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1.
Histopathology ; 82(3): 439-453, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36239561

RESUMEN

Cytokeratin 5 (CK5) is a marker for pulmonary squamous cell carcinoma; however, CK5 is sometimes present in pulmonary adenocarcinoma (ADC), and there is insufficient information regarding the clinicopathological features of CK5-positive ADC. We aimed to explore the clinicopathological characteristics of CK5-positive ADC using immunohistochemistry. We prepared the following two cohorts: a resected cohort containing 220 resected tumours for primarily studying the detailed morphological characteristics, and a tissue microarray (TMA) cohort containing 337 samples for investigating the associations of CK5 expression with other protein expressions, genetic and prognostic findings. CK5-positive ADC was defined to have ≥ 10% tumour cells and presence of CK5-positive tumour cells in the resected and TMA cohorts, respectively. CK5-positive ADCs were identified in 91 (16.3%) patients in the combined cohort. CK5-positive ADCs had male predominance (P = 0.012), smoking history (P = 0.001), higher stage (P < 0.001), histological high-grade components (P < 0.001), vascular invasion (P < 0.001), mucinous differentiation (P < 0.001), spread through airspaces (P < 0.001), EGFR wild-type (P < 0.001), KRAS mutations (P < 0.001), ALK rearrangement (P < 0.001) and ROS1 rearrangement (P = 0.002). In the resected cohort, more than half the CK5-positive ADCs (19 cases, 65.5%) showed mucinous differentiation; the remaining cases harboured high-grade components. In the TMA cohort, CK5-positive ADCs correlated with TTF-1 negativity (P = 0.002) and MUC5B, MUC5AC and HNF4alpha positivity (P < 0.001, 0.048, < 0.001). Further, CK5-positive ADCs had significantly lower disease-free and overall survival rates than CK5-negative ADCs (P < 0.001 for each). Additionally, multivariate analysis revealed that CK5 expression was an independent poor prognostic factor. CK5-positive ADCs showed aggressive clinical behaviour, with high-grade morphology and mucinous differentiation.


Asunto(s)
Adenocarcinoma del Pulmón , Adenocarcinoma , Neoplasias Pulmonares , Humanos , Masculino , Femenino , Neoplasias Pulmonares/patología , Adenocarcinoma/genética , Queratina-5/análisis , Proteínas Tirosina Quinasas , Biomarcadores de Tumor/análisis , Proteínas Proto-Oncogénicas , Pronóstico
2.
Clin Radiol ; 71(11): 1199.e1-7, 2016 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-27567725

RESUMEN

AIM: To examine the prevalence and detailed radiological findings of internal anomalies in thalidomide embryopathy (TE). MATERIALS AND METHODS: Whole-body image screening for internal anomalies using unenhanced whole-body computed tomography (CT) and head magnetic resonance imaging (MRI) was performed in 22 patients (13 women and nine men; mean age, 49 years; range, 47-51 years) with TE. RESULTS: Among the 22 patients with TE, internal anomalies were detected in 19 (86.4%): anomalies of the auditory organ in 10 (45.5%), anomalies of the vascular system in six (27.3%), agenesis of the gallbladder in six (27.3%), hypoplasia or aplasia of the 7th or 8th cranial nerves in five (22.7%), block vertebrae in five (22.7%), fusion of the left lobe and quadrate lobe of the liver in three (9.1%), and others in five (22.7%), respectively. CONCLUSION: In addition to limb defects or hypoplasia, various internal anomalies can be detected at a high incidence in TE using CT and MRI. Understanding these characteristic radiological findings may help radiologists detect a wide range of radiological findings of internal anomalies associated with TE.


Asunto(s)
Anomalías Múltiples/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Tomografía Computarizada Multidetector/métodos , Efectos Tardíos de la Exposición Prenatal/diagnóstico por imagen , Talidomida/efectos adversos , Imagen de Cuerpo Entero/métodos , Anomalías Múltiples/epidemiología , Causalidad , Femenino , Vesícula Biliar/anomalías , Vesícula Biliar/diagnóstico por imagen , Vesícula Biliar/efectos de los fármacos , Humanos , Japón/epidemiología , Hígado/anomalías , Hígado/diagnóstico por imagen , Hígado/efectos de los fármacos , Masculino , Persona de Mediana Edad , Embarazo , Efectos Tardíos de la Exposición Prenatal/epidemiología , Prevalencia , Columna Vertebral/anomalías , Columna Vertebral/diagnóstico por imagen , Columna Vertebral/efectos de los fármacos
3.
Artículo en Inglés | MEDLINE | ID: mdl-23944469

RESUMEN

Dielectric relaxation spectra of a liquid crystalline (LC) material showing blue-phase-III (BPIII) for a considerably large temperature regime consisting of T-shaped molecules are investigated. A low frequency relaxation mode is observed in the isotropic phase (I) as well as in BPIII of the investigating material which is attributed to the short axis rotation of the T-shaped molecules. The outcome of the temperature and dc bias field variation of dielectric strength (Δε) and relaxation frequency (ν(c)) in the vicinity of the I-BPIII transition is also discussed. The temperature dependence of ν(c) in BPIII with a minor deviation from Arrhenius activities in the fluctuation-dominated nonlinear region (FDNLR) is found to follow the unusual thermal behavior of the activation energy (E(A)). The growth of pretransitional fluctuations is found to be nonlinear in the vicinity of the I-BPIII transition. A moderate growth of transition fluctuation commences from the value of the exponent α(eff)=0.38/°C, which is obtained by an exponential variation of ν(c) with respect to temperature in BPIII. Observed dynamic phenomenon in the vicinity of the I-BPIII transition regions is explained on the basis of the Landau-de Gennes and Maier-Saupe Theories.

4.
Am J Transplant ; 12(12): 3406-13, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22994696

RESUMEN

Few studies have examined the long-term outcomes and prognostic factors associated with pediatric living living-donor liver transplantation (LDLT) using reduced and hyper-reduced left lateral segment grafts. We conducted a retrospective, single-center assessment of the outcomes of this procedure, as well as clinical factors that influenced graft and patient survival. Between September 2000 and December 2009, 49 patients (median age: 7 months, weight: 5.45 kg) underwent LDLT using reduced (partial left lateral segment; n = 5, monosegment; n = 26), or hyper-reduced (reduced monosegment grafts; n = 18) left lateral segment grafts. In all cases, the estimated graft-to-recipient body weight ratio of the left lateral segment was more than 4%, as assessed by preoperative computed tomography volumetry, and therefore further reduction was required. A hepatic artery thrombosis occurred in two patients (4.1%). Portal venous complications occurred in eight patients (16.3%). The overall patient survival rate at 1, 3 and 10 years after LDLT were 83.7%, 81.4% and 78.9%, respectively. Multivariate analysis revealed that recipient age of less than 2 months and warm ischemic time of more than 40 min affected patient survival. Pediatric LDLT using reduced and hyper-reduced left lateral segment grafts appears to be a feasible option with acceptable graft survival and vascular complication rates.


Asunto(s)
Supervivencia de Injerto/fisiología , Arteria Hepática/patología , Trasplante de Hígado/mortalidad , Vena Porta/patología , Complicaciones Posoperatorias , Femenino , Rechazo de Injerto , Humanos , Lactante , Recién Nacido , Trasplante de Hígado/efectos adversos , Masculino , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia , Trombosis/etiología , Trombosis/mortalidad
6.
Pediatr Surg Int ; 28(8): 855-9, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22760434

RESUMEN

Early diagnosis and treatment of acute cellular rejection (ACR) after intestinal transplantation (ITx) is challenging. We report the outcome of three patients: two presented mild ACR improved with steroids. One presented steroid-resistant severe rejection, improved after rabbit anti-thymocyte globulin (r-ATG), but unfortunately died for encephalitis caused by opportunistic infections.


Asunto(s)
Suero Antilinfocítico/administración & dosificación , Rechazo de Injerto/diagnóstico , Rechazo de Injerto/tratamiento farmacológico , Inmunosupresores/administración & dosificación , Intestinos/trasplante , Adolescente , Anastomosis Quirúrgica , Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Basiliximab , Niño , Daclizumab , Encefalitis/etiología , Resultado Fatal , Femenino , Humanos , Inmunoglobulina G/uso terapéutico , Enfermedades Intestinales/cirugía , Vólvulo Intestinal/cirugía , Masculino , Enfermedades del Sistema Nervioso/cirugía , Proteínas Recombinantes de Fusión/uso terapéutico , Síndrome del Intestino Corto/cirugía , Tacrolimus/administración & dosificación
7.
J Viral Hepat ; 19(1): 32-8, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21129128

RESUMEN

Approximately 30% of patients who have recurrent hepatitis C after liver transplantation achieve sustained virological response (SVR) by taking a combination therapy of pegylated interferon and ribavirin. For the remaining non-SVR patients, an effective management treatment has not yet been established. In this study, efficacy of long-term peginterferon maintenance therapy for non-SVR patients was evaluated. Forty patients who had previously received the combination therapy for hepatitis C after living donor liver transplantation were classified into one of the following three groups: the SVR group (n = 11); the non-SVR-IFN group (n =17), which received low-dose peginterferon maintenance therapy for non-SVR patients; and the non-SVR-Withdrawal group (n = 12), which discontinued the interferon treatment. We then compared histological changes among these three groups after 2 or more years follow-up. Activity grade of liver histology improved or remained stable in patients in the SVR and non-SVR-IFN groups, but deteriorated in half of the patients in the non-SVR-Withdrawal group. Fibrosis improved or remained stable in 10 of 11 SVR patients and in 13 of 17 non-SVR-IFN patients, but deteriorated in all non-SVR-Withdrawal patients. Mean changes in fibrosis stage between pretreatment and final liver biopsy were -0.18, +0.06 and +2.2 in the SVR, non-SVR-IFN and non-SVR-Withdrawal groups, respectively. Fibrosis stage deteriorated to F3 or F4 significantly more rapidly in the non-SVR-Withdrawal group than in the other two groups. In conclusion, continuing long-term maintenance therapy with peginterferon prevented histological progression of hepatitis C in patients who had undergone living donor liver transplantation.


Asunto(s)
Antivirales/uso terapéutico , Hepatitis C Crónica/tratamiento farmacológico , Interferón-alfa/uso terapéutico , Trasplante de Hígado , Polietilenglicoles/uso terapéutico , Adolescente , Adulto , Anciano , Antivirales/administración & dosificación , Progresión de la Enfermedad , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Hepacivirus/efectos de los fármacos , Hepatitis C Crónica/patología , Humanos , Hígado/patología , Donadores Vivos , Masculino , Persona de Mediana Edad , Proteínas Recombinantes/uso terapéutico , Recurrencia , Ribavirina/uso terapéutico , Resultado del Tratamiento , Adulto Joven
8.
Transplant Proc ; 43(6): 2391-3, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21839274

RESUMEN

INTRODUCTION: The goal of this study was to examine whether the lower limit of the graft-to-recipient weight ratio (GRWR) can be safely reduced to make better use of a left-lobe graft in adult-to-adult living donor liver transplantation (LDLT) in combination with portal pressure control. PATIENTS AND METHODS: Beginning in December 2007, our institution actively selected left-lobe grafts for use in liver transplantation seeking to minimize the risks to healthy donors. We gradually decreased the lower limit of the GRWR to preferentially select a left-lobe over a right-lobe graft: from ≥0.7% beginning in December 2007 to ≥0.6% beginning in April 2009. A portal pressure control program, targeting final portal pressures below 15 mm Hg, was also introduced to overcome small-for-size graft problems. The ratio of left-lobe grafts among all adult-to-adult LDLT grafts and the donor complication rate (defined as Clavien grade ≥ III, excluding wound infection) were compared between two time periods: June 1999 to November 2007 (period 1, n = 541) and December 2007 to February 2010 (period 2, n = 119). Overall survival rates were also compared between those recipients of a GRWR < 0.8% and those with a GRWR ≥ 0.8% in 198 recipients who underwent LDLT at our institution between April 2006 and February 2010. RESULTS: Left-lobe grafts use increased from period 1 (65/541 recipients; 12.0%) to period 2 (50/119 recipients; 42.0%; P < .001). The donor complication rate tended to decrease from 13.8% in period 1 to 9.3% in period 2 (P = .115). The overall survival rate in 52 recipients with a GRWR < 0.8% did not differ from that in 146 recipients with a GRWR ≥ 0.8%. CONCLUSIONS: The lower limit of the GRWR can be safely reduced to 0.6% in adult-to-adult LDLT in combination with portal pressure control.


Asunto(s)
Hepatectomía , Trasplante de Hígado , Hígado/cirugía , Donadores Vivos , Presión Portal , Adulto , Distribución de Chi-Cuadrado , Hepatectomía/efectos adversos , Humanos , Japón , Estimación de Kaplan-Meier , Hígado/irrigación sanguínea , Hígado/patología , Trasplante de Hígado/efectos adversos , Trasplante de Hígado/mortalidad , Tamaño de los Órganos , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Tasa de Supervivencia , Factores de Tiempo , Resultado del Tratamiento
9.
Transplant Proc ; 43(5): 2093-6, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21693334

RESUMEN

Treatment of Budd-Chiari syndrome consists of medical management, surgical shunt, transjugular intrahepatic portosystemic shunt (TIPS), and liver transplantation. Liver transplantation is indicated only when other treatments have failed. A 36-year-old Japanese man underwent living-donor liver transplantation after radiologic intervention procedures. Because of the position of the TIPS stent and the damaged vascular lesion of Budd-Chiari syndrome, a supradiaphragmatic approach was employed to achieve a safe total hepatectomy. Moreover, after resection of damaged portion of the inferior vena cava (IVC), an artificial vascular graft was utilized to fill the IVC gap. The postoperative course was uneventful; no serious complications were experienced within 2 years after liver transplantation. This supradiaphragmatic IVC approach and IVC reconstruction technique emphasized the option of surgical techniques to decrease the operative risk during liver transplantation for Budd-Chiari syndrome.


Asunto(s)
Síndrome de Budd-Chiari/cirugía , Trasplante de Hígado , Donadores Vivos , Adulto , Síndrome de Budd-Chiari/diagnóstico por imagen , Humanos , Masculino , Derivación Portosistémica Intrahepática Transyugular , Tomografía Computarizada por Rayos X
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