of her right breast. Histological examination of a needle biopsy specimen revealed angiosarcoma. Based on a precise evaluation of the tumor by contrast-enhanced MRI and contrast-enhanced CT scan, a wide local excision with sufficient margins was performed. In the resected specimen, three discontinuous small lesions of angiosarcoma were observed around the main tumor. Therefore, total mastectomy was additionally performed. Pathological examination revealed two other small nodules of angiosarcoma in the remnant right breast, which appeared to be close but not continuous to the defective part of the initial resection. Postoperative follow-up at 1 year showed no signs of recurrence or distant metastasis. Multifocal primary breast angiosarcoma is extremely rare with only two previous reports describing its multifocality. CONCLUSIONS Owing to its rarity, a standardized surgical treatment for breast angiosarcoma remains controversial. Our case suggests that primary breast angiosarcoma may occasionally present with multifocal tumor. Thus, it is important to keep in mind the multifocality of breast angiosarcoma when assessing its spread by diagnostic imaging and when planning the surgical strategy.
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Affiliation(s)
- Asako Sasahara
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Masahiko Tanabe
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kanako Hayashi
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takaaki Konishi
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mariko Oya
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kana Sakiyama
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Arisa Morizono
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mayumi Harada
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazutaka Otsuji
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuko Ishibashi
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ayaka Sato
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuko Kikuchi
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takayoshi Niwa
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Munetoshi Hinata
- Department of Pathology, The University of Tokyo Hospital, Tokyo, Japan
| | - Kotoe Nishioka
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuyuki Seto
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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20
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Nakagama Y, Inuzuka R, Ichimura K, Hinata M, Takehara H, Takeda N, Kakiuchi S, Shiraga K, Asakai H, Shindo T, Hirata Y, Saitoh M, Oka A. Accelerated Cardiomyocyte Proliferation in the Heart of a Neonate With LEOPARD Syndrome-Associated Fatal Cardiomyopathy. Circ Heart Fail 2019; 11:e004660. [PMID: 29602897 DOI: 10.1161/circheartfailure.117.004660] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yu Nakagama
- Department of Pediatrics (Y.N., R.I., H.T., S.K., K.S., H.A., T.S., Y.H., A.O.), Department of Pathology (K.I., M.H.), Department of Cardiovascular Medicine (N.T.), and Department of Developmental Medical Sciences (M.S.), Graduate School of Medicine, The University of Tokyo, Japan
| | - Ryo Inuzuka
- Department of Pediatrics (Y.N., R.I., H.T., S.K., K.S., H.A., T.S., Y.H., A.O.), Department of Pathology (K.I., M.H.), Department of Cardiovascular Medicine (N.T.), and Department of Developmental Medical Sciences (M.S.), Graduate School of Medicine, The University of Tokyo, Japan.
| | - Kayoko Ichimura
- Department of Pediatrics (Y.N., R.I., H.T., S.K., K.S., H.A., T.S., Y.H., A.O.), Department of Pathology (K.I., M.H.), Department of Cardiovascular Medicine (N.T.), and Department of Developmental Medical Sciences (M.S.), Graduate School of Medicine, The University of Tokyo, Japan
| | - Munetoshi Hinata
- Department of Pediatrics (Y.N., R.I., H.T., S.K., K.S., H.A., T.S., Y.H., A.O.), Department of Pathology (K.I., M.H.), Department of Cardiovascular Medicine (N.T.), and Department of Developmental Medical Sciences (M.S.), Graduate School of Medicine, The University of Tokyo, Japan
| | - Hiroki Takehara
- Department of Pediatrics (Y.N., R.I., H.T., S.K., K.S., H.A., T.S., Y.H., A.O.), Department of Pathology (K.I., M.H.), Department of Cardiovascular Medicine (N.T.), and Department of Developmental Medical Sciences (M.S.), Graduate School of Medicine, The University of Tokyo, Japan
| | - Norihiko Takeda
- Department of Pediatrics (Y.N., R.I., H.T., S.K., K.S., H.A., T.S., Y.H., A.O.), Department of Pathology (K.I., M.H.), Department of Cardiovascular Medicine (N.T.), and Department of Developmental Medical Sciences (M.S.), Graduate School of Medicine, The University of Tokyo, Japan
| | - Satsuki Kakiuchi
- Department of Pediatrics (Y.N., R.I., H.T., S.K., K.S., H.A., T.S., Y.H., A.O.), Department of Pathology (K.I., M.H.), Department of Cardiovascular Medicine (N.T.), and Department of Developmental Medical Sciences (M.S.), Graduate School of Medicine, The University of Tokyo, Japan
| | - Kazuhiro Shiraga
- Department of Pediatrics (Y.N., R.I., H.T., S.K., K.S., H.A., T.S., Y.H., A.O.), Department of Pathology (K.I., M.H.), Department of Cardiovascular Medicine (N.T.), and Department of Developmental Medical Sciences (M.S.), Graduate School of Medicine, The University of Tokyo, Japan
| | - Hiroko Asakai
- Department of Pediatrics (Y.N., R.I., H.T., S.K., K.S., H.A., T.S., Y.H., A.O.), Department of Pathology (K.I., M.H.), Department of Cardiovascular Medicine (N.T.), and Department of Developmental Medical Sciences (M.S.), Graduate School of Medicine, The University of Tokyo, Japan
| | - Takahiro Shindo
- Department of Pediatrics (Y.N., R.I., H.T., S.K., K.S., H.A., T.S., Y.H., A.O.), Department of Pathology (K.I., M.H.), Department of Cardiovascular Medicine (N.T.), and Department of Developmental Medical Sciences (M.S.), Graduate School of Medicine, The University of Tokyo, Japan
| | - Yoichiro Hirata
- Department of Pediatrics (Y.N., R.I., H.T., S.K., K.S., H.A., T.S., Y.H., A.O.), Department of Pathology (K.I., M.H.), Department of Cardiovascular Medicine (N.T.), and Department of Developmental Medical Sciences (M.S.), Graduate School of Medicine, The University of Tokyo, Japan
| | - Makiko Saitoh
- Department of Pediatrics (Y.N., R.I., H.T., S.K., K.S., H.A., T.S., Y.H., A.O.), Department of Pathology (K.I., M.H.), Department of Cardiovascular Medicine (N.T.), and Department of Developmental Medical Sciences (M.S.), Graduate School of Medicine, The University of Tokyo, Japan
| | - Akira Oka
- Department of Pediatrics (Y.N., R.I., H.T., S.K., K.S., H.A., T.S., Y.H., A.O.), Department of Pathology (K.I., M.H.), Department of Cardiovascular Medicine (N.T.), and Department of Developmental Medical Sciences (M.S.), Graduate School of Medicine, The University of Tokyo, Japan
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21
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Ishida M, Gonoi W, Shirota G, Okuma H, Yamazawa S, Hinata M, Hayashi A, Fukayama M, Abe O. Diffusely decreased liver attenuation on post-mortem computed tomography: Comparison with ante-mortem computed tomography and autopsy findings. Journal of Forensic Radiology and Imaging 2019; 16:1-4. [DOI: 10.1016/j.jofri.2018.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
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22
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Ebisawa K, Masamoto Y, Tokushige J, Nishi H, Honda K, Hinata M, Toyama K, Nangaku M, Kurokawa M. Tocilizumab for focal segmental glomerulosclerosis secondary to multicentric Castleman's disease. Ann Hematol 2019; 98:1995-1997. [PMID: 30761408 DOI: 10.1007/s00277-019-03616-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 01/14/2019] [Indexed: 01/09/2023]
Affiliation(s)
- Kazutoshi Ebisawa
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yosuke Masamoto
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Junji Tokushige
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroshi Nishi
- Department of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kenjiro Honda
- Department of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Munetoshi Hinata
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kazuhiro Toyama
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Masaomi Nangaku
- Department of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan. .,Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-8655, Japan.
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23
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Matsuki R, Okuda K, Mitani A, Yamauchi Y, Tanaka G, Kume H, Homma Y, Hinata M, Hayashi A, Shibahara J, Fukayama M, Nagase T. A case of delayed exacerbation of interstitial lung disease after discontinuation of temsirolimus. Respir Med Case Rep 2017; 22:158-163. [PMID: 28840097 PMCID: PMC5558510 DOI: 10.1016/j.rmcr.2017.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 06/16/2017] [Revised: 08/07/2017] [Accepted: 08/08/2017] [Indexed: 01/29/2023] Open
Abstract
Temsirolimus is an inhibitor of mammalian target of rapamycin and interstitial lung disease (ILD) is known to be one of the adverse events associated with temsirolimus, which usually improves rapidly after discontinuation of the drug and rarely worsens thereafter. Herein, we report a case of delayed exacerbation of ILD after discontinuation of temsirolimus for metastatic renal cell carcinoma in an 86-year-old male with chronic ILD. The patient developed gradually worsening dyspnea five weeks after an initiation of temsirolimus and was admitted to our facility. On his admission, although a pulmonary function test revealed a decreased diffusion capacity, there was no obvious progression of ILD on HRCT scan. His dyspnea once improved after discontinuation of temsirolimus, but it recurred and acute exacerbation of ILD was diagnosed 40 days after his last administration of temsirolimus. He received high-dose steroid therapy, however, he deteriorated and died. Histopathological examination of the lungs at autopsy revealed overlapping diffuse alveolar damage with chronic interstitial changes. In the present case, since there were no specific factors that could have caused acute exacerbation of ILD except for temsirolimus, it was considered to contribute to the exacerbation of underlying ILD. In conclusion, physicians should be aware of the possibility of temsirolimus-induced ILD not only while the medication is administered, but also even after it is discontinued. It is important to carefully interview the patient and to recognize the value of physiological tests, such as respiratory function tests and blood gas analysis, as well as imaging findings on HRCT.
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Key Words
- AaDO2, alveolar-arterial oxygen gradient
- Acute exacerbation
- CMV, cytomegalovirus
- CRP, C-reactive protein
- DAD, diffuse alveolar damage
- DILD, Drug-induced interstitial lung disease
- DLCO/VA, diffusion capacity for carbon monoxide corrected for alveolar volume
- Drug-induced pneumonia
- GGO, ground glass opacities
- HRCT, high resolution computed tomography
- ILD, interstitial lung disease
- IPF, idiopathic pulmonary fibrosis
- Interstitial lung disease
- KL-6, Krebs von den Lungen-6
- LD, lactate dehydrogenase
- NPPV, noninvasive negative pressure ventilation
- PaCO2, carbon dioxide partial pressure
- PaO2, oxygen partial pressure
- Temsirolimus
- UIP, usual interstitial pneumonia
- mPSL, methylprednisolone
- mTOR inhibitor
- mTOR, mammalian target of rapamycin
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Affiliation(s)
- Rei Matsuki
- Department of Respiratory Medicine, The University of Tokyo Hospital, Japan
| | - Kenichi Okuda
- Department of Respiratory Medicine, The University of Tokyo Hospital, Japan
| | - Akihisa Mitani
- Department of Respiratory Medicine, The University of Tokyo Hospital, Japan
| | - Yasuhiro Yamauchi
- Department of Respiratory Medicine, The University of Tokyo Hospital, Japan
| | - Goh Tanaka
- Department of Respiratory Medicine, The University of Tokyo Hospital, Japan
| | - Haruki Kume
- Department of Urology, The University of Tokyo Hospital, Japan
| | - Yukio Homma
- Department of Urology, The University of Tokyo Hospital, Japan
| | - Munetoshi Hinata
- Department of Pathology, The University of Tokyo Hospital, Japan
| | - Akimasa Hayashi
- Department of Pathology, The University of Tokyo Hospital, Japan
| | - Junji Shibahara
- Department of Pathology, The University of Tokyo Hospital, Japan
| | - Masashi Fukayama
- Department of Pathology, The University of Tokyo Hospital, Japan
| | - Takahide Nagase
- Department of Respiratory Medicine, The University of Tokyo Hospital, Japan
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24
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Arakawa S, Kage H, Chino H, Hinata M, Hayashi A, Toya T, Noguchi S, Ushiku T, Yamauchi Y, Kurokawa M, Fukayama M, Nagase T. Reversion of serum VZV-IgG antibody preceding disseminated visceral varicella zoster after hematopoietic stem cell transplantation. Ann Hematol 2016; 96:529-530. [PMID: 27844105 DOI: 10.1007/s00277-016-2876-7] [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: 09/21/2016] [Accepted: 11/06/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Sayaka Arakawa
- Department of Respiratory Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hidenori Kage
- Department of Respiratory Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Haruka Chino
- Department of Respiratory Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | | | - Akimasa Hayashi
- Department of Pathology, The University of Tokyo, Tokyo, Japan
| | - Takashi Toya
- Department of Hematology and Oncology, The University of Tokyo, Tokyo, Japan
| | - Satoshi Noguchi
- Department of Respiratory Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tetsuo Ushiku
- Department of Pathology, The University of Tokyo, Tokyo, Japan
| | - Yasuhiro Yamauchi
- Department of Respiratory Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, The University of Tokyo, Tokyo, Japan
| | | | - Takahide Nagase
- Department of Respiratory Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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25
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Nakamura K, Yoshizaki A, Takahashi T, Saigusa R, Taniguchi T, Asano Y, Gonoi W, Hinata M, Shinozaki-Ushiku A, Sato S. The first case report of fatal acute pulmonary dysfunction in a systemic sclerosis patient treated with rituximab. Scand J Rheumatol 2016; 45:249-50. [PMID: 26727543 DOI: 10.3109/03009742.2015.1102963] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- K Nakamura
- Department of Dermatology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - A Yoshizaki
- Department of Dermatology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - T Takahashi
- Department of Dermatology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - R Saigusa
- Department of Dermatology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - T Taniguchi
- Department of Dermatology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Y Asano
- Department of Dermatology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - W Gonoi
- Department of Radiology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - M Hinata
- Department of Pathology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - A Shinozaki-Ushiku
- Department of Pathology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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Hinata M, Someya T, Yoshizaki H, Seki K, Takeuchi K. Successful treatment of steroid-resistant Weber–Christian disease with biliary ductopenia using cyclosporin A. Rheumatology (Oxford) 2005; 44:821-3. [PMID: 15757971 DOI: 10.1093/rheumatology/keh576] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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27
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Okada H, Kamino Y, Shimo M, Kitamura E, Katoh T, Nishimura H, Akimoto Y, Kaneda T, Hinata M, Yamamoto H. Metastatic hepatocellular carcinoma of the maxillary sinus: a rare autopsy case without lung metastasis and a review. Int J Oral Maxillofac Surg 2003; 32:97-100. [PMID: 12653243 DOI: 10.1054/ijom.2002.0242] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [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: 11/18/2022]
Abstract
A rare case of metastatic hepatocellular carcinoma (HCC) of the maxillary sinus in a 67-year-old man is reported along with the findings at autopsy. A fine needle aspiration biopsy specimen revealed a characteristic tumour structure resembling primary HCC. At autopsy, metastatic lesions were recognized in the bilateral adrenals, spleen, sternum, vertebrae and lymph node at the lesser curvature of the stomach, but not in the lung, suggesting that the HCC had metastasized to the maxillary sinus via the plexus venous vertebralis and/or the azygos vein, or lymph duct. In our reviewed 29 cases of metastatic HCC in the oro-maxillofacial region, most patients were men in the 50- to 70-year age range. At least 11 cases did not have lung metastasis, and in 18, metastasis to the oro-maxillofacial region was the first sign of HCC. One should be aware of the possibility to encounter the oral lesion as first sign of metastatic HCC.
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Affiliation(s)
- H Okada
- Department of Pathology, Nihon University School of Dentistry at Matsudo, Chiba, Japan.
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28
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Kikkawa E, Hinata M, Keng VW, Myint Z, Sato A, Yamada K, Tanaka T, Noguchi T. Sp family members stimulate transcription of the hex gene via interactions with GC boxes. J Biochem 2001; 130:885-91. [PMID: 11726291 DOI: 10.1093/oxfordjournals.jbchem.a003062] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The 5'-flanking region of the mouse Hex gene was examined in order to identify transcription factors regulating its expression in hepatocytes and haematopoietic cells. We have identified two further GC boxes (GC boxes 3 and 4 at nucleotide positions -149 to -140 and -79 to -70, respectively), i.e. in addition to the two previously determined ones (GC boxes 1 and 2 at nucleotide positions -197 to -188 and -176 to -167, respectively). Luciferase reporter assays revealed that all four GC boxes are transcriptionally active in both MH(1)C(1) rat hepatoma and K562 human chronic myelogenous leukemia cells. Electrophoretic mobility shift assays with specific competitors and antibodies showed that members of the Sp family, namely Sp1 and Sp3, bind to these GC boxes. Overexpression of Sp1 and Sp3 in Drosophila SL2 cells stimulated transcription of the Hex gene through interactions with GC boxes 1 to 4, Sp1 being a more potent activator than Sp3. Thus, we conclude that Sp1 and Sp3 stimulate transcription of the Hex gene in both MH(1)C(1) and K562 cells.
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Affiliation(s)
- E Kikkawa
- Graduate School of Bioagricultural Sciences, Nagoya University, Chikusa-ku, Nagoya 464-8601, Japan
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29
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Kikuchi Y, Nagata Y, Hinata M, Kimbara K, Fukuda M, Yano K, Takagi M. Identification of the bphA4 gene encoding ferredoxin reductase involved in biphenyl and polychlorinated biphenyl degradation in Pseudomonas sp. strain KKS102. J Bacteriol 1994; 176:1689-94. [PMID: 8132464 PMCID: PMC205256 DOI: 10.1128/jb.176.6.1689-1694.1994] [Citation(s) in RCA: 48] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The nucleotide sequence of the downstream region of the bph operon from Pseudomonas sp. strain KKS102 was determined. Two open reading frames (ORF1 and ORF2) were found in this region, and the deduced amino acid sequence of ORF2 showed homology with the sequences of four ferredoxin reductases of dioxygenase systems. When this region was inserted just upstream of the bph operon, which does not contain a gene encoding ferredoxin reductase, biphenyl dioxygenase activity was detected. The 24- and 44-kDa polypeptides predicted from the two open reading frames were identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Crude extract which contained the products of ORF2 and bphA1A2A3 showed cytochrome c reduction activity. These data clearly suggest that ORF2 encodes ferredoxin reductase. The deduced amino acid sequence of ORF1 does not show significant homology with the sequences of any other proteins in the SWISS-PROT data bank, and the function of ORF1 is unknown.
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Affiliation(s)
- Y Kikuchi
- Department of Agricultural Chemistry, University of Tokyo, Japan
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