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Irie Y, Wakabayashi H, Matuzawa Y, Hiruta N, Kaneko K. A Case of Anti-Synthetase Syndrome With Anti-Glycyl tRNA Synthetases Antibody Developed After COVID-19. Cureus 2024; 16:e58004. [PMID: 38738103 PMCID: PMC11087665 DOI: 10.7759/cureus.58004] [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: 04/10/2024] [Indexed: 05/14/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a life-threatening respiratory disease characterized by severe acute infection. In some cases, COVID-19 symptoms may persist for a long term, posing a significant social problem. Long-term COVID-19 symptoms resemble those observed in various autoimmune diseases, such as dermatomyositis and polymyositis. In this report, we present the case of a 55-year-old woman who had been experiencing persistent dyspnea on exertion since contracting COVID-19 a month ago and was subsequently diagnosed with anti-synthetase syndrome (ASS). The patient presented with fever, dyspnea, rash, mechanic's hands, and arthritis. Computed tomography imaging revealed findings indicative of interstitial pneumonia. Immunological test results were positive for anti-EJ antibody, leading to a diagnosis of ASS based on Solomon's established criteria. The patient's condition improved following treatment with prednisolone, tacrolimus, and intravenous cyclophosphamide. Pathological findings of transbronchial biopsy revealed nonspecific interstitial pneumonia with organizing pneumonia, leading to speculation that ASS had developed after COVID-19. Given the scarcity of reports on ASS development post COVID-19, we conducted a literature review and compared our present case to previous ones. This report highlights the importance of considering ASS in the differential diagnosis of patients with long-term COVID-19 symptoms.
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Affiliation(s)
- Yusuke Irie
- Respiratory Medicine, Toho University Sakura Medical Center, Sakura-shi, JPN
| | - Hiroki Wakabayashi
- Respiratory Medicine, Toho University Sakura Medical Center, Sakura-shi, JPN
| | - Yasuo Matuzawa
- Respiratory Medicine, Toho University Sakura Medical Center, Sakura-shi, JPN
| | - Nobuyuki Hiruta
- Pathology and Laboratory Medicine, Toho University Sakura Medical Center, Sakura-shi, JPN
| | - Kaichi Kaneko
- Rheumatology, Toho University Sakura Medical Center, Sakura-shi, JPN
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2
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Kurata R, Hiruta N, Kaneko K. Minocycline-induced vasculitis. Clin Rheumatol 2024; 43:815-816. [PMID: 37824035 DOI: 10.1007/s10067-023-06788-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/13/2023]
Affiliation(s)
- Rika Kurata
- Department of Internal Medicine, Narita Red Cross, Iida-Cho, Narita, Chiba, 286-8523, Japan
- Division of Rheumatology, Department of Internal Medicine, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan
| | - Kaichi Kaneko
- Division of Rheumatology, Department of Internal Medicine, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan.
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3
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Namba K, Sakai D, Mikamo H, Sugizaki Y, Sugiura Y, Hiruta N, Matsuzawa Y, Kaneko K. Serum IgG4-negative IgG4-related disease with a cardiac mass: A case report. Medicine (Baltimore) 2023; 102:e34533. [PMID: 37543826 PMCID: PMC10402970 DOI: 10.1097/md.0000000000034533] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2023] Open
Abstract
RATIONALE Although IgG4-related disease (IgG4-RD) can affect various organs, its association with a cardiac mass is exceptionally rare. Here, we report a case of a woman with IgG4-RD and a cardiac mass and discuss 10 similar cases reported previously. PATIENT CONCERNS A 65-year-old woman was referred to our hospital for chest discomfort and back pain. DIAGNOSES In accordance with the 2019 ACR/EULAR diagnostic criteria for IgG4-RD, she was diagnosed with IgG4-RD based on dense lymphocytic infiltration on histopathology, IgG/IgG4-positive cell ratio <40%, >10/hpf IgG4-positive cells on immunostaining, and paraspinal zone soft tissue lesions in the chest. INTERVENTIONS An external pacemaker was implanted for the complete atrioventricular block on the electrocardiogram. After the diagnosis of IgG4-RD, she was treated with glucocorticoids and rituximab. OUTCOMES She remains under observation without disease recurrence. LESSONS IgG4-RD are usually treated with glucocorticoids; however, in cases of a cardiac mass, life-threatening complications may occur and surgery is often needed. Combination therapy with glucocorticoids and rituximab may be effective even in patients with IgG4-RD and cardiac mass, which may avoid the need of invasive treatments, such as surgery.
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Affiliation(s)
- Kensuke Namba
- Division of Rheumatology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
- Division of Respiratory Medicine, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Daiki Sakai
- Division of Rheumatology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
- Division of Respiratory Medicine, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Hiroshi Mikamo
- Division of Cardiology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Yuta Sugizaki
- Division of Cardiology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Yoshiya Sugiura
- Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Yasuo Matsuzawa
- Division of Respiratory Medicine, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Kaichi Kaneko
- Division of Rheumatology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
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4
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Wakabayashi H, Iwayanagi M, Sakai D, Sugiura Y, Hiruta N, Matsuzawa Y, Kaneko K. Development of giant cell arteritis after vaccination against SARS-CoV2: A case report and literature review. Medicine (Baltimore) 2023; 102:e33948. [PMID: 37266628 DOI: 10.1097/md.0000000000033948] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
RATIONALE Giant cell arteritis (GCA) is an autoimmune vasculitis that affects large and medium-sized blood vessels. The mRNA vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has been associated with the development of immune-mediated diseases. In this article, we present a case of GCA that developed after vaccination against SARS-CoV2. PATIENT CONCERNS A 77-year-old man developed fever, general fatigue, and headache 1 day after the third dose of vaccination against SARS-CoV2. Nodular swelling and tenderness of the bilateral temporal arteries were observed. DIAGNOSES Although right temporal artery biopsies were negative, the patient was diagnosed with GCA based on criteria established by the American College of Rheumatology for the classification of GCA. INTERVENTIONS The patient received methylprednisolone 1000 mg for 3 days. This was followed by prednisolone 1 mg/kg/d, which was decreased by 10 mg every week to 30 mg. From day 16 of hospitalization, the patient received tocilizumab 162 mg/wk every other week. OUTCOMES There was no occurrence of acute side effects. After 38 days of treatment, the condition improved and the patient was discharged from the hospital; as stated above, the dose of prednisolone was tapered to 30 mg/d. LESSONS We experienced a case of GCA that occurred immediately after vaccination against SARS-CoV2 with an mRNA vaccine. Early signs of GCA include fever, fatigue, and headache, and often resemble those noted after vaccination against SARS-CoV2. The potential presence of GCA should be determined in individuals with persistent fever and headache after vaccination against SARS-CoV2.
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Affiliation(s)
- Hiroki Wakabayashi
- Division of Respiratory Medicine, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Misa Iwayanagi
- Division of Respiratory Medicine, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
- Division of Rheumatology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Daiki Sakai
- Division of Respiratory Medicine, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
- Division of Rheumatology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Yoshiya Sugiura
- Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Yasuo Matsuzawa
- Division of Respiratory Medicine, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Kaichi Kaneko
- Division of Rheumatology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
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5
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Matsuno T, Mikami T, Hayashi H, Funahashi K, Okazumi S, Hiruta N, Shibuya K, Igarashi Y. Estrogen receptor beta expression in colitis-associated carcinoma in comparison with sporadic colonic tumor: An immunohistochemical study. JGH Open 2023; 7:110-117. [PMID: 36852140 PMCID: PMC9958341 DOI: 10.1002/jgh3.12859] [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: 11/10/2021] [Revised: 12/14/2022] [Accepted: 12/22/2022] [Indexed: 01/06/2023]
Abstract
Background and Aim The rate of ulcerative colitis (UC)-related colorectal cancer (colitis-associated carcinoma) is increasing. Estrogen receptor (ER) beta expression has been studied separately in patients with sporadic colorectal cancer and those with colitis-associated carcinoma. However, no study has compared the expression in both of these cancer types. The present study aimed to evaluate the relationship between colitis-associated carcinoma and ERs and assess whether the expression of ER beta influences cell proliferation. Methods This study included 45 surgically operated colitis-associated carcinomas, 43 high-grade dysplasias, 34 low-grade dysplasias, 36 sporadic colorectal cancers, 44 high-grade adenomas, and 34 low-grade adenomas. ER beta expression was evaluated with immunohistochemistry. Results Colitis-associated carcinoma showed significantly lower ER beta immunoexpression than sporadic colorectal lesions and high- and low-grade dysplasia. In seven colitis-associated carcinoma harboring both intensity score 3 (strong immunoexpression) and score 1 (weak immunoexpression) areas, the correlation among ER beta intensity, Ki-67, and p21 labeling index was assessed; an area with an ER beta intensity score of 3 showed a higher Ki-67 labeling index than that with score 1. In four out of the seven lesions, p21 labeling index was higher in the area of ER beta score 1 than in that of ER beta score 3. Conclusions The data suggest that ER beta expression is an accelerating factor in colorectal tumors. This association may be lower in colitis-associated carcinoma than in sporadic colorectal cancer.
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Affiliation(s)
- Takahisa Matsuno
- Division of Gastroenterology and Hepatology, Department of Internal MedicineToho University Omori Medical CenterTokyoJapan
| | - Tetuo Mikami
- Department of PathologyToho University School of MedicineTokyoJapan
| | - Hiroyuki Hayashi
- Department of PathologyYokohama Municipal Citizen's HospitalYokohamaJapan
| | | | - Shinichi Okazumi
- Department of SurgeryToho University Sakura Medical CenterSakuraJapan
| | - Nobuyuki Hiruta
- Department of Surgical PathologyToho University Sakura Medical CenterSakuraJapan
| | - Kazutoshi Shibuya
- Department of Surgical PathologyToho University School of MedicineTokyoJapan
| | - Yoshinori Igarashi
- Division of Gastroenterology and Hepatology, Department of Internal MedicineToho University Omori Medical CenterTokyoJapan
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6
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Tanaka H, Sakakibara M, Hiratsuka M, Sugiura Y, Hiruta N. [Improved QOL in a Case of Breast Cancer with Meningeal Carcinomatosis Treated with Radiation Therapy and Intrathecal Chemotherapy]. Gan To Kagaku Ryoho 2022; 49:1938-1940. [PMID: 36733050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A 50's woman was diagnosed with left local-advanced breast cancer(pT4bN2aM0, stage ⅢB, estrogen-receptor positive and human epidermal growth factor-2 negative)in 2016. Neoadjuvant therapy consisting of 4 courses of epirubicin plus cyclophosphamide and 4 courses of docetaxel were administered. After neoadjuvant therapy, a mastectomy with axillary node dissection was performed. And after surgery, she was received radiation and endocrine therapy. In May 2019, multiple bone metastases were detected. We administered endocrine therapy. In February 2020, she developed leg paralysis and malignant cells were collected from the cerebrospinal fluid. She was diagnosed with meningeal carcinomatosis without brain metastasis from breast cancer. To improve quality of life, we started radiation therapy, intrathecal chemotherapy and systemic chemotherapy. After 3 months of these therapies, leg paralysis was improved and quality of life was maintained for 9 months. Herein, we report a case of meningeal carcinomatosis without brain metastasis from breast cancer which is improved by radiation therapy, intrathecal chemotherapy and systemic chemotherapy.
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7
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Otsuka-Kamakura N, Sugiura Y, Yamazaki T, Shimizu N, Hiruta N. Case report: Plasmablastic neoplasm with multinucleated giant cells—Analysis of stemness of the neoplastic multinucleated giant cells. Front Oncol 2022; 12:1023785. [DOI: 10.3389/fonc.2022.1023785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/02/2022] [Indexed: 11/30/2022] Open
Abstract
Cancer stem cells have the capability of self-renewal and multipotency and are, therefore, associated with tumor heterogeneity, resistance to chemoradiation therapy, and metastasis. The hypothesis that multinucleated giant cells, which often emerge following chemo- and/or radiotherapy, serve as cancer stem cells has not been fully evaluated. Although a previous study demonstrated that these cells functioned as stem cells, only low levels of Yamanaka factors were expressed, contrasting with the high expression seen from their gestated first-generation mononuclear cells. Herein, we report a case of a plasmablastic neoplasm with multinucleated giant cells that were analyzed for stemness to test the above hypothesis. The patient was a male in his 80s who had a plasmablastic neoplasm that was not easily distinguishable as plasmablastic lymphoma versus plasma cell myeloma of plasmablastic type. Lymph node biopsy showed predominant mononuclear cell proliferation with admixed multinucleated giant cells. Immunohistochemistry and in situ hybridization showed that both multinucleated and mononuclear cells had the same profile: CD138(+), light chain restriction of κ>λ, cyclin D1(+), CD68(-), EBER-ISH (+). These results suggested that both cell types were neoplastic. In accordance with the previous study, the multinucleated giant cells showed low expression of Yamanaka factors, which were highly expressed in some of the mononuclear cells. Furthermore, the multinucleated giant cells showed a much lower proliferative activity (Mib1/Ki67 index) than the mononuclear cells. Based on these results, the multinucleated giant cells were compatible with cancer stem cells. This case is expected to expand the knowledge base regarding biology of cancer stem cells.
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8
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Sato A, Sato Y, Hiruta N, Oshiro T, Yoshida Y, Urita T, Kitahara T, Kadoya K, Nabekura T, Moriyama Y, Okazumi S. Signet-ring cell carcinoma of the appendix with ganglioneuromatosis: a case report. Surg Case Rep 2022; 8:151. [PMID: 35927360 PMCID: PMC9352829 DOI: 10.1186/s40792-022-01509-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/22/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Primary cancer of the appendix, especially signet-ring cell carcinoma, is an uncommon disease, and it is rarely suspected before surgery. Diffuse intestinal ganglioneuromatosis that is not associated with neurofibromatosis-1 or multiple endocrine neoplasia 2b is also rare. The most frequent symptoms caused by it are changes in bowel habits, abdominal pain, and occlusive episodes.
Case presentation
The patient was a 48-year-old woman who had a month-long history of chronic abdominal pain, fullness, constipation, and diarrhoea. Enhanced computed tomography showed a 100-mm irregular swelling in the appendix and thickening of the appendiceal wall with cystic dilatation. Based on a preoperative diagnosis of appendiceal cancer, the patient underwent laparoscopic ileocecal resection with D3 lymph node dissection. Pathological diagnosis revealed a signet-ring cell carcinoma of the appendix with ganglioneuromatosis. The patient completed four courses of capecitabine plus oxaliplatin (CAPEOX) as postoperative adjuvant chemotherapy, and 23-month postoperative outcome was noneventful without recurrence.
Conclusion
We report a signet-ring cell carcinoma of the appendix that was detected early because of its presence with ganglioneuromatosis.
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9
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Nakagomi E, Mikami T, Funahashi K, Okazumi S, Shibuya K, Hiruta N, Igarashi Y. Cancer stem cell markers CD44v9+/CD133- are associated with low apoptosis in both sporadic and ulcerative colitis-associated colorectal cancers. Histol Histopathol 2022; 37:587-595. [PMID: 35224715 DOI: 10.14670/hh-18-445] [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: 06/14/2023]
Abstract
OBJECTIVE To elucidate tumor cell behavior associated with cancer stem cell (CSC) marker expression, the expression of CD133, CD44v9, and ALDH1A1, which are considered markers of CSCs, was examined in sporadic and ulcerative colitis (UC)-associated colorectal tumors. METHODS A total of 23 cases of sporadic colorectal cancer and 44 cases of adenoma were collected. Additionally, 22 cancer lesions and 38 dysplasia lesions were selected from 28 colectomy cases of UC with neoplastic lesions. Lesions were examined by immunohistochemistry using primary antibodies against CD133, CD44v9, ALDH1A1, Ki-67, cleaved-Caspase 3, and p53. RESULTS CD133, CD44v9, and ALDH1A1 showed higher expression in both sporadic and UC-associated tumors than in the normal mucosa. ALDH1A1 expression in sporadic cancer was higher in the right colon than in the left colon (p=0.0089). ALDH1A1 expression in UC-associated cancer was higher in those with longer disease duration than in those with shorter disease duration (p=0.019). The CD44v9+/CD133- region had fewer cleaved-Caspase 3 positive cells in both sporadic and UC-associated cancers. In sporadic cancer, CD133+/ALDH1A1+ regions had fewer apoptotic cells than CD133+/ALDH1A1- regions, while CD133+/ALDH1A1- regions were less proliferative than CD133+/ALDH1A1+ regions in UC-associated cancer. CONCLUSION CD44+/CD133- regions were commonly associated with low apoptosis in sporadic and UC-associated cancers; thus, these were considered target areas for CSCs. Additionally, the combination of markers comprising CSCs may differ between sporadic and UC-associated cancers.
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Affiliation(s)
- Eriko Nakagomi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Graduate School of Medicine, Ota-ku, Tokyo, Japan.
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center Omori Hospital, Ota-ku, Tokyo, Japan
| | - Tetuo Mikami
- Department of Pathology, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Kimihiko Funahashi
- Division of General and Gastroenterological Surgery, Department of Surgery, Toho University Medical Center Omori Hospital, Tokyo, Japan
| | - Shinichi Okazumi
- Department of Surgery, Toho University Medical Center Sakura Hospital, Sakura, Japan
| | - Kazutoshi Shibuya
- Department of Surgical Pathology, Toho University Medical Center Omori Hospital, Tokyo, Japan
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Medical Center Sakura Hospital, Sakura, Japan
| | - Yoshinori Igarashi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center Omori Hospital, Ota-ku, Tokyo, Japan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Graduate School of Medicine, Ota-ku, Tokyo, Japan
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10
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Oda Y, Tanaka K, Hirose T, Hasegawa T, Hiruta N, Hisaoka M, Yoshimoto M, Otsuka H, Bekki H, Ishii T, Endo M, Kunisada T, Hiruma T, Tsuchiya H, Katagiri H, Matsumoto Y, Kawai A, Nakayama R, Kawashima H, Takenaka S, Emori M, Watanuki M, Yoshida Y, Okamoto T, Mizusawa J, Fukuda H, Ozaki T, Iwamoto Y, Nojima T. Standardization of evaluation method and prognostic significance of histological response to preoperative chemotherapy in high-grade non-round cell soft tissue sarcomas. BMC Cancer 2022; 22:94. [PMID: 35062915 PMCID: PMC8783422 DOI: 10.1186/s12885-022-09195-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 01/12/2022] [Indexed: 12/30/2022] Open
Abstract
Background Preoperative chemotherapy is widely applied to high-grade localized soft tissue sarcomas (STSs); however, the prognostic significance of histological response to chemotherapy remains controversial. This study aimed to standardize evaluation method of histological response to chemotherapy with high agreement score among pathologists, and to establish a cut-off value closely related to prognosis. Methods Using data and specimens from the patients who had registered in the Japan Clinical Oncology Group study, JCOG0304, a phase II trial evaluating the efficacy of perioperative chemotherapy with doxorubicin (DOX) and ifosfamide (IFO), we evaluated histological response to preoperative chemotherapy at the central review board. Results A total of 64 patients were eligible for this study. The percentage of viable tumor area ranged from 0.1% to 97.0%, with median value of 35.7%. Regarding concordance proportion between pathologists, the weighted kappa coefficient (κ) score in all patients was 0.71, indicating that the established evaluation method achieved substantial agreement score. When the cut-off value of the percentage of the residual tumor area was set as 25%, the p-value for the difference in overall survival showed the minimum value. Hazard ratio of the non-responder with percentage of the residual tumor < 25%, to the responder was 4.029 (95% confidence interval 0.893–18.188, p = 0.070). Conclusion The standardized evaluation method of pathological response to preoperative chemotherapy showed a substantial agreement in the weighted κ score. The evaluation method established here was useful for estimating of the prognosis in STS patients who were administered perioperative chemotherapy with DOX and IFO. Trial registration UMIN Clinical Trials Registry C000000096. Registered 30 August, 2005 (retrospectively registered).
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11
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Kurose Y, Sano A, Hiranuma A, Nagashima M, Sugiura Y, Hiruta N, Tochigi N, Shibuya K. Lipoleiomyoma arising in soft tissue of the middle mediastinum. Pathol Int 2021; 72:72-74. [PMID: 34729870 DOI: 10.1111/pin.13181] [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: 06/02/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Yasuko Kurose
- Department of Thoracic Surgery, Toho University Sakura Medical Center, Chiba, Japan.,Department of Surgical Pathology, Toho University Omori Medical Center, Chiba, Japan.,Department of Surgical Pathology, Toho University Graduate School of Medicine, Chiba, Japan
| | - Atsushi Sano
- Department of Thoracic Surgery, Toho University Sakura Medical Center, Chiba, Japan
| | - Ayako Hiranuma
- Department of Thoracic Surgery, Toho University Sakura Medical Center, Chiba, Japan
| | - Makoto Nagashima
- Department of Thoracic Surgery, Toho University Sakura Medical Center, Chiba, Japan
| | - Yoshiya Sugiura
- Department of Surgical Pathology, Toho University Sakura Medical Center, Chiba, Japan
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, Chiba, Japan
| | - Naobumi Tochigi
- Department of Surgical Pathology, Toho University Omori Medical Center, Chiba, Japan.,Department of Surgical Pathology, Toho University Graduate School of Medicine, Chiba, Japan
| | - Kazutoshi Shibuya
- Department of Surgical Pathology, Toho University Omori Medical Center, Chiba, Japan.,Department of Surgical Pathology, Toho University Graduate School of Medicine, Chiba, Japan
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12
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Yamashita K, Funauchi Y, Hayakawa K, Ae K, Matsumoto S, Ikuta K, Nishida Y, Ueno T, Shimoyama Y, Hiruta N, Machinami R, Kawachi H, Takeuchi K. S100-negative epithelioid malignant peripheral nerve sheath tumor with possible perineurial differentiation. Virchows Arch 2021; 480:1269-1275. [PMID: 34635937 DOI: 10.1007/s00428-021-03218-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 10/20/2022]
Abstract
Epithelioid malignant peripheral nerve sheath tumor (MPNST) is a rare subtype of MPNST composed of epithelioid cells with abundant cytoplasm. Currently, strong and diffuse immunostaining for S100 protein and SOX10 is generally regarded as a characteristic feature of epithelioid MPNST. However, malignant tumors with epithelioid morphology that arise from a peripheral nerve or a pre-existing benign nerve sheath tumor should be regarded as epithelioid MPNSTs when they do not show characteristic features that definitively lead to other specific diagnoses. Here, we describe 3 cases of epithelioid MPNST in the peripheral nerve or schwannoma that was negative for S100 protein and SOX10 expression. Instead, these tumors were positive for EMA, GLUT1, claudin 1, and cytokeratin to varying degrees, while all of them retained SMARCB1 and H3K27me3 by immunohistochemistry. EMA, GLUT1, and claudin 1 are known markers of perineurial cell differentiation; thus, they could possibly represent epithelioid MPNST with perineurial cell differentiation.
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Affiliation(s)
- Kyoko Yamashita
- Department of Pathology, the Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan. .,Division of Pathology, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.
| | - Yuki Funauchi
- Department of Orthopedic Oncology, the Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Orthopedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiko Hayakawa
- Department of Orthopedic Oncology, the Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Keisuke Ae
- Department of Orthopedic Oncology, the Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Seiichi Matsumoto
- Department of Orthopedic Oncology, the Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kunihiro Ikuta
- Department of Orthopedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Japan
| | - Yoshihiro Nishida
- Department of Orthopedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya, Japan.,Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Teruko Ueno
- Diagnostic Imaging Center, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshie Shimoyama
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Nobuyuki Hiruta
- Division of Pathology, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Pathology, Toho University Sakura Hospital, Sakura, Japan
| | - Rikuo Machinami
- Division of Pathology, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Pathology, Kawakita General Hospital, Tokyo, Japan
| | - Hiroshi Kawachi
- Department of Pathology, the Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan.,Division of Pathology, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kengo Takeuchi
- Department of Pathology, the Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan.,Division of Pathology, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
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Yamaguchi T, Ohira M, Kawagoe N, Nakamura S, Tanaka S, Oka R, Watanabe Y, Sato Y, Nagayama D, Saiki A, Matsuzawa Y, Bujo H, Terai K, Hiruta N, Tatsuno I, Nakaseko C, Kikuchi H, Matsuoka K, Yokota H, Shimizu N. High presepsin concentrations in bile and its marked elevation in biliary tract diseases: A retrospective analysis. Clin Chim Acta 2021; 521:278-284. [PMID: 34331951 DOI: 10.1016/j.cca.2021.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/15/2021] [Accepted: 07/24/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Presepsin is a diagnostic and prognostic biomarker of both bacterial infection and sepsis; however, elevated presepsin levels have also been observed without sepsis. We conducted several analyses to evaluate the clinical laboratory parameters affecting presepsin levels. METHOD We analyzed the association between sequential organ failure assessment (SOFA) scores and plasma presepsin levels and then analyzed clinical laboratory parameters in 567 patients with univariate and multivariate regression analysis and analysis of covariance (ANCOVA). We also determined presepsin in the bile of 11 patients and examined the presepsin immunostaining in liver. RESULTS Spearman's rank correlation analysis with loge change revealed that presepsin levels were closely associated with loge-transformed SOFA score (ρ = 0.541), alkaline phosphatase (ALP); (ρ = 0.454) and gamma-glutamyl transferase; (ρ = 0.505). Multivariate regression analysis revealed that loge-transformed SOFA score (β-coefficient = 0.316), ALP level (β-coefficient = 0.380), and creatinine level (β-coefficient = 0.290) independently and significantly affected loge presepsin levels. ANCOVA revealed that presepsin levels were significantly higher in patients with hepatobiliary disease. Patients who presented with dilatation of the bile ducts and elevated ALP levels or total bilirubin levels exhibited high presepsin levels in the bile. Presepsin production in liver Kupffer cells was also confirmed by immunostaining. CONCLUSION Presepsin levels is correlated with the elevation of biliary enzymes in patients without renal dysfunction or sepsis. Additionally, presepsin exists with high concentrations in the bile and is positive in Kupffer cells.
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Affiliation(s)
- Takashi Yamaguchi
- Center for Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Masahiro Ohira
- Center for Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Naoyuki Kawagoe
- Center for Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Shoko Nakamura
- Center for Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Sho Tanaka
- Center for Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Rena Oka
- Center for Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Yasuhiro Watanabe
- Center for Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Yuta Sato
- Center for Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Daiji Nagayama
- Center for Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Atsuhito Saiki
- Center for Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Yasuo Matsuzawa
- Department of Internal Medicine, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Hideaki Bujo
- Department of Clinical Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Kensuke Terai
- Department of Surgical Pathology, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Ichiro Tatsuno
- Center for Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Chiaki Nakaseko
- Department of Hematology, International University of Health and Welfare School of Medicine, 2860852 Chiba, Japan
| | - Hidemasa Kikuchi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Katsuyoshi Matsuoka
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Sakura Medical Center, 2858741 Chiba, Japan
| | - Hiromitsu Yokota
- Clinical Laboratory Program, Education Development Center, Faculty of Science Toho University, 2748510 Chiba, Japan
| | - Naomi Shimizu
- Department of Hematology, Toho University Sakura Medical Center, 2858741 Chiba, Japan.
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14
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Yoneda K, Kamiya N, Utsumi T, Wakai K, Oka R, Endo T, Yano M, Hiruta N, Ichikawa T, Suzuki H. Impact of Lymphovascular Invasion on Prognosis in the Patients with Bladder Cancer-Comparison of Transurethral Resection and Radical Cystectomy. Diagnostics (Basel) 2021; 11:diagnostics11020244. [PMID: 33557407 PMCID: PMC7915441 DOI: 10.3390/diagnostics11020244] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 02/08/2023] Open
Abstract
(1) Background: This study aimed to evaluate the associations of lymphovascular invasion (LVI) at first transurethral resection of bladder (TURBT) and radical cystectomy (RC) with survival outcomes, and to evaluate the concordance between LVI at first TURBT and RC. (2) Methods: We analyzed 216 patients who underwent first TURBT and 64 patients who underwent RC at Toho University Sakura Medical Center. (3) Results: LVI was identified in 22.7% of patients who underwent first TURBT, and in 32.8% of patients who underwent RC. Univariate analysis identified ≥cT3, metastasis and LVI at first TURBT as factors significantly associated with overall survival (OS) and cancer-specific survival (CSS). Multivariate analysis identified metastasis (hazard ratio (HR) 6.560, p = 0.009) and LVI at first TURBT (HR 9.205, p = 0.003) as significant predictors of CSS. On the other hand, in patients who underwent RC, ≥pT3, presence of G3 and LVI was significantly associated with OS and CSS in univariate analysis. Multivariate analysis identified inclusion of G3 as a significant predictor of OS and CSS. The concordance rate between LVI at first TURBT and RC was 48.0%. Patients with positive results for LVI at first TURBT and RC displayed poorer prognosis than other patients (p < 0.05). (4) Conclusions: We found that the combination of LVI at first TURBT and RC was likely to provide a more significant prognostic factor.
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Affiliation(s)
- Kei Yoneda
- Department of Urology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura-shi, Chiba 285-8741, Japan; (K.Y.); (T.U.); (R.O.); (T.E.); (M.Y.); (H.S.)
- Department of Urology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-city, Chiba 260-8687, Japan; (K.W.); (T.I.)
| | - Naoto Kamiya
- Department of Urology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura-shi, Chiba 285-8741, Japan; (K.Y.); (T.U.); (R.O.); (T.E.); (M.Y.); (H.S.)
- Correspondence: ; Tel.: +81-43-462-8811
| | - Takanobu Utsumi
- Department of Urology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura-shi, Chiba 285-8741, Japan; (K.Y.); (T.U.); (R.O.); (T.E.); (M.Y.); (H.S.)
| | - Ken Wakai
- Department of Urology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-city, Chiba 260-8687, Japan; (K.W.); (T.I.)
| | - Ryo Oka
- Department of Urology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura-shi, Chiba 285-8741, Japan; (K.Y.); (T.U.); (R.O.); (T.E.); (M.Y.); (H.S.)
| | - Takumi Endo
- Department of Urology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura-shi, Chiba 285-8741, Japan; (K.Y.); (T.U.); (R.O.); (T.E.); (M.Y.); (H.S.)
| | - Masashi Yano
- Department of Urology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura-shi, Chiba 285-8741, Japan; (K.Y.); (T.U.); (R.O.); (T.E.); (M.Y.); (H.S.)
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura-shi, Chiba 285-8741, Japan;
| | - Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-city, Chiba 260-8687, Japan; (K.W.); (T.I.)
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura-shi, Chiba 285-8741, Japan; (K.Y.); (T.U.); (R.O.); (T.E.); (M.Y.); (H.S.)
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15
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Sanda M, Kamiya N, Sugizaki Y, Mori T, Sugiyama M, Kato S, Oka R, Utsumi T, Endo T, Yano M, Hiruta N, Suzuki H. [SIGNIFICANCE OF IgG4 IN IDIOPATHIC RETROPERITONEAL FIBROSIS]. Nihon Hinyokika Gakkai Zasshi 2021; 112:192-198. [PMID: 36261349 DOI: 10.5980/jpnjurol.112.192] [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] [Indexed: 06/16/2023]
Abstract
(Objective)Retroperitoneal fibrosis is largely divided into the idiopathic and secondary types. Some idiopathic cases include IgG4-related diseases, which are often similar to malignant diseases, such as lymphoma and sarcoma. The diagnostic criteria for IgG4-related disease are used and pathologic examination is necessary for a definitive diagnosis of IgG4-related retroperitoneal fibrosis. The first choice of treatment for IgG4-related retroperitoneal fibrosis is steroid administration, but no consensus has been established regarding its dose and tapering schedule. We investigated the significance of IgG4 in diagnosis and treatment of idiopathic retroperitoneal fibrosis. (Patients and methods)We examined 14 cases diagnosed as idiopathic retroperitoneal fibrosis between April 2013 and March 2019. Serum IgG4 was measured at the time of diagnosis in 13 cases, and changes over time in serum IgG4 before and after the induction of steroid therapy were measured in 6 cases. Computed tomography-guided biopsy was performed on 4 cases. (Results)Of all cases, 1 patient was diagnosed as IgG4-related retroperitoneal fibrosis and 5 patients were classified as possible group. Ten patients were administered steroid therapy. Percutaneous nephrostomy tube was placed in 3 patients and was removed in 2 of these patients after steroid therapy. The serum high levels of IgG4 were confirmed in all 4 patients who were classified into the possible group and who were treated with steroids. (Conclusion)Although histologic examination is necessary for the diagnosis of retroperitoneal fibrosis, tissue collection by open or laparoscopic surgery is highly invasive. CT-guided biopsy may be useful in high-risk cases, such as elderly patients on anticoagulation. After excluding other diseases in high-risk cases, response to empiric steroid therapy may be diagnostic. In the possible group, changes in serum IgG4 levels may reflect the disease condition and might be useful in determining the maintenance dose of steroids.
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Affiliation(s)
- Masaaki Sanda
- Department of Urology, Toho University Sakura Medical Center
| | - Naoto Kamiya
- Department of Urology, Toho University Sakura Medical Center
| | - Yuka Sugizaki
- Department of Urology, Toho University Sakura Medical Center
| | - Takamichi Mori
- Department of Urology, Toho University Sakura Medical Center
| | | | - Seiji Kato
- Department of Urology, Toho University Sakura Medical Center
| | - Ryo Oka
- Department of Urology, Toho University Sakura Medical Center
| | - Takanobu Utsumi
- Department of Urology, Toho University Sakura Medical Center
| | - Takumi Endo
- Department of Urology, Toho University Sakura Medical Center
| | - Masashi Yano
- Department of Urology, Toho University Sakura Medical Center
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center
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16
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Yashima S, Takaoka H, Iwahana T, Takahashi M, Kondo Y, Ueda H, Saito A, Ito Y, Motomura N, Hiruta N, Ikeda JI, Matsumiya G, Kobayashi Y. Coexistence of Marfan-like Connective Tissue Disease with Morphologic Left Ventricular Non-compaction. Intern Med 2020; 59:3039-3044. [PMID: 32759589 PMCID: PMC7759706 DOI: 10.2169/internalmedicine.5100-20] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We treated a man with co-incident Marfan-like connective tissue disease with morphologic left ventricular non-compaction (LVNC). He underwent valve-sparing aortic root replacement because of aortic root dilation at 43 years old. Pathological findings of the aorta revealed cystic medio-necrosis, consistent with Marfan syndrome. He developed congestive heart failure caused by LVNC at 47 years old. His daughter had scoliosis, and he had several physical characteristics suggestive of Marfan syndrome. We herein report a rare case of a patient who had Marfan-like connective disease with an LVNC appearance.
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Affiliation(s)
- Satomi Yashima
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Hiroyuki Takaoka
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Togo Iwahana
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Manami Takahashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Yusuke Kondo
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Hideki Ueda
- Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Japan
| | - Aya Saito
- Department of Cardiovascular Surgery, Toho University Sakura Medical Center, Japan
| | - Yuya Ito
- Department of Cardiovascular Surgery, Toho University Sakura Medical Center, Japan
| | - Noboru Motomura
- Department of Cardiovascular Surgery, Toho University Sakura Medical Center, Japan
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, Japan
| | - Jun-Ichiro Ikeda
- Department of Diagnostic Pathology, Chiba University Graduate School of Medicine, Japan
| | - Goro Matsumiya
- Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
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17
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Uchida Y, Shimoyama E, Hiruta N, Tabata T. Detection of early stage of human coronary atherosclerosis by angioscopic imaging of collagen subtypes. J Cardiol 2020; 77:452-456. [PMID: 33162263 DOI: 10.1016/j.jjcc.2020.09.011] [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: 12/22/2019] [Revised: 06/29/2020] [Accepted: 09/07/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Detection of the early stage of atherosclerosis, which does not exhibit macroscopic morphological changes, is currently beyond the scope of any available imaging techniques. Collagens provide mechanical support of vascular wall and subtype I is the major component of the normal vascular wall. During the process of atherosclerosis, collagen III appears first, followed by subtypes IV and V during fibrosis of the intima. Therefore, the presence of collagen III indicates initiation of atherosclerosis. Here, we aimed to visualize collagen subtypes in human coronary wall. METHODS Under microscopy, collagen III was stained emerald-green, collagen I was red, and IV and V were pink in the presence of a mixture of Silius red and Fast green dyes. Fifty-one coronary arteries excised from 20 human autopsy subjects were classified by angioscopy and histology as normal segments, white and yellow plaques, and examined after staining collagen subtypes in their superficial layer with the same dye mixtures. RESULTS Normal coronary segments with intimal thickness ≦200 μm stained red, with thickness >200 μm stained red and emerald-green in a mosaic pattern or emerald-green alone, yellow plaques without a necrotic core were pink, and those with a necrotic core showed no staining. CONCLUSION The results suggested that coronary segments stained red indicate no atherosclerosis, red and emerald-green in a mosaic pattern indicates initiation of atherosclerosis, emerald-green is early-stage atherosclerosis, pink is advanced stage of atherosclerosis, and no staining shows the end stage of atherosclerosis at least in superficial layer of coronary artery. Therefore, dye-staining angioscopy using Silius red and Fast green dyes in combination could be used to detect the early and advanced stage of atherosclerosis in superficial layer of human coronary artery.
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Affiliation(s)
- Yasumi Uchida
- Japanese Foundation for Cardiovascular Research, Funabashi, Japan; Department of Cardiology, Tokyo Jikei University School of Medicine, Tokyo, Japan.
| | - Ei Shimoyama
- Department of Pathology, Funabashi-Futawa Hospital, Funabashi, Japan
| | - Nobuyuki Hiruta
- Department of Pathology, Toho University Medical Center Sakura Hospital, Sakura, Japan
| | - Tsuyoshi Tabata
- Department of Clinical Physiology, Toho University Medical Center Sakura Hospital, Sakura, Japan
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18
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Yoneda K, Utsumi T, Wakai K, Oka R, Endo T, Yano M, Kamiya N, Hiruta N, Suzuki H. Preoperative Clinical Predictors of Lymphovascular Invasion of Bladder Tumors at Transurethral Resection Pathology. Curr Urol 2020; 14:135-141. [PMID: 33224006 DOI: 10.1159/000499247] [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: 05/08/2019] [Accepted: 06/03/2019] [Indexed: 11/19/2022] Open
Abstract
Background The assessment of lymphovascular invasion (LVI) on the specimens of a transurethral resection of bladder tumors (TURBT) is very important for risk stratification and decision-making on further treatment for bladder cancer. Objectives The present study aimed to identify clinical predictors associated with the risk of bladder cancer with LVI before a first TURBT. Methods A total of 291 patients underwent a first TURBT for bladder cancer at Toho University Sakura Medical Center between January 2012 and December 2016. We analyzed predictors of LVI based on data from 217 patients and predictors of high grade and ≥ pT1 tumors based on data from the medical records of 237 patients for comparison with LVI risk factors. Results Univariate analysis significantly associated LVI with episodes of gross hematuria, positive urinary cytology, and larger, non-papillary and sessile tumors. Multivariate analysis selected larger tumors [odds ratio (OR) 1.39; 95 % confidence interval (CI) 1.08-1.78; p = 0.01], and non-papillary (OR 10.05; 95% CI 3.75-26.91; p < 0.01) and sessile (OR 2.65; 95% CI 1.18-5.93; p = 0.02) tumors as significant predictors of LVI. Some predictors such as tumor size and non-papillary tumors overlapped between high-grade and ≥ pT1 bladder cancer. Conclusions These predictors can help clinicians to identify patients with, or who are at high-risk for LVI before undergoing a first TURBT and to determine priorities for preoperative evaluation and scheduling consecutive treatments.
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Affiliation(s)
- Kei Yoneda
- Department of Urology, Toho University Sakura Medical Center, Shimoshizu, Sakura
| | - Takanobu Utsumi
- Department of Urology, Toho University Sakura Medical Center, Shimoshizu, Sakura
| | - Ken Wakai
- Department of Urology, Chiba University Graduate School of Medicine, Inohana, Chuo-ku, Chiba
| | - Ryo Oka
- Department of Urology, Toho University Sakura Medical Center, Shimoshizu, Sakura
| | - Takumi Endo
- Department of Urology, Toho University Sakura Medical Center, Shimoshizu, Sakura
| | - Masashi Yano
- Department of Urology, Toho University Sakura Medical Center, Shimoshizu, Sakura
| | - Naoto Kamiya
- Department of Urology, Toho University Sakura Medical Center, Shimoshizu, Sakura
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, Shimoshizu, Sakura, Japan
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, Shimoshizu, Sakura
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Kaji S, Hiruta N, Sasai D, Nagashima M, Ohe R, Yamakawa M. Cytokeratin-positive interstitial reticulum cell (CIRC) tumor in the lymph node: a case report of the transformation from the epithelioid cell type to the spindle cell type. Diagn Pathol 2020; 15:121. [PMID: 32979929 PMCID: PMC7519525 DOI: 10.1186/s13000-020-01032-9] [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] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 09/09/2020] [Indexed: 12/03/2022] Open
Abstract
Background Cytokeratin-positive interstitial reticulum cells (CIRCs), which are a subgroup of fibroblastic reticular cells (FRCs), are known to be present in the lymph nodes. There have been only a few cases of tumors derived from CIRCs. Case presentation We have reported a new case involving a CIRC tumor in a 75-year-old man and reviewed the literature. The resected mediastinal lymph nodes showed epithelial-like proliferation of large atypical round and polygonal epithelioid cells. The tumor cells expressed CK8, CK18, CAM5.2, AE1/AE3, epithelial membrane antigen, vimentin, fascin, and some FRC markers, which is consistent with the diagnosis of a CIRC tumor. Following chemotherapy, the CIRC tumor was observed to have responded very well and became difficult to confirm on imaging, but a small cell lung carcinoma developed 12 months later. Chemoradiotherapy was performed, but the patient passed away 29 months after the initial diagnosis. The autopsy revealed the recurrence of the CIRC tumor, residual small cell lung carcinoma, and a very small latent carcinoma of the prostate. The relapsed CIRC tumor cells had a spindle shape; they were highly pleomorphic and had invaded the superior vena cava. Conclusion We first reported autopsy findings of CIRC tumors and demonstrated the transformation of the tumor from the epithelioid cell type to the spindle cell type.
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Affiliation(s)
- Sachiko Kaji
- Department of Diagnostic Pathology, Chiba Kaihin Municipal Hospital, 3-31-1 Isobe, Mihama-ku, Chiba, 261-0012, Japan.
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Daisuke Sasai
- Department of Pathology, Seirei Sakura Citizen Hospital, Sakura, Japan
| | - Makoto Nagashima
- Department of Surgery, Toho University Sakura Medical Center, Sakura, Japan
| | - Rintaro Ohe
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Mitsunori Yamakawa
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata, Japan
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20
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Uchi T, Inaoka T, Kitamura N, Ishikawa R, Nakatsuka T, Kasuya S, Tokuyama W, Hiruta N, Takahashi H, Terada H. Unexpected discovery of a diffuse astrocytoma of the conus medullaris in an elderly NF1 patient. Radiol Case Rep 2020; 15:784-788. [PMID: 32322332 PMCID: PMC7167499 DOI: 10.1016/j.radcr.2020.02.033] [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: 01/25/2020] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 11/06/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) is one of the most common genetic neurocutaneous disorders, and it is well known to be associated with peripheral or central nervous system malignancies. The most common malignant tumors are malignant peripheral nerve sheath tumors (MPNSTs); MPNSTs are the most common cause of death in patients with NF1. Central nervous system malignancies rarely occur. So far, the occurrence of spinal cord malignancies is exceedingly rare. Herein, we report a rare case of a 69-year-old male with NF1 following tumor resection twice for cutaneous MPNSTs developing intramedullary diffuse astrocytoma in the conus medullaris, which initially presented with traumatic spinal cord injury associated with a compression fracture from fall. Contrast-enhanced magnetic resonance imaging and biopsy of the spinal cord were required to establish the final diagnosis.
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Affiliation(s)
- Takamistu Uchi
- Department of Radiology, Toho University Sakura Medical Center
| | - Tsutomu Inaoka
- Department of Radiology, Toho University Sakura Medical Center
| | - Noriko Kitamura
- Department of Radiology, Toho University Sakura Medical Center
| | - Rumiko Ishikawa
- Department of Radiology, Toho University Sakura Medical Center
| | | | - Shusuke Kasuya
- Department of Radiology, Toho University Sakura Medical Center
| | - Wataru Tokuyama
- Division of Surgical Pathology, Toho University Sakura Medical Center
| | - Nobuyuki Hiruta
- Division of Surgical Pathology, Toho University Sakura Medical Center
| | - Hiroshi Takahashi
- Department of Orthopedic Surgery, Toho University Sakura Medical Center
| | - Hitoshi Terada
- Department of Radiology, Toho University Sakura Medical Center
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21
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Ishida H, Jiang M, Ebinuma H, Hiruta N, Schneider WJ, Kinoshita T, Bujo H. Circulating soluble LR11, a differentiation regulator for vascular cells, is increased during pregnancy and exaggerated in patients with pre-eclampsia. Clin Chim Acta 2019; 497:172-177. [PMID: 31299181 DOI: 10.1016/j.cca.2019.07.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 06/13/2019] [Accepted: 07/01/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Pre-eclampsia is a pregnancy-specific disease characterized by onset of hypertension and proteinuria, sometimes progressing into damaging other organs. Here, we investigated the pathological significance of the soluble fragment of LR11 (sLR11), a cell differentiation regulator, in comparison to circulating IL-6 and TNF-α, in pre-eclampsia. METHODS The study was conducted in a cross-sectional research design with fourteen pre-eclampsia patients and fifty healthy pregnant subjects. Pre-eclampsia was defined as hypertensive disorders in pregnancy at over 20 weeks of gestation with proteinuria. RESULTS Plasma levels of sLR11 as well as IL-6 in pre-eclampsia were increased compared with those in the healthy pregnant subjects at the first, the second, and the third trimester. Receiver operating characteristic analysis for the detection of pre-eclampsia among third-trimester subjects showed that the areas under the curves of sLR11 and IL-6 were equivalent. sLR11 and IL-6 correlated positively with TNF-α in healthy pregnant subjects. In the pre-eclampsia patients, there was neither a correlation between sLR11 and IL-6 nor between sLR11 and TNF-α. CONCLUSIONS sLR11 increases during pregnancy, with levels further exaggerated in pre-eclampsia, and may be related to the pathology of pre-eclampsia.
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Affiliation(s)
- Hiroaki Ishida
- Department of Obstetrics and Gynecology, Toho University Sakura Medical Center, Sakura, Japan
| | - Meizi Jiang
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Hiroyuki Ebinuma
- Tsukuba Research Institute, Sekisui Medical Co Ltd, Ryugasaki, Japan
| | - Nobuyuki Hiruta
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan; Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Wolfgang J Schneider
- Department of Medical Biochemistry, Max F. Perutz Laboratories, Medical University of Vienna, Vienna, Austria
| | - Toshihiko Kinoshita
- Department of Obstetrics and Gynecology, Toho University Sakura Medical Center, Sakura, Japan
| | - Hideaki Bujo
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan.
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22
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Yamashita N, Kanno Y, Saito N, Terai K, Sanada N, Kizu R, Hiruta N, Park Y, Bujo H, Nemoto K. Aryl hydrocarbon receptor counteracts pharmacological efficacy of doxorubicin via enhanced AKR1C3 expression in triple negative breast cancer cells. Biochem Biophys Res Commun 2019; 516:693-698. [PMID: 31253396 DOI: 10.1016/j.bbrc.2019.06.119] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 06/21/2019] [Indexed: 12/24/2022]
Abstract
Triple-negative breast cancer (TNBC) is associated with poor prognosis, because of no effective targeted therapy. In the present study, we demonstrated the crucial role of the aryl hydrocarbon receptor (AhR) in mediating the effects of the chemotherapeutic agent doxorubicin (DOX) in the chemotherapeutic sensitivity of TNBC. Firstly, we established AhR knockout (KO) MDA-MB 231 TNBC cells. The cytotoxic effects of DOX were more pronounced in AhR KO cells than in parental cells. In addition, our results indicated that AhR KO cells showed downregulated expression of DOX-metabolism enzyme, aldo-keto reductase (AKR) 1C3, relative to those of parental cells. Furthermore, AhR was found to enhance AKR1C3 promoter reporter activity, suggesting that AKR1C3 mRNA transcription is activated by AhR. Additionally, our findings confirmed that the downregulation of AKR1C3 expression enhanced DOX sensitivity in MDA-MB 231 cells. Finally, AhR and AKR1C3 expression were positively correlated in human breast cancer. Taken together, our results suggested that AhR is involved in DOX sensitivity by regulating AKR1C3 expression in TNBC cells.
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Affiliation(s)
- Naoya Yamashita
- Department of Molecular Toxicology, Faculty of Pharmaceutical Sciences, Toho University, Miyama 2-2-1, Funabashi, Chiba, 274-8510, Japan; Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Kodo, Kyotanabe, Kyoto, 610-0395, Japan
| | - Yuichiro Kanno
- Department of Molecular Toxicology, Faculty of Pharmaceutical Sciences, Toho University, Miyama 2-2-1, Funabashi, Chiba, 274-8510, Japan.
| | - Nao Saito
- Department of Molecular Toxicology, Faculty of Pharmaceutical Sciences, Toho University, Miyama 2-2-1, Funabashi, Chiba, 274-8510, Japan
| | - Kensuke Terai
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura, Chiba, 285-8741, Japan; Department of Surgical Pathology, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura, Chiba, 285-8741, Japan
| | - Noriko Sanada
- Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Kodo, Kyotanabe, Kyoto, 610-0395, Japan
| | - Ryoichi Kizu
- Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Kodo, Kyotanabe, Kyoto, 610-0395, Japan
| | - Nobuyuki Hiruta
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura, Chiba, 285-8741, Japan; Department of Surgical Pathology, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura, Chiba, 285-8741, Japan
| | - Youngjin Park
- Department of Surgical Pathology, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura, Chiba, 285-8741, Japan; Department of Breast and Endocrine Surgery, Tohoku Medical and Pharmaceutical University, Fukumuro 1-15-1, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan
| | - Hideaki Bujo
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura, Chiba, 285-8741, Japan
| | - Kiyomitsu Nemoto
- Department of Molecular Toxicology, Faculty of Pharmaceutical Sciences, Toho University, Miyama 2-2-1, Funabashi, Chiba, 274-8510, Japan
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Harada M, Jiang M, Terai K, Ebinuma H, Hiruta N, Schneider WJ, Sugo N, Nagao T, Bujo H. Levels of circulating soluble LR11, a regulator of smooth muscle cell migration, are highly associated with atherosclerotic plaques in patients with carotid artery stenosis. Clin Chim Acta 2018; 490:69-76. [PMID: 30550937 DOI: 10.1016/j.cca.2018.12.005] [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: 08/30/2018] [Revised: 11/14/2018] [Accepted: 12/07/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND The levels of plasma sLR11, released from intimal SMCs, are positively associated with intima-media thickness (IMT) in asymptomatic subjects. We have evaluated the yet unknown pathological significance of sLR11 for plaque conditions in patients with carotid artery stenosis. METHODS The presence of LR11 in carotid plaques was investigated using autopsy specimens. A clinical ultrasonography study for elucidating relationships between sLR11 and plaque condition was performed in 46 patients. RESULTS Immunohistochemistry showed high levels of LR11 in SMCs within thickened intima and at the media-intima border of atherosclerotic carotid plaques. The levels of sLR11 in patients were clearly elevated compared to healthy controls. Univariate analysis of sLR11 revealed significant positive correlation with plaque score and a tendency to correlate with the stenotic fraction. Univariate and multiple regression analyses of plaque scores showed that sLR11, maximum IMT, and HDL-cholesterol independently determined plaque score. Finally, univariate analysis of initial sLR11 levels for changes in imaging markers after one-year follow-up showed that initial sLR11 levels significantly correlated with stenotic fraction progression. CONCLUSIONS The levels of sLR11, abundantly expressed in carotid atherosclerotic plaques, are highly associated with increased plaque score. sLR11 levels may be predictive of plaque conditions in patients with advanced carotid atherosclerosis.
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Affiliation(s)
- Masashi Harada
- Department of Neurosurgery, Toho University Sakura Medical Center, Sakura, Japan
| | - Meizi Jiang
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura 285-8741, Japan
| | - Kensuke Terai
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura 285-8741, Japan; Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Hiroyuki Ebinuma
- Sekisui Medical Co Ltd, Tsukuba Research Institute, Ryugasaki, Japan
| | - Nobuyuki Hiruta
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura 285-8741, Japan; Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Wolfgang J Schneider
- Department of Medical Biochemistry, Max F. Perutz Laboratories, Medical University of Vienna, Vienna, Austria
| | - Nobuo Sugo
- Department of Neurosurgery, Toho University Omori Medical Center, Omori, Japan
| | - Takeki Nagao
- Department of Neurosurgery, Toho University Sakura Medical Center, Sakura, Japan
| | - Hideaki Bujo
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura 285-8741, Japan.
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Watanabe T, Nema T, Hiruta N, Murano T, Schneider WJ, Bujo H. Lp8 is potentially associated with partial lecithin:cholesterol acyltransferase deficiency in a patient with primary biliary cirrhosis. J Clin Lipidol 2018; 12:1157-1163. [PMID: 30055975 DOI: 10.1016/j.jacl.2018.06.007] [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: 03/13/2018] [Revised: 05/30/2018] [Accepted: 06/19/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The significance of Lp8, that is, abnormal lipoprotein(s) detected in fraction 8 by combined high-performance liquid chromatography/gel filtration column in patients with familial lecithin:cholesterol acyltransferase (LCAT) syndrome, in relation to the severity of LCAT deficiency has not been analyzed. OBJECTIVE We have studied Lp8 in a patient with primary biliary cirrhosis. METHODS Plasma lipoproteins were analyzed using high-performance liquid chromatography/gel filtration column in the course of treatment of a 47-year-old female patient with primary biliary cirrhosis. RESULTS Electrophoretic lipoprotein analyses showed massive accumulation of abnormal ß- and preß-lipoproteins with a minor lipoprotein fraction at a position near the cathode corresponding to Lp-X, on day A (status: hypercholesterolemia, LCAT activity undetectable). Chromatographic lipoprotein subfraction analysis revealed free cholesterol- and phospholipid-rich lipoproteins in fractions 1-6, corresponding to chylomicrons and very low-density lipoprotein, and phospholipid- and triglyceride-rich lipoproteins with increased free cholesterol, that is, Lp8, in fractions 7-9 (corresponding to low-density lipoprotein). On day B, after additional treatment for 7 months (status: almost normolipidemia, decreased LCAT activity), although the abnormal lipoprotein and the lipoproteins in fractions 1-6, were drastically decreased, the presence of Lp8 persisted. CONCLUSIONS Lp8 likely is a minor abnormal lipoprotein fraction in patients with mildly decreased secondary LCAT activity, as well as with severely reduced primary LCAT activity.
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Affiliation(s)
- Toshiyuki Watanabe
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan; LSI Medience Corporation, Tokyo, Japan
| | - Toshirou Nema
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan; LSI Medience Corporation, Tokyo, Japan
| | - Nobuyuki Hiruta
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan; Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Takeyoshi Murano
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Wolfgang J Schneider
- Department of Medical Biochemistry, Max F. Perutz Laboratories, Medical University of Vienna, Vienna, Austria
| | - Hideaki Bujo
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan.
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25
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Kato S, Kamijima S, Inaoka T, Kamiya N, Sasai D, Terada H, Hiruta N, Suzuki H. Quantitative evaluation of the relative apparent diffusion coefficient values on multiparametric magnetic resonance imaging to predict higher Gleason score prostate cancer. Scand J Urol 2018; 52:180-185. [PMID: 29939084 DOI: 10.1080/21681805.2018.1481143] [Citation(s) in RCA: 4] [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] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Apparent diffusion coefficient (ADC) values on multiparametric magnetic resonance imaging (mpMRI) have been reported to correlate with high-Gleason score (GS) prostate cancer. However, the relative ADC values between tumor lesions and normal tissue have been suggested as more suitable than the absolute ADC values for evaluation of diffusion abnormalities, because absolute ADC values are susceptible to differences in scanners or scanner settings. The present study evaluated the usefulness of the relative assessment of ADC values between tumor lesions and normal tissue on preoperative mpMRI for the prediction of high-risk prostate cancer on radical prostatectomy specimens. MATERIALS AND METHODS A retrospective analysis of 48 men who underwent radical prostatectomy between January 2013 and December 2014 was conducted. MpMRI was performed with a 3.0-T scanner using b-values of 0 and 1500 s/mm2. ADC values of the tumor (ADCTUMOR) and normal prostate and the relative ADC tumor/normal ratio (ADCTNR) were evaluated by two radiologists. RESULTS The inter-rater reliability between two radiologists for ADCTUMOR measurement was high, with Pearson's r = 0.982. There was no difference in ADCTUMOR between GS ≤7 and GS ≥8. In contrast, ADCTNR was significantly lower in GS ≥8 than in GS ≤7. ROC curves of ADCTNR to predict higher GS (≥8) showed better classification performance (AUC = 0.8243, p = .0012 by radiologist A and AUC = 0.7961, p = .0031 by radiologist B) than of ADCTUMOR. CONCLUSIONS The relative assessment of ADC values between tumor lesions and normal tissue could improve the detection rate of high-risk prostate cancers.
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Affiliation(s)
- Seiji Kato
- a Department of Urology , Toho University Sakura Medical Center , Sakura , Japan
| | - Shuichi Kamijima
- a Department of Urology , Toho University Sakura Medical Center , Sakura , Japan
| | - Tsutomu Inaoka
- b Department of Radiology , Toho University Sakura Medical Center , Sakura , Japan
| | - Naoto Kamiya
- a Department of Urology , Toho University Sakura Medical Center , Sakura , Japan
| | - Daisuke Sasai
- c Department of Surgical Pathology , Toho University Sakura Medical Center , Sakura , Japan.,d Department of Pathology , Seirei Sakura Citizen Hospital , Sakura , Japan
| | - Hitoshi Terada
- b Department of Radiology , Toho University Sakura Medical Center , Sakura , Japan
| | - Nobuyuki Hiruta
- c Department of Surgical Pathology , Toho University Sakura Medical Center , Sakura , Japan
| | - Hiroyoshi Suzuki
- a Department of Urology , Toho University Sakura Medical Center , Sakura , Japan
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Qu J, Hiruta N, Terai K, Nosato H, Murakawa M, Sakanashi H. Gastric Pathology Image Classification Using Stepwise Fine-Tuning for Deep Neural Networks. J Healthc Eng 2018; 2018:8961781. [PMID: 30034677 PMCID: PMC6033298 DOI: 10.1155/2018/8961781] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/14/2018] [Accepted: 05/27/2018] [Indexed: 02/06/2023]
Abstract
Deep learning using convolutional neural networks (CNNs) is a distinguished tool for many image classification tasks. Due to its outstanding robustness and generalization, it is also expected to play a key role to facilitate advanced computer-aided diagnosis (CAD) for pathology images. However, the shortage of well-annotated pathology image data for training deep neural networks has become a major issue at present because of the high-cost annotation upon pathologist's professional observation. Faced with this problem, transfer learning techniques are generally used to reinforcing the capacity of deep neural networks. In order to further boost the performance of the state-of-the-art deep neural networks and alleviate insufficiency of well-annotated data, this paper presents a novel stepwise fine-tuning-based deep learning scheme for gastric pathology image classification and establishes a new type of target-correlative intermediate datasets. Our proposed scheme is deemed capable of making the deep neural network imitating the pathologist's perception manner and of acquiring pathology-related knowledge in advance, but with very limited extra cost in data annotation. The experiments are conducted with both well-annotated gastric pathology data and the proposed target-correlative intermediate data on several state-of-the-art deep neural networks. The results congruously demonstrate the feasibility and superiority of our proposed scheme for boosting the classification performance.
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Affiliation(s)
- Jia Qu
- Department of Intelligent Interaction Technologies, University of Tsukuba, Tsukuba 305-8573, Japan
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura 285-8741, Japan
| | - Kensuke Terai
- Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura 285-8741, Japan
| | - Hirokazu Nosato
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba 305-8560, Japan
| | - Masahiro Murakawa
- Department of Intelligent Interaction Technologies, University of Tsukuba, Tsukuba 305-8573, Japan
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba 305-8560, Japan
| | - Hidenori Sakanashi
- Department of Intelligent Interaction Technologies, University of Tsukuba, Tsukuba 305-8573, Japan
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba 305-8560, Japan
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27
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Wakai K, Utsumi T, Yoneda K, Oka R, Endo T, Yano M, Fujimura M, Kamiya N, Sekita N, Mikami K, Sugano I, Hiruta N, Suzuki H. Development and external validation of a nomogram to predict high-grade papillary bladder cancer before first-time transurethral resection of the bladder tumor. Int J Clin Oncol 2018; 23:957-964. [DOI: 10.1007/s10147-018-1299-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/23/2018] [Indexed: 11/30/2022]
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28
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Yoneda K, Utsumi T, Somoto T, Wakai K, Oka R, Endo T, Yano M, Kamiya N, Hiruta N, Suzuki H. External validation of two web-based postoperative nomograms predicting the probability of early biochemical recurrence after radical prostatectomy: a retrospective cohort study. Jpn J Clin Oncol 2018; 48:195-199. [PMID: 29228232 DOI: 10.1093/jjco/hyx174] [Citation(s) in RCA: 4] [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: 09/12/2017] [Accepted: 11/14/2017] [Indexed: 12/29/2022] Open
Abstract
The present study aimed to validate and compare the predictive accuracies of the Memorial Sloan Kettering Cancer Center (MSKCC) and Johns Hopkins University (JHU) web-based postoperative nomograms for predicting early biochemical recurrence (BCR) after radical prostatectomy (RP) and to analyze clinicopathological factors to predict early BCR after RP using our dataset. The c-index was 0.72 (95% confidence (CI): 0.61-0.83) for the MSKCC nomogram and 0.71 (95% CI: 0.61-0.81) for the and JHU nomogram, demonstrating fair performance in the Japanese population. Furthermore, we statistically analyzed our 174 patients to elucidate prognostic factors for early BCR within 2 years. Lymphovascular invasion (LVI) including lymphatic vessel invasion (ly) was a significant predictor of early BCR in addition to common variables (pT stage, extraprostatic extension, positive surgical margin and seminal vesicle invasion). LVI, particularly ly, may provide a good predictor of early BCR after RP and improve the accuracy of the nomograms.
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Affiliation(s)
- Kei Yoneda
- Department of Urology, Toho University Sakura Medical Center, Chiba,Japan
| | - Takanobu Utsumi
- Department of Urology, Toho University Sakura Medical Center, Chiba, Japan.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Takatoshi Somoto
- Department of Urology, Toho University Sakura Medical Center, Chiba,Japan
| | - Ken Wakai
- Department of Urology, Toho University Sakura Medical Center, Chiba,Japan
| | - Ryo Oka
- Department of Urology, Toho University Sakura Medical Center, Chiba,Japan
| | - Takumi Endo
- Department of Urology, Toho University Sakura Medical Center, Chiba,Japan
| | - Masashi Yano
- Department of Urology, Toho University Sakura Medical Center, Chiba,Japan
| | - Naoto Kamiya
- Department of Urology, Toho University Sakura Medical Center, Chiba,Japan
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, Chiba,Japan
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, Chiba,Japan
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29
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Mikamo H, Jiang M, Noro M, Suzuki Y, Hiruta N, Unoki-Kubota H, Schneider WJ, Bujo H. Susceptibilities of epicardial and subcutaneous fat tissue for browning-gene expression and diet-induced volume reduction are different. Mol Med Rep 2018; 17:6542-6550. [PMID: 29512723 PMCID: PMC5928636 DOI: 10.3892/mmr.2018.8690] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 01/25/2018] [Indexed: 12/13/2022] Open
Abstract
The upregulation of brown or brown-like beige adipocytes is a potential strategy for the prevention or treatment of diabetes and coronary artery diseases in obese patients. Epicardial adipose tissue (EAT) differs significantly from subcutaneous fat tissue (SAT) in metabolic properties. To investigate properties of EAT further, thermogenesis gene expression was investigated in human autopsy and murine samples, and adipocytes differentiated from EAT mesenchymal cells. Subsequently, analyzed EAT volume alterations were observed to be associated with weight reduction in obese patients by imaging. Gene expression analyses of autopsy samples revealed that UCP‑1 mRNA levels in EAT were significantly increased compared with SAT, and β3‑adrenergic receptor (AR) levels tended to be increased; this finding was verified in comparing EAT with SAT in mice. Browning stimulation of human EAT‑derived MCs increased uncoupling protein‑1 and β3‑AR levels by 3.2 fold‑ and 12.6‑fold compared with SAT‑derived MCs, respectively. Subsequent imaging for EAT volume measurement using multi‑detector computed tomography in 10 obese patients revealed that mean EAT volumes did not significantly decrease following weight loss therapy. The EAT volume alterations were not correlated with weight changes, whereas positive correlations were observed in SAT and visceral adipose tissue. Therefore, the studies in man and mouse on EAT properties demonstrated that susceptibilities of EAT and SAT for browning‑gene expression and diet‑induced volume reduction were grossly different. The data suggest a potential association of EAT with local thermogenetic and metabolic homeostasis in cardiac and/or cardiovascular cells, in conjunction with systemic energy metabolism.
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Affiliation(s)
- Hiroshi Mikamo
- Department of Cardiology, Toho University Sakura Medical Center, Sakura, Chiba 285‑8741, Japan
| | - Meizi Jiang
- Department of Clinical‑Laboratory and Experimental‑Research Medicine, Toho University Sakura Medical Center, Sakura, Chiba 285‑8741, Japan
| | - Mahito Noro
- Department of Cardiology, Toho University Sakura Medical Center, Sakura, Chiba 285‑8741, Japan
| | - Yasuo Suzuki
- Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Chiba 285‑8741, Japan
| | - Nobuyuki Hiruta
- Department of Pathology, Toho University Sakura Medical Center, Sakura, Chiba 285‑8741, Japan
| | - Hiroyuki Unoki-Kubota
- Department of Diabetic Complications, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Wolfgang J Schneider
- Department of Medical Biochemistry, Max F. Perutz Laboratories, Medical University of Vienna, Vienna 1090, Austria
| | - Hideaki Bujo
- Department of Clinical‑Laboratory and Experimental‑Research Medicine, Toho University Sakura Medical Center, Sakura, Chiba 285‑8741, Japan
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30
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Yamashita N, Saito N, Zhao S, Terai K, Hiruta N, Park Y, Bujo H, Nemoto K, Kanno Y. Heregulin-induced cell migration is promoted by aryl hydrocarbon receptor in HER2-overexpressing breast cancer cells. Exp Cell Res 2018; 366:34-40. [PMID: 29501698 DOI: 10.1016/j.yexcr.2018.02.033] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 12/08/2017] [Revised: 02/16/2018] [Accepted: 02/26/2018] [Indexed: 12/19/2022]
Abstract
HER2 overexpression accounts for approximately 15-20% of all breast cancers. We have shown that HER2 overexpression leads to elevated expression of the aryl hydrocarbon receptor (AhR) in breast cancer cells. In this study, firstly, we showed that AhR expression was up-regulated by treatment with the HER3 ligand heregulin (HRG) in HER2-overexpressing breast cancer cell lines. Induction of AhR was mediated by transcriptional activation of the region of AhR promoter corresponding to - 190 to - 100 bp. In addition, HRG treatment elicited nuclear translocation of AhR. To investigate the role of AhR in HRG-HER2/HER3 signaling in HER2-overexpressing cells, we established AhR knockout (KO) HER2-overexpressing cells to perform wound-healing assays. HRG-induced cell migration was markedly attenuated by AhR KO. HRG-induced cell migration was associated with increased expression of the inflammatory cytokines interleukin (IL)-6 and IL-8 in wild type cells, but not in AhR KO cells. These results elucidate that AhR is an important factor for the malignancy in HER2 overexpressing breast cancers.
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Affiliation(s)
- Naoya Yamashita
- Department of Molecular Toxicology, Faculty of Pharmaceutical Sciences, Toho University, Miyama 2-2-1, Funabashi, Chiba 274-8510, Japan
| | - Nao Saito
- Department of Molecular Toxicology, Faculty of Pharmaceutical Sciences, Toho University, Miyama 2-2-1, Funabashi, Chiba 274-8510, Japan
| | - Shuai Zhao
- Department of Molecular Toxicology, Faculty of Pharmaceutical Sciences, Toho University, Miyama 2-2-1, Funabashi, Chiba 274-8510, Japan
| | - Kensuke Terai
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura, Chiba 285-8741, Japan; Department of Surgical Pathology, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura, Chiba 285-8741, Japan
| | - Nobuyuki Hiruta
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura, Chiba 285-8741, Japan; Department of Surgical Pathology, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura, Chiba 285-8741, Japan
| | - Youngjin Park
- Department of Surgery, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura, Chiba 285-8741, Japan; Department of Breast and Endocrine Surgery, Tohoku Medical and Pharmaceutical University, Fukumuro 1-15-1, Miyagino-ku, Sendai, Miyagi prefecture, 983-8536, Japan
| | - Hideaki Bujo
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura, Chiba 285-8741, Japan
| | - Kiyomitsu Nemoto
- Department of Molecular Toxicology, Faculty of Pharmaceutical Sciences, Toho University, Miyama 2-2-1, Funabashi, Chiba 274-8510, Japan
| | - Yuichiro Kanno
- Department of Breast and Endocrine Surgery, Tohoku Medical and Pharmaceutical University, Fukumuro 1-15-1, Miyagino-ku, Sendai, Miyagi prefecture, 983-8536, Japan.
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31
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Shimizu N, Tanaka S, Watanabe Y, Tokuyama W, Hiruta N, Ohwada C, Sakaida E, Nakaseko C, Tatsuno I. Syndrome of Inappropriate Antidiuretic Hormone Secretion in a Patient with Mucosa-associated Lymphoid Tissue Lymphoma. Intern Med 2017; 56:3225-3229. [PMID: 29021471 PMCID: PMC5742398 DOI: 10.2169/internalmedicine.9048-17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 01/25/2023] Open
Abstract
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) may develop in association with several malignancies. However, as an immunohistochemical analysis is not performed in the majority cases, its true cause is often uncertain. We herein report a case of SIADH following chemotherapy due to tumor-derived ADH production in a patient with mucosa-associated lymphoid tissue (MALT) lymphoma. A retrospective immunohistochemical analysis demonstrated ADH expression by lymphoma cells. These findings highlight the importance of using an immunohistochemical analysis to determine ADH production by tumor cells in patients with SIADH. Such analyses play an important role in elucidating the pathogenesis of SIADH and determining the most appropriate treatment.
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Affiliation(s)
- Naomi Shimizu
- Center for Diabetes, Metabolism and Endocrinology, Toho University Sakura Medical Center, Japan
| | - Sho Tanaka
- Center for Diabetes, Metabolism and Endocrinology, Toho University Sakura Medical Center, Japan
| | - Yasuhiro Watanabe
- Center for Diabetes, Metabolism and Endocrinology, Toho University Sakura Medical Center, Japan
| | - Wataru Tokuyama
- Division of Pathology, Toho University Sakura Medical Center, Japan
| | - Nobuyuki Hiruta
- Division of Pathology, Toho University Sakura Medical Center, Japan
| | - Chikako Ohwada
- Department of Hematology, Chiba University Hospital, Japan
| | - Emiko Sakaida
- Department of Hematology, Chiba University Hospital, Japan
| | | | - Ichiro Tatsuno
- Center for Diabetes, Metabolism and Endocrinology, Toho University Sakura Medical Center, Japan
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Ota Y, Ishikawa F, Sato T, Hiruta N, Kitamura M, Yokota H, Ikemiyagi Y, Bujo H, Fujiwara M, Suzuki M. A case of refractory chronic rhinosinusitis with anti-desmoglein 3 IgG4 autoantibody. Allergol Int 2017; 66:634-636. [PMID: 28522276 DOI: 10.1016/j.alit.2017.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 04/11/2017] [Accepted: 04/12/2017] [Indexed: 12/24/2022] Open
Affiliation(s)
- Yasushi Ota
- Department of Otorhinolaryngology, Toho University Sakura Medical Center, Chiba, Japan.
| | - Fumio Ishikawa
- Department of Molecular Immunology, Toho University School of Medicine, Tokyo, Japan
| | - Toshiya Sato
- Clinical Laboratory Department, Toho University Sakura Medical Center, Chiba, Japan
| | - Nobuyuki Hiruta
- Pathology Department, Toho University Sakura Medical Center, Chiba, Japan
| | - Makoto Kitamura
- Pathology Department, Toho University Sakura Medical Center, Chiba, Japan
| | - Hiromitsu Yokota
- Clinical Laboratory Program Education Development Center, Faculty of Science, Toho University, Chiba, Japan
| | - Yoshihiro Ikemiyagi
- Department of Otorhinolaryngology, Toho University Sakura Medical Center, Chiba, Japan
| | - Hideaki Bujo
- Department of Molecular Immunology, Toho University School of Medicine, Tokyo, Japan
| | - Mutsunori Fujiwara
- Department of Clinical Laboratory, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Mitsuya Suzuki
- Department of Otorhinolaryngology, Toho University Sakura Medical Center, Chiba, Japan
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Yamaguchi T, Murano T, Tatsuno I, Hiruta N, Suzuki T, Sawada S, Katagiri H, Shirai K, Schneider WJ, Bujo H. Severely impaired activity of lipoprotein lipase Arg243His is partially ameliorated by emulsifying phospholipids in in vitro triolein hydrolysis analysis. Ann Clin Biochem 2017; 54:712-715. [PMID: 28114790 DOI: 10.1177/0004563217693258] [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] [Indexed: 11/16/2022]
Abstract
Background We investigated the in vitro effects of various phospholipids as emulsifiers on the hydrolysing activities of lipoprotein lipase (LPL) Arg243His against triolein as substrate. LPL Arg243His, identified in a patient with hyperchylomicronaemia, displays severely diminished activity for triolein when emulsified with Triton X-100. Methods Lipolytic activities of plasma obtained by heparin injection from a homozygous patient with LPL Arg243His were analysed using triolein emulsified with phosphatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylserine (PS), phosphatidylinositol (PI), lysophosphatidylcholine (LPC), or Triton X-100 as substrates. Results The hydrolysing activities of the patient's plasma for triolein emulsified with PC, PE, PS, PI, LPC and Triton X-100 were 9.22 ± 1.06 μmol/ml/h/ngLPL, 2.94 ± 1.60 μmol/ml/h/ng LPL, 3.72 ± 1.63 μmol/ml/h/ng LPL, 3.40 ± 1.20 μmol/ml/h/ngLPL, 3.72 ± 1.96 μmol/ml/h/ngLPL and 7.80 ± 4.48 μmol/ml/h/ng LPL, respectively. Thus, the specific activities of the patient's LPL determined with triolein emulsified with PC were significantly higher than those with PE, PS, PI or LPC as emulsifiers. Relative to the activities of normal plasma measured with PC, PE, PS, PI and LPC as emulsifiers, the mutant's activities were 49.1 ± 5.2%, 44.1 ± 5.7%, 31.7 ± 12.6%, 19.2 ± 6.9% and 23.8 ± 11.3%, respectively. Using PC, PE, PS, PI and LPC as emulsifiers, the mutant's activities for triolein-lipolysis relative to normal were significantly increased in comparison to the relative activity measured with the classical emulsifier, Triton X-100 (12.9 ± 6.7%). Conclusions Impaired triolein hydrolysis by LPL Arg243His was partially ameliorated by triolein emulsification with phospholipids. The in vitro analysis of triolein hydrolysis using various phospholipid emulsifiers may be useful for the further understanding of impaired LPL function.
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Affiliation(s)
- Takashi Yamaguchi
- 1 Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, Sakura, Japan
| | - Takeyoshi Murano
- 2 Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Ichiro Tatsuno
- 1 Center of Diabetes, Endocrinology and Metabolism, Toho University Sakura Medical Center, Sakura, Japan
| | - Nobuyuki Hiruta
- 2 Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Toru Suzuki
- 3 Department of Diabetes and Metabolism, Tohoku University Hospital, Sendai, Japan
| | - Shojiro Sawada
- 3 Department of Diabetes and Metabolism, Tohoku University Hospital, Sendai, Japan
| | - Hideki Katagiri
- 3 Department of Diabetes and Metabolism, Tohoku University Hospital, Sendai, Japan
| | - Kohji Shirai
- 4 Department of Vascular Function, Toho University Sakura Medical Center, Sakura, Japan
| | - Wolfgang J Schneider
- 5 Department of Medical Biochemistry, Max F. Perutz Laboratories, Medical University of Vienna, Vienna, Austria
| | - Hideaki Bujo
- 2 Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan
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Uchida Y, Uchida Y, Kobayashi T, Shirai S, Hiruta N, Shimoyama E, Tabata T. Detection of Ceramide, a Risk Factor for Coronary Artery Disease, in Human Coronary Plaques by Fluorescent Angioscopy. Circ J 2017; 81:1886-1893. [DOI: 10.1253/circj.cj-17-0363] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | | | | | - Nobuyuki Hiruta
- Department of Pathology, Toho University Medical Center Sakura Hospital
| | - Ei Shimoyama
- Department of Pathology, Funabashi-Futawa Hospital
| | - Tsuyoshi Tabata
- Department of Clinical Physiology, Toho University Medical Center Sakura Hospital
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35
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Uchida Y, Uchida Y, Hiruta N, Shirai S, Yoshida T. Imaging of Triglycerides in Human Coronary Plaques by Color Fluorescent Angioscopy and Microscopy. Am J Cardiol 2016; 118:1306-1310. [PMID: 27614848 DOI: 10.1016/j.amjcard.2016.07.065] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 07/28/2016] [Accepted: 07/28/2016] [Indexed: 12/01/2022]
Abstract
Native triglycerides (TG) deposited in the human vascular wall is not measurable or visible in vivo to date. We discovered that by exciting fluorescence at 345 nm and emitting at 420 nm, 3-amino-4-hydroxy-5-nitrobenzene sulfonic acid monohydrate (3-ANA) elicits a brown fluorescence that is characteristic of just TG. Therefore, localization of TG in coronary plaques and normal segments that were obtained from 19 human autopsy cases was examined by color fluorescent angioscopy (CFA) and microscopy using 3-ANA as a biomarker of TG. By CFA, the percentage (%) incidence of TG in 23 normal segments, 13 white plaques without lipid deposition, 18 white plaques (growth stage) with lipid deposition, 11 yellow plaques without necrotic core (mature stage), and 12 yellow plaques with necrotic core (advanced mature stage) was 95, 92, 50, 27, and 25, respectively. By color fluorescent microscopy, TG deposited mostly in the fibrotic area of the plaques. Contrary to the general belief that TG amount increases with plaque maturation, the results indicated that TG was deposited in most of the normal coronary segments, but the amount decreased with plaque maturation. If 3-ANA becomes applicable clinically, the CFA system could be used for imaging TG within coronary plaques in patients in vivo.
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Affiliation(s)
- Yasumi Uchida
- Japan Foundation for Cardiovascular Research, Funabashi, Japan; Department of Cardiology, Tokyo Jikei University School of Medicine, Tokyo, Japan.
| | - Yasuto Uchida
- Department of Cardiology, Tsukuba Memorial Hospital, Tsukuba, Japan
| | - Nobuyuki Hiruta
- Department of Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Seiichiro Shirai
- Department of Cardiology, Funabashi-Futawa Hospital, Funabashi, Japan
| | - Tomoe Yoshida
- Department of Otolaryngology, Toho University Sakura Medical Center, Sakura, Japan
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Ota Y, Ikemiyagi Y, Sato T, Funakoshi T, Hiruta N, Kitamura M, Bujo H, Suzuki M. Measuring local immunoglobulin E in the inferior turbinate nasal mucosa in patients with allergic rhinitis. Allergol Int 2016; 65:396-399. [PMID: 27516133 DOI: 10.1016/j.alit.2016.03.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 02/18/2016] [Accepted: 03/01/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Studies show that immunoglobulin E (IgE) is produced in the local nasal mucosa in allergic rhinitis patients. However, no study involved the measurement of IgE levels in the local nasal mucosal tissue in allergic rhinitis patients. This study aimed to measure the local IgE levels in the nasal mucosal tissue and to compare the levels of total IgE and specific IgEs in the serum and the inferior turbinate nasal mucosa in allergic rhinitis patients using the AlaSTAT 3gAllergy assay (Siemens Healthcare Diagnostics AG, Erlangen, Germany). METHODS Total IgE antibodies and allergen-specific IgE antibodies in each sample of nasal mucosal tissue from 11 allergic rhinitis patients were measured with the AlaSTAT 3gAllergy assay. We compared the levels of total IgE and IgEs specific for house dust (HD), mites, and cedar pollen in the serum and the inferior turbinate. RESULTS The total IgE levels and the cedar pollen-specific IgE levels in the inferior turbinate mucosal tissue correlated significantly with their respective levels in serum. The HD- and mite-specific IgE levels in the inferior turbinate mucosal tissue did not correlate significantly with their respective levels in the serum. CONCLUSIONS Our results evaluating the correlations between nasal mucosal and serum levels of antigen-specific IgE indicate that IgE produced in the nasal mucosa affects the IgE levels in the serum, especially the cedar pollen-specific IgE.
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Wakai K, Utsumi T, Oka R, Endo T, Yano M, Kamijima S, Kamiya N, Hiruta N, Suzuki H. Clinical predictors for high-grade bladder cancer before first-time transurethral resection of the bladder tumor: a retrospective cohort study. Jpn J Clin Oncol 2016; 46:964-967. [PMID: 27511986 DOI: 10.1093/jjco/hyw111] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 07/14/2016] [Indexed: 11/12/2022] Open
Abstract
The aim of this study was to identify the clinical predictors related to the risk of high-grade bladder cancer before first-time transurethral resection of the bladder tumor (TUR-Bt) and to externally validate the accuracy of Shapur's nomogram predicting the risk of high-grade bladder cancer in Japanese patients. As a result, episode of gross hematuria (odds ratio: 2.68, P = 0.02), larger tumor size (odds ratio: 1.89, P < 0.01) and positive urinary cytology (odds ratio: 8.34, P < 0.01) were found to be significant predictors for high-grade bladder cancer. Furthermore, the nomogram showed a high predictive accuracy in our Japanese population (area under the curve: 0.79). Clinicians will be able to predict high-grade bladder cancer using the common factors in Shapur's study and ours, such as tumor size and urinary cytology, and gross hematuria as the additional factor first identified here to decide priorities for the treatment of patients diagnosed with bladder cancer.
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Affiliation(s)
- Ken Wakai
- Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan
| | - Takanobu Utsumi
- Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan
| | - Ryo Oka
- Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan
| | - Takumi Endo
- Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan
| | - Masashi Yano
- Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan
| | - Shuichi Kamijima
- Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan
| | - Naoto Kamiya
- Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, Sakura-shi, Chiba, Japan
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Aiba Y, Sakakibara R, Abe F, Higuchi T, Tokuyama W, Hiruta N, Tateno F, Tsuyusaki Y, Kishi M, Tateno H, Ogata T. Neuronal intranuclear inclusion disease with leukoencephalopathy and light motor-sensory and autonomic neuropathy diagnosed by skin biopsy. J Neurol Sci 2016; 368:263-5. [PMID: 27538646 DOI: 10.1016/j.jns.2016.07.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 07/08/2016] [Accepted: 07/15/2016] [Indexed: 01/01/2023]
Affiliation(s)
- Yosuke Aiba
- Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan
| | - Ryuji Sakakibara
- Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan.
| | - Fumihito Abe
- Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan
| | - Tetsuya Higuchi
- Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan
| | - Wataru Tokuyama
- Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan
| | - Nobuyuki Hiruta
- Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan
| | - Fuyuki Tateno
- Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan
| | - Yohei Tsuyusaki
- Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan
| | - Masahiko Kishi
- Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan
| | - Hiromi Tateno
- Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan
| | - Tsuyoshi Ogata
- Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan
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Uchida Y, Uchida Y, Shimoyama E, Hiruta N, Kishimoto T, Watanabe S. Human pericoronary adipose tissue as storage and possible supply site for oxidized low-density lipoprotein and high-density lipoprotein in coronary artery. J Cardiol 2016; 69:236-244. [PMID: 27209423 DOI: 10.1016/j.jjcc.2016.03.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 03/22/2016] [Accepted: 03/25/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Thickening of the pericoronary adipose tissue (PCAT) is a proven risk factor for coronary artery disease, but it is poorly understood whether PCAT stores pro-atherogenic substances with oxidized low-density lipoprotein (oxLDL) and low-density lipoprotein (LDL), and an anti-atherogenic substance with high-density lipoprotein (HDL) and supply them to the coronary intima. METHODS Using immunohistochemical techniques, the localization of oxLDL, LDL and HDL in PCAT and its adjacent coronary segments was examined in 30 epicardial coronary arteries excised from 11 human autopsy cases. RESULTS PCAT stored oxLDL and HDL in all, but LDL rarely, in 77 specimens examined, irrespective of the presence or absence of coronary plaques and underlying disease. The percentage (%) incidence of oxLDL, HDL and LDL deposits in intima was, respectively, 28, 10, 35 in 29 normal segments, 80 (p<0.05 vs. normal segments), 12, 75 in 19 white plaques (growth stage), 57, 36, 90 in 15 yellow plaques without necrotic core (NC; mature stage), and 40, 21, 100 (p<0.05 vs. normal segments) in 14 yellow plaques with NC (end-stage of maturation) as classified by angioscopy and histology. In coronary intima, oxLDL deposited in either a dotted or diffuse pattern whereas HDL and LDL showed diffuse patterns. Dotted oxLDL deposits were contained in CD68(+)-macrophages traversing the border of PCAT and adventitia, external and internal elastic laminae. Diffuse oxLDL and HDL deposits colocalized with intimal vasa vasorum. CONCLUSIONS The results suggested that, as a hitherto unrecognized supplying route, the human PCAT stores oxLDL and HDL and oxLDL is supplied to coronary intima either by CD68(+)-macrophages or vasa vasorum and HDL by vasa vasorum, and that deposition of oxLDL and HDL in the intima increased with plaque growth but the former decreased while the latter increased further with plaque maturation. Molecular therapy targeting PCAT before plaque maturation could be effective in preventing atherosclerosis.
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Affiliation(s)
- Yasumi Uchida
- Japanese Foundation for Cardiovascular Research, Funabashi, Japan; Department of Cardiology, Tokyo Jikei University School of Medicine, Tokyo, Japan.
| | - Yasuto Uchida
- Department of Cardiology, Tsukuba Memorial Hospital, Tsukuba, Japan
| | - Ei Shimoyama
- Department of Pathology, Funabashi-Futawa Hospital, Funabashi, Japan
| | - Nobuyuki Hiruta
- Department of Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | | | - Soichiro Watanabe
- Department of Biomolecular Science, Toho University, Funabashi, Japan
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Terai K, Jiang M, Tokuyama W, Murano T, Takada N, Fujimura K, Ebinuma H, Kishimoto T, Hiruta N, Schneider WJ, Bujo H. Levels of soluble LR11/SorLA are highly increased in the bile of patients with biliary tract and pancreatic cancers. Clin Chim Acta 2016; 457:130-6. [PMID: 27079357 DOI: 10.1016/j.cca.2016.04.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 12/15/2015] [Revised: 03/24/2016] [Accepted: 04/07/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND The utility of molecules derived from cancer cells as biomarkers of the pathological status in biliary tract and pancreatic cancers is still limited. Soluble LDL receptor relative with 11 ligand-binding repeats (sLR11), a molecule released from immature cells, has been shown to be a circulating biomarker for early stage hematological malignancies. METHODS We have evaluated the pathological significance of bile sLR11 levels in 147 samples from 72 patients with biliary tract cancer (BTC), pancreatic cancer (PC), or benign diseases. RESULTS The bile sLR11 levels in the cancer patients were significantly increased compared with those in patients without cancer, independent of cytological detection of cancer cells in bile. The average bile sLR11 levels in cancer patients were significantly higher than in those with benign diseases, while levels of bile carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) were not different. LR11 protein was found to be highly expressed in the BTC and PC cells. The LR11 transcript levels in cholangiocarcinoma and pancreatic cancer cell lines were sharply induced during proliferation and significantly increased under hypoxic conditions. CONCLUSIONS Therefore, sLR11 levels in bile may be indicative of cancer cell conditions and may serve as potential novel biomarker in patients with BTC and PC.
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Affiliation(s)
- Kensuke Terai
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan; Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan; Department of Biomolecular Science, Toho University Graduate School of Science, Funabashi, Japan
| | - Meizi Jiang
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Wataru Tokuyama
- Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Takeyoshi Murano
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Nobuo Takada
- Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Kengo Fujimura
- Tsukuba Research Institute, Sekisui Medical Co Ltd, Ryugasaki, Japan
| | - Hiroyuki Ebinuma
- Tsukuba Research Institute, Sekisui Medical Co Ltd, Ryugasaki, Japan
| | - Toshihiko Kishimoto
- Department of Biomolecular Science, Toho University Graduate School of Science, Funabashi, Japan
| | - Nobuyuki Hiruta
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan; Department of Surgical Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Wolfgang J Schneider
- Department of Medical Biochemistry, Max F. Perutz Laboratories, Medical University of Vienna, Vienna, Austria
| | - Hideaki Bujo
- Department of Clinical-Laboratory and Experimental-Research Medicine, Toho University Sakura Medical Center, Sakura, Japan.
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Uchida Y, Uchida Y, Shimoyama E, Hiruta N, Kishimoto T, Watanabe S. Pericoronary Adipose Tissue as Storage and Supply Site for Oxidized Low-Density Lipoprotein in Human Coronary Plaques. PLoS One 2016; 11:e0150862. [PMID: 27010927 PMCID: PMC4807097 DOI: 10.1371/journal.pone.0150862] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 02/19/2016] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES It is generally believed that low-density lipoprotein enters the vascular wall from its lumen and oxidized (oxLDL), after which it plays an important role in atherosclerosis. Because voluminous epicardial adipose tissue is a risk factor for coronary events, there is a possibility that the pericoronary adipose tissue (PCAT), which is a part of epicardial adipose tissue, acts as a risk factor by supplying oxLDL to the coronary arterial wall. The present study was performed whether PCAT stores and supplies oxLDL to the coronary wall. METHODS Localization of oxLDL in PCAT and its relation to plaque morphology were examined by immunohistochemical techniques in 27 epicardial coronary arteries excised from 9 human autopsy cases. RESULTS OxLDL deposited in all PCAT of the studied cases. The percent (%) incidence of oxLDL in the intima of 25 normal segment, 19 white plaques, 15 yellow plaques without necrotic core (NC) and 10 yellow plaques with NC, was 32, 84, 93 (p<0.05 vs normal segments and yellow plaques with NC), and 30, respectively. OxLDL deposited either in dotted or diffuse pattern. Double immunohistochemical staining revealed that the dotted oxLDL was that contained in CD68(+)-macrophages. The oxLDL-containing macrophages were observed in the interstitial space but not inside of the vasa vasorum, and they traversed PCAT, adventitia, external and internal elastic laminae, suggesting their migration towards the intima. Diffuse oxLDL deposits were observed in 17 preparations, the majority of which were co-localized with the vasa vasorum in outer or in both inner and outer halves of intima, and rarely in the inner half alone. CONCLUSIONS The results suggested that PCAT is a supply source of oxLDL to coronary intima and acts as a risk factor for coronary events, that oxLDL increasingly deposits in the intima with plaque growth and decreases after plaque maturation, and therefore molecular therapies targeting the PCAT before plaque growth could be effective in preventing human coronary atherosclerosis.
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Affiliation(s)
- Yasumi Uchida
- Japanese Foundation for Cardiovascular Research, Funabashi, Japan
- Department of Cardiology, Tokyo Jikei University School of Medicine, Tokyo, Japan
| | - Yasuto Uchida
- Department of Cardiology, Tsukuba Memorial Hospital, Tsukuba, Japan
| | - Ei Shimoyama
- Department of Pathology, Funabashi-Futawa Hospital, Funabashi, Japan
| | - Nobuyuki Hiruta
- Department of Pathology, Toho University Sakura Medical Center, Sakura, Japan
| | - Toshihiko Kishimoto
- Department of Biomolecular Science, Faculty of Science, Toho University, Okubo, Funabashi, Japan
| | - Soichiro Watanabe
- Department of Biomolecular Science, Faculty of Science, Toho University, Okubo, Funabashi, Japan
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Utsumi T, Oka R, Endo T, Yano M, Kamijima S, Kamiya N, Fujimura M, Sekita N, Mikami K, Hiruta N, Suzuki H. External validation and comparison of two nomograms predicting the probability of Gleason sum upgrading between biopsy and radical prostatectomy pathology in two patient populations: a retrospective cohort study. Jpn J Clin Oncol 2015; 45:1091-5. [PMID: 26292699 DOI: 10.1093/jjco/hyv128] [Citation(s) in RCA: 6] [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: 04/10/2015] [Accepted: 08/02/2015] [Indexed: 12/24/2022] Open
Abstract
The aim of this study is to validate and compare the predictive accuracy of two nomograms predicting the probability of Gleason sum upgrading between biopsy and radical prostatectomy pathology among representative patients with prostate cancer. We previously developed a nomogram, as did Chun et al. In this validation study, patients originated from two centers: Toho University Sakura Medical Center (n = 214) and Chibaken Saiseikai Narashino Hospital (n = 216). We assessed predictive accuracy using area under the curve values and constructed calibration plots to grasp the tendency for each institution. Both nomograms showed a high predictive accuracy in each institution, although the constructed calibration plots of the two nomograms underestimated the actual probability in Toho University Sakura Medical Center. Clinicians need to use calibration plots for each institution to correctly understand the tendency of each nomogram for their patients, even if each nomogram has a good predictive accuracy.
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Affiliation(s)
- Takanobu Utsumi
- Department of Urology, Toho University Sakura Medical Center, Sakura-shi
| | - Ryo Oka
- Department of Urology, Toho University Sakura Medical Center, Sakura-shi
| | - Takumi Endo
- Department of Urology, Toho University Sakura Medical Center, Sakura-shi
| | - Masashi Yano
- Department of Urology, Toho University Sakura Medical Center, Sakura-shi
| | - Shuichi Kamijima
- Department of Urology, Toho University Sakura Medical Center, Sakura-shi
| | - Naoto Kamiya
- Department of Urology, Toho University Sakura Medical Center, Sakura-shi
| | - Masaaki Fujimura
- Department of Urology, Chibaken Saiseikai Narashino Hospital, Narashino-shi
| | - Nobuyuki Sekita
- Department of Urology, Chibaken Saiseikai Narashino Hospital, Narashino-shi
| | - Kazuo Mikami
- Department of Urology, Chibaken Saiseikai Narashino Hospital, Narashino-shi
| | - Nobuyuki Hiruta
- Department of Pathology, Toho University Sakura Medical Center, Sakura-shi, Japan
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, Sakura-shi
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Manrai M, Takesita N, Ishida H, Takashima A, Adachi T, Sasaki I, Yokokawa K, Tokuyama W, Hiruta N, Kinoshita T. Primary retroperitoneal mucinous cystic tumors with borderline malignancy: a case report and literature review. Clin Pract 2015; 5:722. [PMID: 25918634 PMCID: PMC4387346 DOI: 10.4081/cp.2015.722] [Citation(s) in RCA: 7] [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: 10/15/2014] [Revised: 12/13/2014] [Accepted: 12/17/2014] [Indexed: 11/22/2022] Open
Abstract
Primary retroperitoneal mucinous cystic tumors with borderline malignancy are rarely encountered. To date, only 12 cases have been reported in the literature. In this report, we present an additional case. A 65-year-old nulliparous woman complained of abdominal fullness. Her medical history included a hysterectomy and a single salpingo-oophorectomy performed 25 years prior to the present event. Physical examination revealed a large cystic mass in the abdomen and pelvis. During laparotomy, a cystic tumor measuring 21×14 cm in size was observed in the left retroperitoneal space. The tumor was resected, and the final diagnosis was primary retroperitoneal mucinous cystic cancer with borderline malignancy.
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Affiliation(s)
- Megumi Manrai
- Department of Obstetrics and Gynecology, Toho University Medical Center-Sakura Hospital , Chiba, Japan
| | - Naoki Takesita
- Department of Obstetrics and Gynecology, Toho University Medical Center-Sakura Hospital , Chiba, Japan
| | - Hiroaki Ishida
- Department of Obstetrics and Gynecology, Toho University Medical Center-Sakura Hospital , Chiba, Japan
| | - Akiko Takashima
- Department of Obstetrics and Gynecology, Toho University Medical Center-Sakura Hospital , Chiba, Japan
| | - Tomohiro Adachi
- Department of Obstetrics and Gynecology, Toho University Medical Center-Sakura Hospital , Chiba, Japan
| | - Izumi Sasaki
- Department of Obstetrics and Gynecology, Toho University Medical Center-Sakura Hospital , Chiba, Japan
| | - Kei Yokokawa
- Department of Obstetrics and Gynecology, Toho University Medical Center-Sakura Hospital , Chiba, Japan
| | - Wataru Tokuyama
- Department of Pathology, Toho University Medical Center-Sakura Hospital , Chiba, Japan
| | - Nobuyuki Hiruta
- Department of Pathology, Toho University Medical Center-Sakura Hospital , Chiba, Japan
| | - Toshihiko Kinoshita
- Department of Obstetrics and Gynecology, Toho University Medical Center-Sakura Hospital , Chiba, Japan
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Deguchi Y, Maeno T, Hori Y, Hiruta N, Sasai D, Sato Y. Migration of intraocular silicone oil from the vitreous cavity into the upper eyelid causing ptosis. Case Rep Ophthalmol 2014; 5:226-30. [PMID: 25202267 PMCID: PMC4152929 DOI: 10.1159/000365647] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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] [Indexed: 11/24/2022] Open
Abstract
Introduction To report a case in which intraocular silicone oil migrated into the upper eyelid and caused ptosis. Methods A 65-year-old woman presented with proliferative vitreoretinopathy in the right eye. Vitrectomies, injection of silicone oil and encircling were performed. Two months after the last operation, swelling of her right eyelid occurred. Result Magnetic resonance imaging revealed moisture in the palpebral fat tissue. We incised the bulbar conjunctiva and confirmed silicone oil leakage from the vitreous cavity through the scleral button hole of the encircling suture. Postoperatively, the right upper eyelid swelling decreased. Histopathologically, dense macrophage infiltration was seen in the palpebral tissues. Conclusions We report a rare case with a postoperative complication caused by silicone oil. In cases with swelling of the eyelid and decreased silicon oil in the vitreous cavity postoperatively, clinicians should consider the possibility of silicone oil leakage.
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Affiliation(s)
- Yuzo Deguchi
- Department of Ophthalmology, Toho University Sakura Medical Center, Chiba, Tochigi, Japan
| | - Takatoshi Maeno
- Department of Ophthalmology, Toho University Sakura Medical Center, Chiba, Tochigi, Japan
| | - Yuichi Hori
- Department of Ophthalmology, Toho University Sakura Medical Center, Chiba, Tochigi, Japan
| | - Nobuyuki Hiruta
- Department of Surgical Pathology, Toho University Sakura Medical Center, Chiba, Tochigi, Japan
| | - Daisuke Sasai
- Department of Surgical Pathology, Toho University Sakura Medical Center, Chiba, Tochigi, Japan
| | - Yukihiro Sato
- Department of Diabetes Center, Jichi Medical University, Tochigi, Japan
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Yoshida I, Shiba T, Taniguchi H, Takahashi M, Murano T, Hiruta N, Hori Y, Bujo H, Maeno T. Evaluation of plasma vascular endothelial growth factor levels after intravitreal injection of ranibizumab and aflibercept for exudative age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2014; 252:1483-9. [PMID: 25030237 DOI: 10.1007/s00417-014-2717-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 06/19/2014] [Accepted: 06/30/2014] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND To evaluate the plasma vascular endothelial growth factor (VEGF) levels after one intravitreal injection of aflibercept or ranibizumab in patients with exudative age-related macular degeneration (AMD). METHODS Twenty-four Japanese with exudative AMD, polypoidal choroidal vasculopathy, and retinal angiomatous proliferation were included. Fourteen patients received an intravitreal injection of aflibercept, and ten patients received an intravitreal injection of ranibizumab. Plasma VEGF levels were evaluated within 7 days before the intravitreal injections and 1 day, 1 week, and 1 month after the intravitreal injection. RESULTS In the ranibizumab group, the mean plasma VEGF levels were 245.7 ± 233.4 pg/ml before the injection, 246.6 ± 304.8 pg/ml after 1 day, 217.8 ± 212.9 pg/ml after 1 week, and 260.0 ± 290.1 pg/ml after 1 month. The plasma VEGF levels did not decrease significantly in patients in the ranibizumab group at any time point. In the aflibercept group, the mean plasma VEGF levels were 280.0 ± 170.3 pg/ml before the intravitreal injection and 8.2 ± 12.9 pg/ml after 1 day, 9.1 ± 9.1 pg/ml after 1 week, and 41.9 ± 41.4 pg/ml after 1 month (p < 0.0001, vs before injection). CONCLUSION Intravitreally injected aflibercept reduced plasma VEGF over at least 1 month. In contrast, intravitreal injection of ranibizumab did not cause a significant reduction in the plasma VEGF levels.
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Affiliation(s)
- Izumi Yoshida
- Department of Ophthalmology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Chiba, Sakura, 285-8741, Japan
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Uchida Y, Hiruta N, Yamanoi D, Shimoyama E, Maezawa Y, Uchida Y. Imaging of native high-density lipoprotein in human coronary plaques by color fluorescent angioscopy. Circ J 2014; 78:1667-75. [PMID: 24770335 DOI: 10.1253/circj.cj-13-1585] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND High-density lipoprotein (HDL) plays a key role in reverse cholesterol transport, and halts the progression of atherosclerosis. The aim of the present study was to visualize native HDL in the human coronary arterial wall. METHODS AND RESULTS The fluorescence characteristics of HDL were investigated by color fluorescent microscopy (CFM) using excitation at 470 nm and emission at 515 nm with Fast green dye (FG) as the biomarker. HDL in 30 normal coronary segments, and in 25 white and 25 yellow plaques in excised human coronary arteries, was visualized by color fluorescent angioscopy (CFA) and CFM. Localization of HDL visualized by CFM was compared with that stained by immunostaining using an anti-HDL antibody. FG elicited a characteristic brown fluorescence of HDL. By CFA, the percent incidence of HDL in normal segments, white (early stage of plaque growth) and yellow (advanced stage of plaque growth) plaques was, respectively, 33%, 76% (P<0.05 vs. normal segments and yellow plaques) and 21%. Localization of HDL visualized by CFM did not differ from that stained by immunostaining. CONCLUSIONS In the human coronary arterial wall, HDL deposits infrequently in normal segments, but increasingly deposits with plaque formation, and decreases in the advanced stage of plaque growth.
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Uchida Y, Hiruta N, Uchida Y, Shimoyama E. Localization of native high-density lipoprotein and its relation to plaque morphology in human coronary artery. Int Heart J 2013; 54:348-54. [PMID: 24309443 DOI: 10.1536/ihj.54.348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
High-density lipoprotein (HDL) plays a key role in reverse cholesterol transport, and halts the progression of atherosclerosis. However, its localization in human vascular wall is not well understood. We discovered that by exciting at 470-nm and emitting at 515-nm light wavelengths, Fast green dye (FG) elicits brown fluorescence characteristic of HDL only. Therefore, the localization of native HDL in normal segments and plaques in excised human coronary artery was investigated by scanning their transected surface with color fluorescent microscopy (CFM) using FG as a biomarker, and the relationships between the localization of HDL and morphology of plaques and normal segments classified by conventional angioscopy and histology were examined. The % incidence of HDL in 13 normal segments (NS) with thin (≤ 200 µm) intima, 28 NS with thick (200 µm <) intima, 41 white plaques (early stage of plaque growth), 15 yellow plaques (Y) without necrotic core (NC), and 20 Y with NC (advanced stage of plaque growth), was 30, 71 (P < 0.05 versus NS with thin intima and Y with NC), 83 (P < 0.05 versus NS with thin intima and Y with NC), 60, and 35, respectively. HDL begins to deposit in human coronary arterial wall in the early stage of atherosclerosis and deposits increase with plaque growth, but HDL decreases in plaques at an advanced stage of growth.
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Nagashima M, Sugishita Y, Moriyama A, Ooshiro M, Kadoya K, Sato A, Kitahara T, Takagi R, Urita T, Yoshida Y, Tanaka H, Oshiro T, Nakamura K, Suzuki Y, Hiruta N, Okazumi S, Katoh R. Tumor-like growth of giant inflammatory polyposis in a patient with ulcerative colitis. Case Rep Gastroenterol 2013; 7:352-7. [PMID: 24019769 PMCID: PMC3764960 DOI: 10.1159/000354974] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
We report a unique case of giant obstructing inflammatory polyposis associated with ulcerative colitis (UC). A 25-year-old Japanese man with an UC history of 2 years and 6 months was referred to our institution because of diarrhea and melena. His computed tomography scan showed marked dilation of the transverse and descending colon; therefore, we performed total colectomy. Macroscopic evaluation of the excised specimen indicated constricting lesions with giant polyposis in the transverse and descending colon. The polyposis consisted of narrow worm- or noodle-like polyps that bridged over the irregular ulcers. Histologic evaluation of the excised specimen indicated transmural inflammation with a thickened proper muscular layer overlaid with inflammatory polyposis. Based on these data, a diagnosis of giant inflammatory polyposis should be considered in patients who have had UC. Although giant inflammatory polyposis is considered benign, surgical treatment may be indicated to avoid serious complications.
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Affiliation(s)
- Makoto Nagashima
- Department of Surgery, Toho University Sakura Medical Center, Sakura, Japan
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Hiruta N, Uchida Y, Maezawa Y, Shimoyama E, Uchida Y. Molecular imaging of apolipoprotein B-100 in human coronary plaques by color fluorescent angioscopy and microscopy. Int Heart J 2013; 54:68-74. [PMID: 23676365 DOI: 10.1536/ihj.54.68] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Apolipoprotein B-100 (ApoB-100) is an important risk factor for coronary artery disease. However, its localization in human coronary plaques is not well understood. The present study was performed to visualize ApoB-100 in human coronary artery wall. Deposition of native ApoB-100 in excised human coronary plaques and normal segments classified by conventional angioscopy was investigated by color fluorescent angioscopy (CFA) and microscopy (CFM) using Nile blue dye (NB) which elicits a golden fluorescence characteristic of ApoB-100 as a biomarker. By CFA, the % incidence of ApoB-100 was 20 in 40 normal segments, 38 in 42 white, and 11 in 35 yellow plaques (P < 0.05 versus white plaques). There was no significant difference in detection sensitivity between CFA and luminal surface scan by CFM. By CFM transected surface scan, ApoB-100 deposited in superficial, deep, and/or in both layers. Deposition in both layers was frequently observed in white plaques and yellow plaques without necrotic core (NC), less frequently in normal segments, and rarely in yellow plaques with NC. (1) Taking into consideration the well known process of plaque growth, the results suggest that ApoB-100 begins to deposit before plaque formation, increasingly deposits with plaque growth, and disappears after necrotic core formation. (2) CFA is feasible for imaging of ApoB-100 in human coronary artery wall.
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Affiliation(s)
- Nobuyuki Hiruta
- Department of Pathology, Toho University Sakura Hospital, Chiba, Japan
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Uchida Y, Maezawa Y, Uchida Y, Hiruta N, Shimoyama E, Kawai S. Localization of oxidized low-density lipoprotein and its relation to plaque morphology in human coronary artery. PLoS One 2013; 8:e55188. [PMID: 23393566 PMCID: PMC3564947 DOI: 10.1371/journal.pone.0055188] [Citation(s) in RCA: 27] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 12/19/2012] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Oxidized low-density lipoprotein (oxLDL) plays a key role in the formation of atherosclerotic plaques. However, its localization in human coronary arterial wall is not well understood. The present study was performed to visualize deposition sites and patterns of native oxLDL and their relation to plaque morphology in human coronary artery. METHODS Evans blue dye (EB) elicits a violet fluorescence by excitation at 345-nm and emission at 420-nm, and a reddish-brown fluorescence by excitation at 470-nm and emission at 515-nm characteristic of oxLDL only. Therefore, native oxLDL in excised human coronary artery were investigated by color fluorescent microscopy (CFM) using EB as a biomarker. RESULTS (1) By luminal surface scan with CFM, the % incidence of oxLDL in 38 normal segments, 41 white plaques and 32 yellow plaques that were classified by conventional angioscopy, was respectively 26, 44 and 94, indicating significantly (p<0.05) higher incidence in the latter than the former two groups. Distribution pattern was classified as patchy, diffuse and web-like. Web-like pattern was observed only in yellow plaques with necrotic core. (2) By transected surface scan, oxLDL deposited within superficial layer in normal segments and diffusely within both superficial and deep layers in white and yellow plaques. In yellow plaques with necrotic core, oxLDL deposited not only in the marginal zone of the necrotic core but also in the fibrous cap. CONCLUSION Taken into consideration of the well-known process of coronary plaque growth, the results suggest that oxLDL begins to deposit in human coronary artery wall before plaque formation and increasingly deposits with plaque growth, exhibiting different deposition sites and patterns depending on morphological changes.
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Affiliation(s)
- Yasumi Uchida
- Japan Foundation for Cardiovascular Research, Funabashi, Japan.
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