A Case of Gangliocytic Paraganglioma of the Jejunum KOIDE, Fumihiko; KAWAI, Toru; OCHIAI, Yosuke ...
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association),
2017, 2017-00-00, Letnik:
78, Številka:
8
Journal Article
Odprti dostop
A 51-year-old female visited our hospital complaining of tarry stool. Contrast-enhanced abdominal CT revealed an enhancing jejunal tumor measuring 3 cm in size. Upper gastrointestinal endoscopy ...revealed a submucosal tumor in the upper jejunum, adjacent to Treitz ligament. Endoscopic ultrasonography demonstrated a hypo- to isoechoic submucosal tumor in the third layer. The biopsy specimen showed no abnormal histopathological findings. PET-CT revealed abnormal uptake in the mass lesion. Based on a tentative preoperative diagnosis of gastrointestinal stromal tumor of the small intestine, we performed hand-assisted laparoscopic resection of the tumor. Histopathological examination of the resected tumor revealed the diagnosis of gangliocytic paraganglioma of the jejunum. In general, gangliocytic paragangliomas arise from the duodenum, and this tumor arising from the jejunum is extremely rare. This is the first reported case from Japan and the fifth reported case from around the world.
In recent years, extremely late-harvesting peach ‘Fuyumomogatari®’, which is commercially harvested in November, has been grown in Okayama, Japan. The fruit developmental pattern of ‘Fuyumomogatari®’ ...was investigated at an orchard across two seasons and compared with ‘Akizora’, which is harvested in late-August. In ‘Fuyumomogatari®’, Stage 1 of fruit growth was completed at almost the same time in ‘Akizora’, while Stage 2 of fruit growth continued for more than two months, one month longer than ‘Akizora’. In this period, the relative fruit growth rate in ‘Fuyumomogatari®’ was clearly lower than that in the other stages. On the other hand, no significant difference was observed in developmental speeds of the endosperm and embryo between ‘Fuyumomogatari®’ and ‘Akizora’. Fruit growth during Stage 3 in ‘Fuyumomogatari®’ continued until the end of October at a slower growth rate than that observed in ‘Akizora’. Thereafter, several weeks of possible mature stage were observed before commercial harvest in ‘Fuyumomogatari®’. Significant levels of ethylene were already present in ‘Fuyumomogatari®’ fruit at harvest in both experimental seasons. Harvested fruits were ripened at 20°C for 15 days and the ripening characteristics were investigated. The decrease in flesh firmness was relatively slow in both seasons, and all fruit showed optimum edible quality from Days 6 to 12 during ripening at 20°C. Similar developmental and ripening characteristics were observed in ‘Fuyumomogatari®’ grafted onto its seedling and grown on the experimental farm of Okayama University, suggesting that these unique traits shown in ‘Fuyumomogatari®’ are stable traits that can be transferred by grafting.
Pemetrexed is an antifolate agent that is regarded as an alternative second-line chemotherapy against advanced or metastatic urothelial carcinoma (UC). However, there is limited information on ...pemetrexed in a third-line setting. We report a case of metastatic UC treated with pemetrexed as third-line chemotherapy following gemcitabine and cisplatin (GC) and gemcitabine and docetaxel (GD) therapies. A 73-year-old man with a history of transurethral resection of bladder carcinoma presented with pollakiuria. CT revealed a mass in the left renal pelvis that had invaded into the parenchyma of the left kidney, as well as para-aortic and mediastinum lymph node enlargement. Urinary cytology of the lesion in the left renal pelvis revealed UC. Thus, the patient was diagnosed with left renal pelvic carcinoma (cT3N2M0). After having received 4 courses of GC therapy, another mediastinum lymph node was enlarged. He subsequently received 3 courses of GD therapy as second-line chemotherapy, which showed little efficacy against the metastatic lesions. The patient was administered 3 courses of pemetrexed as third-line chemotherapy; however, its effect on tumor reduction was not sufficient. Finally, metastasis to the liver was observed, and he died 21 months after initiation of chemotherapy. For pathological confirmation, needle biopsy of a metastatic lymph node performed after death revealed high-grade UC and a high positivity of programmed death ligand 1 (PD-L1) in the tumor, which suggested that he could have benefited from anti-PD-L1 antibody immunotherapy. This report describes the outcome of pemetrexed treatment and proposes another possible candidate as third-line chemotherapy against metastatic UC.
Intracellular sodium (Na+i) kinetics are involved in cardiac diseases including ischemia, heart failure, and hypertrophy. Because Na+i plays a crucial role in modulating the electrical and ...contractile activity in the heart, quantifying Na+i is of great interest. Using fluorescent microscopy with sodium-binding benzofuran isophthalate (SBFI) is the most commonly used method for measuring Na+i. However, one limitation associated with this technique is that the test cannot simultaneously evaluate the effects of several types or various concentrations of compounds on Na+i. Moreover, there are few reports on the long-term effects of compounds on Na+i in cultured cells, although rapid changes in Na+i during a period of seconds or several minutes have been widely discussed.
We established a novel technique for quantifying Na+i in cultured neonatal rat cardiomyocytes attached to a 96-well plate using a microplate reader in combination with SBFI and probenecid. We showed that probenecid is indispensable for the accurate measurement because it prevents dye leakage from the cells. We further confirmed the reliability of this system by quantifying the effects of ouabain, which is known to transiently alter Na+i. To illustrate the utility of the new method, we also examined the chronic effects of aldosterone on Na+i in cultured cardiomyocytes.
Our technique can rapidly measure Na+i with accuracy and sensitivity comparable to the traditional microscopy based method. The results demonstrated that this 96-well plate based measurement has merits, especially for screening test of compounds regulating Na+i, and is useful to elucidate the mechanisms and consequences of altered Na+i handling in cardiomyocytes.
Candidate imprinted transcriptional units in the mouse genome were identified systematically from 27,663 FANTOM2 full-length mouse cDNA clones by expression profiling. Large-scale cDNA microarrays ...were used to detect differential expression dependent upon chromosomal parent of origin by comparing the mRNA levels in the total tissue of 9.5 dpc parthenogenote and androgenote mouse embryos. Of the FANTOM2 transcripts, 2114 were identified as candidates on the basis of the array data. Of these, 39 mapped to known imprinted regions of the mouse genome, 56 were considered as nonprotein-coding RNAs, and 159 were natural antisense transcripts. The imprinted expression of two transcripts located in the mouse chromosomal region syntenic to the human Prader-Willi syndrome region was confirmed experimentally. We further mapped all candidate imprinted transcripts to the mouse and human genome and were shown in correlation with the imprinting disease loci. These data provide a major resource for understanding the role of imprinting in mammalian inherited traits.
Byline: Yosuke Nakamura (1,2), Satoshi Matsuo (1), Masae Hosogai (1), Yasuaki Kawai (1) Keywords: Head down rotation; Renal sympathetic nerve; Aortic depressor nerve; Arterial pressure; Rabbit This ...study was undertaken to elucidate neural control of the arterial blood pressure (ABP) in head-down postural change which causes both stimulation to the vestibular system and head-ward fluid shift. Experiments were carried out with urethane-anesthetized rabbits. The animal was mounted on a tilting table, tilted to 45deg head-down in 5 s, and kept at the position for 5 min. The head-down rotation (HDR) induced a transient decrease in ABP (10 +- 3 mmHg mean +- SE), and then the pressure gradually recovered toward the pre-HDR level during the 5 min at the head-down position. Pretreatment with hexamethonium bromide, a ganglionic transmission blocker, suppressed the HDR-induced drop of ABP, suggesting that the ABP drop was induced by an inhibition of autonomic neural outflows. Renal sympathetic nerve activity (RSNA) decreased considerably after 1.6 +- 0.2 s from the onset of HDR, which was followed by the ABP drop. Aortic depressor nerve activity (ADNA), an afferent for baroreceptor reflex, increased significantly during the rotation, but the peak of ADNA increase was 3.2 +- 0.5 s after the initiation of the HDR. Therefore, the suppression of RSNA seems to be induced mainly by a quicker mechanism than baroreceptor reflex. In order to test the possibility, we examined changes in ABP and RSNA during HDR using vestibular-lesioned rabbits. In these rabbits, RSNA and ABP did not change significantly during HDR. These results suggest that vestibular organs play a role in the transient drop in ABP induced by HDR through the suppression of sympathetic nerve outflows. Author Affiliation: (1) Division of Adaptation Physiology, Faculty of Medicine, Tottori University, 86 Nishi-cho, Yonago, 683-8503, Japan (2) Division of Otolaryngology, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan Article History: Registration Date: 31/01/2009 Received Date: 03/07/2008 Accepted Date: 29/01/2009 Online Date: 19/02/2009
Patients with a primary pure seminoma in the testis who have elevated serum alpha-fetoprotein are rare and should be treated as patients with nonseminomatous germ cell tumors. However, nonpalpable ...testicular tumors in this condition have never been reported. We describe a case of nonpalpable pure testicular seminoma with elevated serum alpha-fetoprotein presenting retroperitoneal metastasis.
A 29-year-old Asian man was referred to our hospital with right flank pain. Computed tomography showed a mass located between his aorta and inferior vena cava, but a testicular tumor was not detected. His serum levels of lactate dehydrogenase, alpha-fetoprotein, and DUPAN-2 were high. Although no tumor or nodule was palpable in his testis, ultrasonography revealed multiple low echoic lesions in his right testicular parenchyma. He was diagnosed with right testicular cancer with retroperitoneal lymph node metastasis and underwent right high orchiectomy. A pathological examination revealed pure seminoma and no nonseminomatous components were found in the specimen. Three courses of induction systemic chemotherapy (cisplatin, etoposide, and bleomycin) normalized his serum alpha-fetoprotein and DUPAN-2 levels. Three additional courses of chemotherapy (etoposide and bleomycin) were performed, and treatment was completed with laparoscopic retroperitoneal lymph node dissection. Pathology of the dissected specimen showed fibrous and necrotic tissue with no viable cells. He is alive without recurrence 54 months after orchiectomy.
We report a case of pure testicular seminoma with elevated serum alpha-fetoprotein and DUPAN-2 presenting retroperitoneal metastasis. We recommend an ultrasound examination of bilateral testes when large retroperitoneal tumors are detected in young men, even if a mass is not palpable in the scrotum.
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