Clinicopathological and prognostic significance of immunophenotypic characterization of endocervical adenocarcinoma using CLDN18, CDH17, and PAX8 in association with HPV status.

In 2020, the WHO published a new system for classifying invasive endocervical adenocarcinoma based on histological features and high-risk human papillomavirus (HPV) infection. However, immunophenotypes of each histological subtype require further investigation. We immunohistochemically analyzed 66 invasive endocervical adenocarcinomas using three cell-lineage-specific markers: claudin 18 (CLDN18) for gastric, cadherin 17 (CDH17) for intestinal, and PAX8 for Müllerian epithelial cells. We identified five immunophenotypes of endocervical adenocarcinoma: gastric (21%); intestinal (14%); gastrointestinal (11%); Müllerian (35%); and not otherwise specified (NOS) (20%). Adenocarcinomas with gastric immunophenotype, characterized by aging (p = 0.0050), infrequent HPV infection (p < 0.0001), concurrent lobular endocervical glandular hyperplasia (p = 0.0060), lymphovascular invasion (p = 0.0073), advanced clinical stage (p = 0.0001), and the poorest progression-free (p < 0.0001) and overall (p = 0.0023) survivals, were morphologically compatible with gastric-type adenocarcinoma of the WHO 2020 classification. Conversely, most adenocarcinomas with Müllerian (91%) and intestinal (89%) immunophenotypes were HPV associated and morphologically compatible with usual- or intestinal-type adenocarcinomas of the WHO 2020 classification. The morphology of adenocarcinomas with gastrointestinal immunophenotype was intermediate or mixed between those of gastric and intestinal immunophenotypes; 57% were HPV associated. Adenocarcinomas with NOS immunophenotype were mainly HPV associated (85%) and histologically poorly differentiated. Multivariate analysis revealed that gastric (p = 0.008), intestinal + gastrointestinal (p = 0.0103), and NOS (p = 0.009) immunophenotypes were independent predictors of progression-free survival. Immunophenotypes characterized by CLDN18, CDH17, and PAX8 exhibited clinicopathological relevance and may improve the diagnostic accuracy and prognostic value of conventional histological classification.

Superiority of sucrase-isomaltase to CD10 for immunohistochemical detection of intestinal absorptive cell phenotype in differentiated-type gastric adenocarcinoma.

Gastric adenocarcinoma (GAC) can be divided immunophenotypically into gastric, intestinal, or mixed gastric and intestinal phenotypes. Cadherin 17 (CDH17) and CD10 have been used as comprehensive markers for intestinal epithelial cells and for small intestinal absorptive cells in GACs, respectively. Sucrase-isomaltase (SI) and CD10 are expressed in small intestinal absorptive cells and SI is more frequently expressed than CD10 in gastric intestinal metaplasia (IM). The aim of this study was to evaluate the potential of SI as a marker for intestinal absorptive cells compared to CD10 in differentiated-type (DT) GACs. We compared the immunohistochemical expression of CDH17, SI, and CD10 in IMs and tissue microarrays of 40 samples of DTGACs. In IMs and DTGACs, CDH17 showed a diffuse lateral cytoplasmic membrane staining both in columnar and goblet cells. SI and CD10 were expressed on the luminal surfaces of the columnar cells. In IMs, SI was positive both in both complete-type IMs and in incomplete-type IMs. CD10 was positive only in complete-type IMs. In DTGACs, CDH17, SI, and CD 10 were positive in 37 (92.5%), 22 (55%), and 11 (27.5%) cases, respectively. In SI-positive cases, the degrees of expression of SI were equal to (7 cases) or less than (15 cases) those of CDH17; the degrees of expression of SI were equal to (5 cases), more than (16 cases), or less than (1 case) those of CD10. In conclusion, SI is a more sensitive immunohistochemical marker for intestinal absorptive cells than CD10 in DTGACs.

Inhibitory effects of antihypertensive drugs on human cytochrome P450 2J2 activity: Potent inhibition by azelnidipine and manidipine.

The inhibitory effects of antihypertensive drugs (dihydropyridine calcium channel blockers, angiotensin II receptor blockers, and angiotensin-converting enzyme inhibitors) on cytochrome P450 2J2 (CYP2J2) activity were examined. Amlodipine, azelnidipine, barnidipine, benidipine, cilnidipine, efonidipine, felodipine, manidipine, nicardipine, nifedipine, nilvadipine, nisoldipine, nitrendipine, telmisartan, delapril, and quinapril inhibited luciferin-2J2/4F12 O-dealkylase activity of recombinant human CYP2J2 in a concentration-dependent manner (IC50 = 0.116-9.19 µM). Kinetic analyses of the inhibition indicated that azelnidipine, barnidipine, benidipine, cilnidipine, efonidipine, manidipine, nicardipine, telmisartan, delapril, and quinapril competitively inhibited CYP2J2 activity, while amlodipine, felodipine, nifedipine, nilvadipine, nisoldipine, and nitrendipine showed mixed inhibition. Among these drugs, manidipine showed the strongest reversible inhibition with Ki value of 0.0294 µM. The docking simulation data supported the potent inhibition of CYP2J2 by these drugs. Next, the effect of preincubation on CYP2J2 inhibition was investigated to determine whether these antihypertensive drugs inhibited CYP2J2 activity in a metabolism-dependent manner. A 20-min preincubation of azelnidipine and felodipine in the presence of NADPH potentiated the inhibition of CYP2J2. Furthermore, kinetic analysis of the inactivation showed that azelnidipine caused a preincubation time- and concentration-dependent decrease in CYP2J2 activity yielding kinact/KI value of 105 l/mmol/min, although felodipine showed no preincubation time-dependent inhibition. The azelnidipine-mediated inactivation required NADPH. These results indicated that manidipine is a potent competitive reversible inhibitor while azelnidipine is a potent mechanism-based inactivator of human CYP2J2.

[A 36-year-old woman with primary central nervous system lymphoma diagnosed by twice brain biopsies, showing relapsing and remitting brain lesions].

A 36-year-old woman visited a local hospital suffering from acute onset dizziness. Brain MRI revealed multiple white matter lesions without gadolinium enhancement in the both hemispheres. Although she began to receive a treatment under a clinical diagnosis of multiple sclerosis, she developed newly emerging brain lesions and was referred to our hospital. Neurological examination detected intention tremor, right-sided dysdiadochokinesis, and gait ataxia. Both blood and cerebrospinal fluid tests were unremarkable but follow-up brain MRIs showed rapidly relapsing and remitting lesions. The first brain biopsy ended up showing non-specific changes but the second biopsy with five months interval confirmed primary central nervous system lymphoma (PCNSL). The patient was treated by chemotherapy and showed partial response. It is important to consider sequential brain biopsies if needed because PCNSL may present diverse brain lesions on MRI including non-neoplastic early lesions.

Crystal growth of La2/3-x Li3x TiO3 by the TSFZ method.

Double-perovskite-type La2/3-x Li3x TiO3 (LLT) crystals were grown by the travelling solvent floating zone (TSFZ) method. When the floating zone (FZ) crystal growth method was applied, the La2Ti2O7 phase was deposited as an inclusion in the initial growth region. Using the TSFZ crystal growth method, however, inclusion-free LLT crystals were obtained for a 10 mol% La2Ti2O7-poor composition solvent relative to the stoichiometric LLT crystals. The molten zone was initially unstable as a result of habit plane formation during the crystal growth; however, the molten zone was stably maintained for a long period of time by decreasing the feed rate compared with the growth rate. Hence, LLT crystals of approximately 5 mmφ and 37 mm in length were obtained. The anisotropic ionic conductivity of the crystals annealed in air was σ[110]/σ[001] ≈ 3, with σ[110] = 1.64 × 10-3 S cm-1 and σ[001] = 5.26 × 10-4 S cm-1. LLT single crystals are candidates for high-performance solid-state electrolytes in all-solid-state Li ion batteries.

Intractable Cutaneous Nontuberculous Mycobacteriosis (Mycobacterium abscessus) during Treatment for Systemic Lupus Erythematosus.

Mycobacterium abscessus infection tends to occur in patients with an advanced immunocompromised status. We encountered a case of intractable cutaneous M. abscessus infection that developed in a patient with systemic lupus erythematosus (SLE) during maintenance therapy. A 28-year-old woman developed a fever and redness of the skin on her buttocks. General antibacterial therapy was ineffective, and acid-fast bacteria were detected in the biopsy that was conducted to differentiate the dermal symptoms of SLE. The clinical findings eventually improved; however, the symptoms recurred multiple times during treatment. Despite recent advances in SLE treatment, M. abscessus infection remains a considerable complication of SLE.

Elevation of serum heat-shock protein levels in amyotrophic lateral sclerosis.

Heat-shock proteins (HSPs) have been implicated in the pathogenesis of amyotrophic lateral sclerosis (ALS). In this study, we aimed to examine whether the serum levels of HSPs (HSP27, HSP70, and HSP90) are altered in patients with ALS. We included 58 patients diagnosed with ALS and 85 control individuals. Serum HSP levels of patients and controls were determined using enzyme-linked immunosorbent assay. The serum levels of HSP70 and HSP90 were significantly higher in patients than in controls. In contrast, serum levels of HSP27 did not differ significantly between the patient and control groups. Moreover, serum levels of HSP70 and HSP90 in patients remained high throughout the duration of the disease. Taken together, our findings suggest that HSPs might have a role in ALS progression throughout the course of the disease. Further studies are needed to clarify the role of HSPs in the pathogenesis of ALS.

Slowly progressing lower motor neuron disease caused by a novel duplication mutation in exon 1 of the SOD1 gene.

Familial amyotrophic lateral sclerosis accounts for about 5% of all cases of the neurodegenerative disorder amyotrophic lateral sclerosis. Genetic mutations in Cu/Zn superoxide dismutase (SOD1) have been associated with one kind of familial amyotrophic lateral sclerosis (ALS1). We identified a novel duplication mutation in exon 1 of the SOD1 gene in a Japanese family whose members had lower motor neuron diseases. The patients showed slow disease progression, with the onset of lower limb muscle weakness and exertional dyspnea. Some patients had mild motor and sensory neuropathy and/or bladder dysfunction, which is further evidence that SOD1 mutation results in a predominantly lower motor neuron phenotype.

Long-term efficacy and safety of the small-sized ß2-microglobulin adsorption column for dialysis-related amyloidosis.

Dialysis-related amyloidosis (DRA) is one of the major complications often seen in long-term dialysis patients, and is one of the factors that decreases quality of life. ß2-microglobulin (ß2-m) is considered to be a major pathogenic factor in dialysis-related amyloidosis. The Lixelle adsorbent column, with various capacities, has been developed to adsorb ß2-m from the circulating blood of patients with dialysis-related amyloidosis. Using a minimum type of ß2-m-adsorbing column (Lixelle S-15), we evaluated its therapeutic efficacy and safety in dialysis patients. Seventeen hemodialysis patients with DRA were treated with the S-15 column for one year. Treatment was performed three times a week in this study. During the study period, pinch strength, visual analog scale for joint pain, and activities of daily living were evaluated every three months, and blood sampling was performed every six months. After one year's treatment with the S-15 column, the ß2-m level decreased from 29.3±9.6mg/L to 24.7±5.1mg/L (P<0.05), and the high sensitive C-reactive protein level decreased from 2996±4380ng/mL to 1292±1774ng/mL. After one year of S-15 column use, pinch strength increased from 5.9±3.0pounds to 7.2±3.2pounds (P<0.05), and the visual analog scale for joint pain and activities of daily living score also improved. Long-term use of the Lixelle S-15 column is safe and effective for improvement of quality of life in chronic dialysis patients. Improvement of chronic inflammation may be one of the mechanisms through which the beneficial effects of the column is effected.

Antiatherosclerotic effect of the edible mushrooms Pleurotus eryngii (Eringi), Grifola frondosa (Maitake), and Hypsizygus marmoreus (Bunashimeji) in apolipoprotein E-deficient mice.

In the present study, we examined the antiatherosclerotic effects of 3 edible mushrooms, Pleurotus eryngii (Eringi), Grifola frondosa (Maitake), and Hypsizygus marmoreus (Bunashimeji), in atherosclerosis-susceptible C57BL/6J, apolipoprotein E-deficient (apoE(-/-)) mice. Male apoE(-/-) mice (6 weeks of age) were fed a normal diet (cholesterol concentration <66 mg/100 g) or a normal diet containing 3% dried Eringi, Maitake, or Bunashimeji mushroom powder for 10 weeks. Food intake, body weight, serum total cholesterol (TC), and serum triacylglycerols (TG) were measured periodically during the experimental period. At the end of the experiment (at 16 weeks of age), the atherosclerotic lesion area was measured in cross-sections of the aortic root. Serum TC concentrations in the Bunashimeji group were significantly lower than that in the control group at 8, 10, 12, 14, and 16 weeks of age. Serum TC concentrations in the Eringi, and Maitake groups were significantly lower than that in the control group only at 12 weeks of age. There was no significant difference in the serum TG concentrations in all groups during the experimental period. The atherosclerotic lesions were significantly decreased in the Eringi, Maitake, and Bunashimeji groups than that in the control group at the end of the experiment. Dietary supplementation with the Bunashimeji mushroom powder had the strongest antiatherosclerotic effect among 3 mushrooms. In conclusion, supplementation of the 3 edible mushrooms prevents the development of atherosclerosis, even normal diet. Antiatherosclerotic effect is partly via lowering of serum TC concentrations; further mechanisms should be investigated.

Effect of radical scavenger N-tert-butyl-alpha-phenylnitrone on stroke in a rat model using a telemetric system.

We used malignant stroke-prone spontaneously hypertensive rats (M-SHRSP) as a stroke model to explore the effects of the radical scavenger N-tert-butyl-alpha-phenylnitrone (PBN) on stroke. PBN was administrated in drinking water to M-SHRSP. Circadian rhythms in heart rate, blood pressure, and locomotive activity in M-SHRSP were monitored with a telemetric system, in addition to measurement of water intake and body weight. Stroke-onset was assessed by changes in neurological symptoms, water intake, and body weight. Circadian rhythms were basically the same between PBN-treated and control rats several days after stroke onset. Significant differences were seen in blood pressure, relative weight of brain and water intake, heart rate, and locomotive activity between two groups. As a result, no significant difference in age of stroke onset was seen between PBN-treated and control rats, but PBN-treated rats displayed prolonged mean life spans. PBN might be effective in prolonging life span.