RESUMEN
PURPOSE: To investigate the clinical practices of diagnosing multicystic cervical lesions as a means to develop a more appropriate diagnostic algorithm for gastric-type adenocarcinoma (GAS) and its precursors. METHODS: Clinical information for 159 surgically treated patients for multicystic disease of the uterine cervix was collected from 15 hospitals. We performed a central review of the MRI and pathological findings. The MRI findings were categorized into four types including two newly proposed imaging features based on the morphology and distribution of cysts, and the diagnosis accuracy was assessed. Among the four MRI types, types 1 and 2 were categorized as benign lesions that included LEGH; type 3 were precancerous lesions (with an assumption of atypical LEGH); and type 4 were malignant lesions. RESULTS: The central pathological review identified 56 cases of LEGH, seven with GAS, four with another form of carcinoma, and 92 with benign disease. In clinical practice, over-diagnosis of malignancy (suspicion of MDA) occurred for 12/19 cases (63.2%) and under-diagnosis of malignancy occurred for 4/11 (36%). Among the 118 patients who had a preoperative MRI and underwent a hysterectomy, type 3 or 4 MRI findings in conjunction with abnormal cytology were positively indicative of premalignancy or malignancy, with a sensitivity and specificity of 61.1% and 96.7%, respectively. CONCLUSIONS: Although the correct preoperative diagnosis of cervical cancer with a multicystic lesion is challenging, the combination of cytology and MRI findings creates a more appropriate diagnostic algorithm that significantly improves the diagnostic accuracy for differentiating benign disease from premalignancy and malignancy.
Asunto(s)
Adenocarcinoma , Lesiones Precancerosas , Neoplasias del Cuello Uterino , Femenino , Humanos , Neoplasias del Cuello Uterino/diagnóstico por imagen , Neoplasias del Cuello Uterino/cirugía , Cuello del Útero/cirugía , Cuello del Útero/patología , Adenocarcinoma/cirugía , Adenocarcinoma/patología , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/cirugía , Lesiones Precancerosas/patología , Imagen por Resonancia MagnéticaRESUMEN
Recently, we identified and characterized a novel protein, granuphilin, whose domain structure is similar to that of the Rab3 effector protein rabphilin3 (J. Wang, T. Takeuchi, H. Yokota, and T. Izumi, J. Biol. Chem. 274:28542-28548, 1999). Screening its possible Rab partner by a yeast two-hybrid system revealed that an amino-terminal zinc-finger domain of granuphilin interacts with Rab27a. Granuphilin preferentially bound to the GTP form of Rab27a. Formation of the Rab27a/granuphilin complex was readily detected in the pancreatic beta cell line MIN6. Moreover, the tissue distributions of Rab27a and granuphilin are remarkably similar: both had significant and specific expression in pancreatic islets and in pituitary tissue, but no expression was noted in the brain. Analyses by immunofluorescence, immunoelectron microscopy, and sucrose density gradient subcellular fractionation showed that Rab27a and granuphilin are localized on the membrane of insulin granules. These findings suggest that granuphilin functions as a Rab27a effector protein in beta cells. Overexpression of wild-type Rab27a and its GTPase-deficient mutant significantly enhanced high K(+)-induced insulin secretion without affecting basal insulin release. Although Rab3a, another exocytotic Rab protein, has some similarities with Rab27a in primary sequence, intracellular distribution, and affinity toward granuphilin, overexpression of Rab3a caused different effects on insulin secretion. These results indicate that Rab27a is involved in the regulated exocytosis of conventional dense-core granules possibly through the interaction with granuphilin, in addition to its recently identified role in lysosome-related organelles.
Asunto(s)
Proteínas Portadoras/metabolismo , Exocitosis/fisiología , Insulina/metabolismo , Islotes Pancreáticos/metabolismo , Vesículas Secretoras/metabolismo , Proteínas de Unión al GTP rab , Animales , Proteínas Portadoras/análisis , Proteínas Portadoras/genética , Línea Celular , Expresión Génica , Insulina/análisis , Membranas Intracelulares/química , Membranas Intracelulares/metabolismo , Islotes Pancreáticos/química , Islotes Pancreáticos/citología , Sustancias Macromoleculares , Ratones , Datos de Secuencia Molecular , Especificidad de Órganos , Hipófisis/citología , Hipófisis/metabolismo , Vesículas Secretoras/química , Transfección , Técnicas del Sistema de Dos Híbridos , Proteínas de Transporte Vesicular , Proteínas rab27 de Unión a GTP , Proteína de Unión al GTP rab3A/genética , Proteína de Unión al GTP rab3A/metabolismoRESUMEN
To identify the chemical forms of aluminum (Al) transported from roots to shoots of tea plants (C. sinensis L.), 27Al-nuclear magnetic resonance and 19F NMR spectroscopy were used to analyze xylem sap. The concentration of Al in collected xylem sap was 0.29 mM, twice as high as that of F. Catechins were not detected in xylem sap. The concentration of malic acid in xylem sap was higher than that of citric acid, whereas the concentration of oxalic acid was negligible. There were two signals in the 27Al NMR spectra of xylem sap, a larger signal at 11 ppm and a smaller one at -1.5 ppm. The former signal was consistent with the peak for an Al-citrate model solution, suggesting that an Al-citrate complex was present in xylem sap. Although the latter signal at -1.5 ppm was thought to indicate the presence of an Al-F complex (at 1.7 ppm) in xylem sap, there was only one signal at -122 ppm in the 19F NMR spectrum of xylem sap, indicating that the main F complex in xylem sap was F-. These results indicate that Al might be translocated as a complex with citrate, while Al-malate, Al-oxalate and Al-F complexes are not major Al complexes in xylem sap of tea plants.