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1.
Gan To Kagaku Ryoho ; 48(10): 1284-1286, 2021 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-34657065

RESUMO

We experienced a case of kidney metastasis of a gastric tumor. An 81-year-old man underwent distal gastrectomy with D2 lymph node dissection and partial hepatic resection for antral gastric tumor with hepatic infiltration in July 2019. A histological examination showed undifferentiated tubular adenocarcinoma. The final stage was pT4bN1P0H0M0, Stage ⅢB. He rejected the recommended adjuvant chemotherapy. Seven months after surgery, abdominal enhanced CT showed a hypovascular mass, 20 mm in diameter, on the right upper pole of kidney. Eleven months after surgery, CT showed that the mass had enlarged to 35 mm, infiltrated the renal pelvis, and advanced to para-aortic lymph node metastasis. We performed a retroperitoneoscopic partial right nephrectomy and diagnosed kidney metastasis of the gastric tumor. His right flank pain worsened, and radiotherapy(50 Gy)was performed for the mass and para-aortic lymph node metastasis. His right flank pain resolved. Kidney metastasis of the gastric tumor is very rare. Radiotherapy effectively relieves pain.


Assuntos
Neoplasias Gástricas , Idoso de 80 Anos ou mais , Gastrectomia , Humanos , Rim , Excisão de Linfonodo , Linfonodos , Metástase Linfática , Masculino , Neoplasias Gástricas/cirurgia
2.
Gan To Kagaku Ryoho ; 48(10): 1293-1295, 2021 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-34657068

RESUMO

A 65-year-old woman underwent distal gastrectomy with D2 lymph node dissection for advanced gastric cancer in November 2016. The histopathological diagnosis was pT3N0M0, pStage ⅡA, HER2-negative. In August 2019, transverse colon stenosis due to peritoneal dissemination was detected, and an ileum-transverse colon anastomosis was performed. Postoperatively, she received chemotherapy with S-1 plus oxaliplatin. After 6 courses, CT revealed an increase in ascites and dissemination nodules. We diagnosed her with progressive disease and initiated second-line chemotherapy, a ramucirumab plus nab-paclitaxel regimen. On the 20th day during the 5th course of treatment, she visited our hospital with acute abdominal pain. CT revealed free air, and we diagnosed acute panperitonitis with a gastrointestinal perforation. Emergency surgery was performed, and perforation of the appendix end and mild cloudy ascites were observed. We performed an appendectomy and intraperitoneal drainage. Histopathological examination revealed perforation of the appendix, possibly as an adverse effect of the ramucirumab. It should be noted that angiogenesis inhibitors may cause the fatal adverse effect of gastrointestinal perforation.


Assuntos
Apêndice , Divertículo , Neoplasias Gástricas , Idoso , Albuminas , Anticorpos Monoclonais Humanizados , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Feminino , Gastrectomia , Humanos , Paclitaxel/uso terapêutico , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/cirurgia
3.
Gan To Kagaku Ryoho ; 48(10): 1296-1298, 2021 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-34657069

RESUMO

Chylothorax after esophagectomy is a relatively rare complication that can be difficult to manage. Here, we report a case of refractory chylothorax after surgery for esophageal cancer treated with lymphatic duct lipiodol imaging by inguinal lymph node puncture to confirm patency of the thoracic duct and thoracic duct ligation. A 71-year-old female with esophageal cancer(cT3N0M0)underwent video-assisted thoracoscopic esophagectomy with 2-field lymph node dissection, intrathoracic gastric tube reconstruction, and an enterostomy. A chylothorax appeared when we started enteral nutrition on the day after surgery. She became markedly dehydrated due to over 2,000 mL/day of drainage from the chest drain, and we managed her general condition in the ICU. We started octreotide acetate on postoperative day(POD)6 and etilefrine on POD 8, but neither was effective. Lymphatic duct lipiodol imaging by bilateral inguinal lymph node puncture was performed, and we confirmed leakage from the main thoracic duct. On POD 11, a thoracic duct ligation performed via a thoracotomy revealed that the volume of the chylothorax was remarkably decreased. The chest tube was removed on re-POD 12.


Assuntos
Quilotórax , Neoplasias Esofágicas , Idoso , Quilotórax/diagnóstico por imagem , Quilotórax/etiologia , Quilotórax/cirurgia , Neoplasias Esofágicas/cirurgia , Esofagectomia/efeitos adversos , Feminino , Humanos , Linfografia , Complicações Pós-Operatórias/cirurgia , Ducto Torácico/diagnóstico por imagem , Ducto Torácico/cirurgia
4.
J Surg Oncol ; 2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34704609

RESUMO

BACKGROUND AND OBJECTIVES: Contrary to the Japanese guidelines recommendations regarding lateral lymph node dissection (LatLND) for rectal cancer, its omission is common in clinical practice without reliable omission criteria. Negative pathological mesorectal lymph node metastasis (MesLNM) is reportedly highly correlated with negative pathological lateral lymph node metastasis (p-LatLNM); however, this cannot be used as a criterion because pathological features are revealed postoperatively. Herein, we prospectively evaluated the negative predictive value (NPV) of MesLNM diagnosed via the one-step nucleic acid amplification (OSNA) method for p-LatLNM. METHODS: This prospective study was conducted at a single academic study group in Japan. The key eligibility criterion was mid-to-low rectal cancer planned to be treated using mesorectal excision with LatLND. According to the study protocol, the OSNA method was considered useful if the point estimate of the NPV exceeded 95%. RESULTS: Preoperative case registration was conducted between 2018 and 2020; 34 patients were registered. Among these, 16 were negative for OSNA-MesLNM, and negative p-LatLNM was confirmed in all cases. The point estimate of the NPV was 100%, with the 95% confidence interval ranging from 79.4% to 100.0%. CONCLUSIONS: The OSNA method is useful in selecting patients in whom LatLND can be omitted in real-world clinical practice.

5.
Nihon Shokakibyo Gakkai Zasshi ; 118(5): 455-461, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-33967130

RESUMO

Although amebiasis is usually asymptomatic, fulminant amebic colitis is associated with a high mortality rate. Here, we report the case of a patient with amebic colitis in which bowel perforation occurred despite treatment with metronidazole. A man in his 70s underwent steroid pulse therapy to treat serious acute hepatitis A. After corticosteroid therapy, he developed acute abdomen because of amebic colitis. We immediately administered metronidazole and his symptoms improved. After completing treatment, he developed colon perforation. Amebic colitis can progress to bowel perforation even after administering the appropriate medication, so this abdominal symptom requires careful attention.


Assuntos
Amebíase , Disenteria Amebiana , Perfuração Intestinal , Corticosteroides , Disenteria Amebiana/tratamento farmacológico , Humanos , Perfuração Intestinal/induzido quimicamente , Masculino , Metronidazol/efeitos adversos
6.
Am J Case Rep ; 22: e929565, 2021 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-33819210

RESUMO

BACKGROUND Non-malignant and non-cirrhotic portal and mesenteric vein thrombosis is rare. It has been reported that the hyperthyroid state is associated with increased risks of venous thrombosis due to increases in levels of various coagulation and anti-fibrinolytic factors. Particularly, changes in levels of these factors are also reported in cases of portal and mesenteric vein thrombosis. Although hyperthyroidism is not known as a risk factor for portal and mesenteric vein thrombosis, it might be an underlying pathogenesis of hyperthyroidism-associated portal and mesenteric vein thrombosis. CASE REPORT A 59-year-old Japanese man with a history of Grave's disease presented with acute portal and mesenteric vein thrombosis and hyperthyroidism. Anticoagulation therapy was initiated and the dose of antithyroid drug was increased. He underwent various tests to identify causes of portal and mesenteric vein thrombosis. However, all test results were within normal range except for hyperthyroidism. Therefore, we discontinued anticoagulation therapy after normalization of thyroid hormone status. After 3 years, he experienced recurrence of portal vein thrombosis concomitant with hyperthyroidism. CONCLUSIONS Hyperthyroidism might be associated with portal vein thrombosis. Thyroid function tests should be performed in cases of portal and mesenteric vein thrombosis in the absence of other risk factors.


Assuntos
Hipertireoidismo , Trombose Venosa , Humanos , Hipertireoidismo/complicações , Masculino , Veias Mesentéricas/diagnóstico por imagem , Pessoa de Meia-Idade , Veia Porta/diagnóstico por imagem , Terapia Trombolítica , Trombose Venosa/tratamento farmacológico , Trombose Venosa/etiologia
7.
Langenbecks Arch Surg ; 405(8): 1139-1145, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33089391

RESUMO

PURPOSE: Guidelines advocate minimal ileal resection when right hemicolectomy is performed for right-sided colon cancer. The practice, thought to prevent malabsorption syndrome, does not appear to foster local recurrence. Little evidence based on rigorous study exists, however. To understand the pattern of lymphatic spread of right-sided colon cancer toward the small bowel and thus determine the appropriate margin size, we prospectively investigated anatomical distribution of lymph nodes (LNs) in the small bowel mesentery and of metastasis to these nodes in patients with right-sided colon cancer treated by such surgery. METHODS: In each case, the mesenteric specimen, which had been dissected along the ileocolic vessels and included intermediate LNs, was divided into 2 areas: that 0-3 cm from the vessel pedicle (area 1) and that 3-5 cm from the pedicle (area 2). The peri-intestinal mesentery was cut into 9 segments. RESULTS: Ninety-one patients were included in the study. Overall, 3366 LNs were dissected. Four hundred fifty-three of these LNs were located in area 1 (90 cases), and 15 (3.3%) were metastatic. Only 63 LNs were located in area 2 (34 cases; average of 0.69 per patient); none was metastatic. Overall, 269 LNs were found in the small bowel mesentery (in 56 of the 91 patients). Only 4 were positive (3 cases), and all were within 5 cm of the ileocecal valve. CONCLUSION: Our data indicate that a surgical margin 3 cm from the ileocecal pedicle and a short (5 cm) ileal margin are oncologically reasonable for effective right hemicolectomy.


Assuntos
Neoplasias do Colo , Colectomia , Neoplasias do Colo/cirurgia , Humanos , Excisão de Linfonodo , Mesentério/cirurgia , Recidiva Local de Neoplasia
8.
J Anus Rectum Colon ; 3(2): 84-90, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31559373

RESUMO

OBJECTIVES: Raman spectroscopy yields precise information, not only regarding the secondary structure of proteins but also regarding the discrimination between normal and malignant tissues. There is, however, no standard measurement method. We evaluated the use of a miniaturized, handheld, all-in-one Raman spectrometer with a 1064-nm laser excitation source for the diagnosis of colorectal cancer. The ultimate goal is real-time, in vivo diagnosis. METHODS: Tissue samples were obtained from 20 patients who underwent surgery for colorectal cancer. The samples were irradiated with the portable Progeny™ Raman spectrometer, with which the Raman spectra were also obtained. We searched for characteristic Raman shifts and examined whether these shifts could distinguish the cancer tissues. To improve accuracy, we divided the spectra into 100 cm-1 bands and applied principal component analysis (PCA) to each range. We evaluated the contribution of each range for cancer discrimination. RESULTS: Intensities at 1261 and 1427 cm-1 differed significantly between the normal tissues and cancer tissues, but these did not efficiently discriminate the cancer tissues. However, we were able to identify the characteristic spectral range in fingerprint regions; accuracy was 85.1%. CONCLUSIONS: Use of the all-in-one type Raman spectrometer can efficiently discriminate colorectal cancer, not on the basis of the intensities at 1261 and 1427 cm-1 but rather on the basis of PCA. Thus, Raman spectroscopy performed using a handheld device has potential to become a clinically powerful tool for producing high-quality data, obtaining highly reproducible measurements, and thus accurately diagnosing colorectal cancer.

9.
Cancer Med ; 8(7): 3359-3369, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31062495

RESUMO

BACKGROUND: Radiation therapy (RT) for women with ductal carcinoma in situ (DCIS) undergoing breast-conserving surgery (BCS) may be overtreatment for some, especially for those in which DCIS is eradicated, and ipsilateral breast tumor recurrence (IBTR) risk approaches the contralateral breast cancer (CBC) level. The aim of this study was to clarify whether the polygon method, a new systematic method of en face (tangential, shaved) margin assessment, can identify a subset of DCIS that can be safely treated by BCS alone. METHODS: A key tool of the polygon method is an adjustable mold that prevents the "pancake phenomenon" (flattening) of breast tissue after surgical removal so that the specimen is fixed in the shape of a polygonal prism. This preanalytical procedure enables us to command a panoramic view of entire en face margins 3-5-mm deep from the real peripheral cut surfaces. Competing risk analysis was used to quantify rates of IBTR and CBC and to evaluate risk factors. RESULTS: From 2000 to 2013, we identified 146 DCIS patients undergoing BCS with a contralateral breast at risk. In 100 DCIS patients whose margin was negative by the polygon method, 5 IBTR (3 DCIS and 2 invasive ductal carcinoma [IDC]) and 10 CBC (6 DCIS and 4 IDC) cases were identified during a median follow-up of 7.6 years (range, 0.9-17.4). Five- and 10-year cumulative incidence rates were 3.0% and 5.3% for IBTR, and 7.1% and 13.3% for CBC, respectively. Thus, patients with a negative margin consistently showed at least twofold lower IBTR than CBC despite omission of RT. CONCLUSIONS: Japanese women classified with a negative margin by the polygon method show a very low risk of IBTR and account for approximately half of CBC cases. In this subset of DCIS patients, additional RT is not beneficial.


Assuntos
Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Margens de Excisão , Mastectomia Segmentar/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Estudos Retrospectivos
10.
Gan To Kagaku Ryoho ; 46(3): 508-510, 2019 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-30914597

RESUMO

Perforated gastric cancer reported to be relatively rare and to have a poor prognosis. This study examined 9 patients with perforated gastric cancer. Two-thirds of the patients were male and the median age was 69 years. The timing of the diagnosis of gastric cancer was preoperative clinical findings in 4 cases, intraoperative surgical findings in 3 cases, and postoperative examination in 2 cases. The depths of tumor invasion were T3 in 3 cases, T4a in 4 cases, and T4b in 2 cases and 5 patients were Stage Ⅳ. Four patients underwent palliative gastrectomy and only 1 patient underwent curative(R0)gastrectomy. Four patients underwent repair surgery, 2 of which underwent omental patch repair during the initial surgery. One of patients with omental patch repair received 2-stage curative gastrectomy; the other patient received chemotherapy after recovering from acute peritonitis. The median overall survival was 17.9 months and the prognosis was favorable in cases with curative resection or chemotherapy. For patients with perforated gastric cancer, if curative resection cannot be expected, the initial surgery should be directed toward the treatment of peritonitis and radical oncological surgery or systemic chemotherapy should be planned following patient recovery.


Assuntos
Peritonite , Neoplasias Gástricas , Idoso , Feminino , Gastrectomia , Humanos , Masculino , Período Pós-Operatório , Prognóstico , Neoplasias Gástricas/cirurgia
11.
Eur J Ophthalmol ; 29(3): 330-337, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-29991284

RESUMO

PURPOSE: To describe the optical coherence tomography findings of retinal astrocytic hamartoma of tuberous sclerosis and to confirm the association between the type of retinal astrocytic hamartoma and systemic manifestations in Japanese patients. STUDY DESIGN: A retrospective observational case series. METHODS: The medical records of 35 patients with tuberous sclerosis who underwent ophthalmological examination were reviewed. The retinal astrocytic hamartomas were classified into four types based on the optical coherence tomography findings, and their association with systemic disease was evaluated. RESULTS: A total of 40 retinal astrocytic hamartomas in 13 eyes of eight patients aged 4-28 years were identified. Optical coherence tomography images were obtained for 23 lesions in 10 eyes of seven patients. Retinal astrocytic hamartomas were seen as protruding lesions of varying heights (maximum thickness, range between 221 to 1043 µm). Of the 23, 15 lesions showed homogeneous reflectivity; in six lesions, hyper-reflective spots that presumably represented intratumoral calcification were noted. Vitreous changes were noted in 13 lesions; vitreous seeding by retinal astrocytic hamartoma was observed in seven eyes. There were no significant differences in the rates of each systemic feature among the optical coherence tomography types. CONCLUSION: Retinal astrocytic hamartomas were classified into four types according to the previous reports; however, this classification may be worthless because the extent of protrusion did not correspond to the intratumoral characteristics, and the involved depth of the retina was not same even in the same type. An association between the type of retinal astrocytic hamartoma and systemic manifestations was not confirmed in this small case series. We considered that the classification of retinal astrocytic hamartoma and its association with systemic manifestations need further study.


Assuntos
Astrócitos , Hamartoma/diagnóstico por imagem , Doenças Retinianas/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Esclerose Tuberosa/diagnóstico por imagem , Adolescente , Adulto , Calcinose/patologia , Criança , Pré-Escolar , Neoplasias Oculares/patologia , Feminino , Humanos , Lactente , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Agitação Psicomotora , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
12.
Gan To Kagaku Ryoho ; 45(13): 2030-2032, 2018 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-30692434

RESUMO

The aim of this study was to clarify the risk factors of severe postoperative complications and prognostic factors in patients who underwent emergent surgery for colorectal cancer perforation. ASA-PSB3 and Mannheim Prognostic Index(MPI)B27 were selected as the independent risk factors for postoperative severe complications on multivariate analysis. Moreover, severe postoperative complications and non-curative surgery were selected as the independent factors of poor prognosis.


Assuntos
Neoplasias Colorretais , Perfuração Intestinal , Neoplasias Colorretais/cirurgia , Humanos , Perfuração Intestinal/etiologia , Complicações Pós-Operatórias , Prognóstico , Estudos Retrospectivos , Fatores de Risco
13.
Gynecol Oncol ; 147(2): 388-395, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28847642

RESUMO

OBJECTIVE: Lynch syndrome (LS), an autosomal-dominant inherited disorder, increases the risk for LS-associated cancers (LS-AC). Molecular LS assessment for all cases is referred to as universal screening (U/S) and is recommended for endometrial cancer (EC) and colorectal cancer. Lynch-like cases (LL) lack LS-pathogenic mutations despite being suspected as LS by U/S, but have been poorly investigated in EC. The aim of this study was to capture the features of LL in EC and to devise LL management in EC. METHODS: U/S, consisting of immunohistochemistry and reflex methylation analysis, was applied to 348 Asian ECs, and sporadic cancer (SC) cases were screened out. Genetic testing was offered to "suspected-LS" cases selected by U/S. The features of the LS, LL, and SC groups were recorded and compared. RESULTS: U/S screened 306 ECs as SC. The recurrence rates of suspected-LS and SC cases were 14.3% (6/42) and 26.5% (81/306), respectively. Of the 42 suspected-LS cases, 10 were identified as LS, 17 were classified as LL, and 15 did not undergo genetic testing. In the LS group, the frequency of personal history (50%) and family history (100%) of LS-AC were prominent. Of note, the prevalence of family history of LS-AC and gastric cancer was significantly higher in the LL group than in the SC group (76.5% vs. 38.6% and 47.1% vs. 25.2%, respectively). CONCLUSIONS: Herein, we report the features of LL classified by LS identification via U/S in Asian EC. LL should be candidates for tailored surveillance based on regionality and family history.


Assuntos
Neoplasias Colorretais Hereditárias sem Polipose/diagnóstico , Neoplasias do Endométrio/diagnóstico , Adulto , Idoso , Neoplasias Colorretais Hereditárias sem Polipose/genética , Neoplasias Colorretais Hereditárias sem Polipose/metabolismo , Detecção Precoce de Câncer/métodos , Neoplasias do Endométrio/genética , Neoplasias do Endométrio/metabolismo , Feminino , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Proteína 1 Homóloga a MutL/biossíntese , Proteína 1 Homóloga a MutL/genética , Recidiva Local de Neoplasia/diagnóstico , Estudos Retrospectivos
14.
Kyobu Geka ; 70(9): 765-769, 2017 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-28790244

RESUMO

A 66-year-old woman was referred to our hospital with dyspnea. Right-sided congestive pleural effusion of an unknown etiology was detected and she was diagnosed with constrictive pericarditis. Pericardiectomy was performed via median sternotomy under extracorporeal circulation because severe adhesion was observed. However, hemodynamics did not improve after pericardial resection because of thickend epicardium in front of the right ventricle. Hence, the waffle procedure was additionally performed on the anterior surface of the right ventricle after coming-off the extracorporeal circulation. Although significant cardiac dilatation was achieved, hemodynamics did not change markedly. The symptoms gradually alleviated postoperatively and cardiac catheterization performed 3 weeks later revealed marked improvement in hemodynamics. Although improvement in hemodynamics takes time, the waffle procedure appears to be effective.


Assuntos
Pericardite Constritiva/cirurgia , Idoso , Cateterismo Cardíaco , Feminino , Humanos , Pericardiectomia , Pericardite Constritiva/diagnóstico por imagem , Período Pós-Operatório , Esternotomia , Resultado do Tratamento
15.
Gan To Kagaku Ryoho ; 44(12): 1211-1213, 2017 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-29394584

RESUMO

In elderly patients, surgical procesure is decided considering the general condition and surgical invasion. The aim of this study was to clarify the appropriate rage of lymph node dissection for elderly colorectal cancer patients. One hundred forty one colorectal cancer patients aged 75 years or more, who underwent R0 colorectal resection with D2 or D3 lymph node dissection in clinical T3/T4 or clinical N+, were enrolled in this study. The patients whose tumor located in the rectum below the peritoneal reflection(Rb)were excluded. Five-year overall survival(OS)rate and disease specific survival(DSS)rate were 79.1% and 89.4%, respectively. More than 2 preoperative co-morbidities and macroscopic type 3-5 were independent prognostic factors in OS, whereas the rage of lymph node dissection was not risk factor. When comparing the outcomes of D2 and D3 dissections by age, D3 dissection was better tendency in DSS in patients aged under 80, however, D2 dissection was better tendency in patients aged 80 or more. In elderly colorectal cancer patients, there was no difference in prognosis between D2 and D3 dissection, and especially in patients aged 80 years or more, D2 might be sufficient if R0 resection was possible.


Assuntos
Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Excisão de Linfonodo , Metástase Linfática , Masculino , Fatores de Risco , Resultado do Tratamento
16.
Genes Cells ; 22(1): 94-104, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27935186

RESUMO

Yeast has a homologue of mammalian voltage-gated Ca2+ channels (VGCCs), enabling the efficient uptake of Ca2+ . It comprises two indispensable subunits, Cch1 and Mid1, equivalent to the mammalian pore-forming α1 and auxiliary α2 /δ subunits, respectively. Unlike the physiological roles of Cch1/Mid1 channels, the regulatory mechanisms of the yeast VGCC homologue remain unclear. Therefore, we screened candidate proteins that interact with Mid1 by an unbiased proteomic approach and identified a plasma membrane H+ -ATPase, Pma1, as a candidate. Mid1 coimmunoprecipitated with Pma1, and Mid1-EGFP colocalized with Pma1-mCherry at the plasma membrane. The physiological relevance of their interaction was determined using the temperature-sensitive mutant, pma1-10. At the nonpermissive temperature, the membrane potential was less negative and Ca2+ uptake was lower in pma1-10 than in wild-type cells. Increased extracellular H+ increased the rate of Ca2+ uptake. Therefore, H+ extrusion by Pma1 may be important for Ca2+ influx through Cch1/Mid1. These results suggest that Pma1 interacts physically with Cch1/Mid1 Ca2+ channels to enhance their activity via its H+ -pumping activity.


Assuntos
Canais de Cálcio/metabolismo , Glicoproteínas de Membrana/metabolismo , Proteômica , ATPases Translocadoras de Prótons/metabolismo , Proteínas de Saccharomyces cerevisiae/metabolismo , Sequência de Aminoácidos , Cálcio/metabolismo , Canais de Cálcio/genética , Membrana Celular/genética , Membrana Celular/metabolismo , Glicoproteínas de Membrana/genética , Mapeamento de Interação de Proteínas/métodos , ATPases Translocadoras de Prótons/genética , Saccharomyces cerevisiae , Proteínas de Saccharomyces cerevisiae/genética
17.
Clin Case Rep ; 4(8): 721-4, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27525069

RESUMO

A mass developing in operating scar part with fistula should raise concern for caseating granuloma even if many years after operation.

18.
Am J Surg Pathol ; 40(6): 770-6, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-26848797

RESUMO

Lynch syndrome (LS) is an autosomal-dominant inherited disorder mainly caused by a germline mutation in the DNA mismatch repair (MMR) genes (MLH1, MSH2, MSH6, and PMS2) and is associated with increased risk for various cancers, particularly colorectal cancer and endometrial cancer (EC). Women with LS account for 2% to 6% of EC patients; it is clinically important to identify LS in such individuals for predicting and/or preventing additional LS-associated cancers. PMS2 germline mutation (PMS2-LS) is the rarest contribution to LS etiology among the 4 LS-associated MMR germline mutations, and its detection is complicated. Therefore, prudent screening for PMS2-LS is important as it leads to an efficient LS identification strategy. Immunohistochemistry is recommended as a screening method for LS in EC. Isolated loss of PMS2 (IL-PMS2) expression is caused not only by PMS2-LS but also by MLH1 germline mutation or MLH1 promoter hypermethylation (MLH-PHM). This study aimed to determine the association between MLH1-PHM and IL-PMS2 to avoid inappropriate genetic analysis. We performed MLH1 methylation analysis and MLH1/PMS2 germline mutation testing on the IL-PMS2 cases. By performing MMR-immunohistochemistry on 360 unselected ECs, we could select 8 (2.2%) cases as IL-PMS2. Heterogenous MLH1 staining and MLH1-PHM were detected in 4 of 8 (50%) IL-PMS2 tumors. Of the 5 IL-PMS2 patients who underwent genetic analysis, 1 had PMS2 germline mutation with normal MLH1 expression (without MLH1-PHM), and no MLH1 germline mutation was detected. We suggest that MLH1 promoter methylation analysis for IL-PMS2 EC should be performed to exclude sporadic cases before further PMS2 genetic testing.


Assuntos
Neoplasias Colorretais Hereditárias sem Polipose/diagnóstico , Neoplasias Colorretais Hereditárias sem Polipose/genética , Detecção Precoce de Câncer , Neoplasias do Endométrio/genética , Endonuclease PMS2 de Reparo de Erro de Pareamento/biossíntese , Proteína 1 Homóloga a MutL/genética , Biomarcadores Tumorais/análise , Metilação de DNA/genética , Feminino , Predisposição Genética para Doença/genética , Testes Genéticos/métodos , Humanos , Imuno-Histoquímica , Endonuclease PMS2 de Reparo de Erro de Pareamento/análise , Regiões Promotoras Genéticas/genética
19.
Tohoku J Exp Med ; 237(1): 25-30, 2015 09.
Artigo em Inglês | MEDLINE | ID: mdl-26310275

RESUMO

Endometrial cancer (EC) rates are rising in Japan. Lymph node (LN) metastasis is an important prognostic factor in EC, and its risk is increased with higher tumor grade, deep myometrial invasion, larger tumor size, and lymphovascular space invasion (LVSI). Current methodologies to assess these factors are unreliable. We previously showed the association between C-reactive protein (CRP) 1846C>T (rs1205) polymorphism and LN metastasis in esophageal, non-small cell lung, and breast cancers. The CRP gene is located on chromosome 1q21-q23, and the polymorphism in the noncoding region (1846C>T) of this gene decreases serum CRP levels. We investigated the relationship between CRP 1846C>T genetic polymorphism and LN metastasis or LVSI in 130 EC patients using polymerase chain reaction-restriction fragment length polymorphism. The CRP 1846C/T genotype was C/C in 11 patients, C/T in 58 patients and T/T in 61 patients. The patients were divided into two groups based on their CRP 1846 genotypes: "C/C" and "C/T + T/T". Nine (7%) and 18 (13%) patients, all with the polymorphism, had LN metastasis and moderate or prominent lymphatic invasion, respectively. LN metastasis and/or severe lymphatic invasion were observed in the C/T + T/T group, while patients with the C/C genotype had no LN metastases or severe lymphatic invasion. Univariate and multivariate logistic regression models revealed that the C/T + T/T patients had a significant likelihood of developing LN metastasis and/or severe lymphatic invasion. Our results suggest that CRP genetic polymorphism is a novel risk predictor of LN metastasis and/or lymphatic invasion in EC.


Assuntos
Proteína C-Reativa/genética , Neoplasias do Endométrio/genética , Metástase Linfática/genética , Adulto , Idoso , Neoplasias do Endométrio/patologia , Feminino , Genótipo , Humanos , Metástase Linfática/patologia , Pessoa de Meia-Idade , Invasividade Neoplásica , Razão de Chances , Polimorfismo Genético/genética
20.
Virchows Arch ; 467(1): 71-8, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25838080

RESUMO

Breast cancer is occasionally complicated by sclerosing adenosis (SA). Although both lesions usually originate in the terminal duct lobular unit, their pathogenetic relationship has not yet been elucidated. The present study analyzed 63 breast cancer patients with SA (involving a total of 75 breasts) to clarify if coexisting SA increased the frequency of multicentric breast cancer or not. Using the topographical classification proposed in our previous study, breast cancers with SA were classified into the following three types: type A (n = 22), cancer area was completely surrounded by the SA; type B (n = 26), cancer area partially overlapped the SA; and type C (n = 27), cancer area was located separate from the SA. Breast cancers with SA had a significant (P < 0.001) increase in frequency of harboring bilateral and multicentric cancers [17 of 63 (27%) and 15 of 63 (24%), respectively] when compared to breast cancer patients without SA, regardless of topographical type. Breast cancers with SA were less invasive (P < 0.001), of lower histological grade (P = 0.034), and had similar frequency of estrogen receptor-positive (P = 0.21) and HER2-positive (P = 0.74) tumors. In conclusion, contralateral and ipsilateral multicentric breast cancers occurred at a higher frequency in those with SA. Our data suggest that SA is, in addition to lobular neoplasia, a predictor of multicentric breast cancers.


Assuntos
Neoplasias da Mama/patologia , Mama/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Proliferação de Células , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Esclerose
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