Altered glycosylation associated with hepatocellular carcinoma (HCC) is well documented. However, few reports have investigated the association between dedifferentiation and glycosylation. Therefore, ...the aim of this study was to analyze glycosylation associated with dedifferentiation of HCC within the same nodule and to investigate glycosyltransferase related to the glycosylation.
We analyzed resected HCC specimens (n = 50) using lectin microarray to comprehensively and sensitively analyze glycan profiles, and identify changes to glycosylation between well- and moderately-differentiated components within the same nodule. Moreover, we performed immunohistochemical staining of mannosyl(α-1,3-)-glycoprotein β-1,2-N-acetylglucosaminyltransferase (MGAT1), which is an essential glycosyltransferase that converts high-mannose glycans to complex- or hybrid-type N-glycans.
Four lectins from Narcissus pseudonarcissus agglutinin (NPA), Concanavalin A, Galanthus nivalis agglutinin, and Calystegia sepium agglutinin were significantly elevated in moderately-differentiated components of HCC compared with well-differentiated components, and all lectins showed binding specificity to high-mannose glycans. Therefore, these structures were represented to a greater extent in moderately-differentiated components than in well-differentiated ones. Immunohistochemical staining revealed significantly increased NPA expression and decreased MGAT1 expression in moderately-differentiated components. Low MGAT1 expression in moderately-differentiated components of tumors was associated with intrahepatic metastasis and had tendency for poor prognosis.
Dedifferentiation of well-differentiated HCC is associated with an increase in high-mannose glycans. MGAT1 may play a role in the dedifferentiation of HCC.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
An ectopic bile duct opening into the stomach is a rare congenital anomaly of the biliary system, and thus, there are few case reports with gastric ulcer hemorrhage. Herein, we presented a ...case of ectopic bile duct concomitant with gastric ulcer hemorrhage.
Case presentation
A 75-year-old woman was referred to our hospital because she repeatedly vomited blood and had melena. Endoscopic hemostasis was attempted for hemorrhage from a gastric ulcer located on the anterior wall of the antrum. However, the bleeding was difficult to stop, and a laparoscopic distal gastrectomy was performed. Her postoperative course was uneventful. Pathological examination revealed that the bleeding point was an ectopic bile duct. In retrospect, an annual endoscopy performed at her family clinic had revealed a bulge in the same portion of the stomach. Exposure to bile acids from an ectopic bile duct opening can cause gastric mucosal damage and ulceration.
Conclusions
Ectopic bile ducts opening into the stomach can cause gastric ulcer and hemorrhage. Hemorrhage from a submucosal ridge with ulcer in the stomach may be rarely related to the presence of ectopic bile ducts.
Background/Aim
Laparoscopic sleeve gastrectomy (SG) is an increasingly used bariatric surgery, which is reported to be effective for nonalcoholic fatty liver disease (NAFLD). Recently, activation of ...farnesoid X receptor (FXR), which is a nuclear receptor of bile acid (BA), was reported to contribute to the resolution of NAFLD. However, it is unclear whether SG has an effect on expression of FXR in the liver. We aimed to investigate the expression of FXR and its related factors in the liver after SG and to clarify the relationship between changes in FXR expression and NAFLD in an obese rat model.
Methods
Thirty male Zucker fatty rats were divided into three groups: sham-operated (SO) control, pair-fed (PF) control, and SG. Eight weeks after the surgery, metabolic parameters, plasma levels of total BA and liver enzymes, liver triglyceride (TG) content, and mRNA expression of FXR and its related factors, such as small heterodimer partner (SHP) and peroxisome proliferator-activated receptor α (PPARα), were measured.
Results
Metabolic parameters in the SG group were significantly improved compared with the SO group. Liver enzymes and TG were significantly lower in the SG group than in the SO group. Plasma levels of BA were significantly higher in the SG group than in the SO and PF groups. mRNA expression of FXR, SHP, and PPARα in the liver was significantly higher in the SG group than in the SO group.
Conclusions
These results suggest that the effects of SG on NAFLD should be associated with the expression of the FXR pathway in the liver in a Zucker fatty rat model.
Purposes
This study aimed to evaluate a novel surgical device combination VIO system containing a bipolar clamp (BiClamp) and the monopolar soft-coagulation (SOFT COAG) in hepatic resection for ...patients with hepatocellular carcinoma (HCC).
Methods
This study performed 124 hepatic resections for HCC and divided them into 2 groups: 60 patients (Conventional group) underwent liver parenchymal transection using Cavitron Ultrasonic Surgical Aspirator (CUSA) system and saline-coupled bipolar electrocautery for hemostasis; the BiClamp was used with the CUSA system for liver parenchymal transection and SOFT COAG was used with saline-coupled bipolar electrocautery for hemostasis in 64 patients (VIO group).
Results
The median blood loss in the VIO group was 345 mL, which was less than that in the Conventional group (median 548 mL,
P
= 0.0423). A multivariate logistic regression analysis showed that no use of the VIO system (
P
= 0.0172) was an independent predictor of intraoperative blood loss, respectively. In patients with liver cirrhosis, the VIO group included a significantly lower proportion of patients with liver cirrhosis that experienced more than 500 mL of intraoperative blood loss in comparison to those in the Conventional group (
P
= 0.0262).
Conclusions
The VIO system was safe for hepatic resection and its use was associated with a significant decrease in intraoperative blood loss even in cirrhotic patients.
Lanthanum carbonate (LaC) is used to prevent hyperphosphatemia in dialysis patients. It is commonly believed that there is little LaC absorption from the intestines. However, La deposition in the ...gastric mucosa, which we coined “gastric lanthanosis”, was recently reported. We describe here the clinicopathological features of and a possible mechanism for gastric lanthanosis. This study included 23 patients with definite gastric lanthanosis. We extracted characteristic clinicopathological features of gastric lanthanosis by computed tomography (CT) imaging and endoscopic, histologic, electron‐microscopic, and element analysis examinations. The Helicobacter pylori infection rate in the lanthanosis group was much lower than that among the general population. The clinicopathological features characteristic of gastric lanthanosis were mucosal high‐density linear appearance by CT, reflective bright‐white spots (BWS) by gastroscopy, eosinophilic histiocytes occasionally phagocytizing foreign materials by histology, and numerous electron‐dense particles in the histiocytes. The particles had burr‐like skeletons resembling La crystals. Gastric lanthanosis is an under‐reported, but not a rare lesion. It is characterized by endoscopic BWS and histologic eosinophilic histiocytes in dialysis patients treated with LaC. The proposed mechanism for gastric lanthanosis is that LaC is dissolved by gastric juice, crystallized within the mucosa and is phagocytized by histiocytes.
Objectives
After gastrectomy with extended lymph node (LN) dissection, the damage of celiac plexus seems to cause of disorder of eating habits. To clarify the indication of gastrectomy with limited ...LN dissection for elderly patients, the pathological characteristics of advanced gastric cancer in elderly patients were examined in this study.
Methods
Forty-seven patients aged ≥80 years with advanced gastric cancer (deeper than pT2) who underwent curative gastrectomy from 1998 to 2015 were enrolled. Patients were classified into two groups by extent of LN metastasis: Group A, with N0 or only perigastric LN metastasis (
n
= 33); Group B, LN metastasis beyond the perigastric area (
n
= 14). Pathological factors were then evaluated.
Results
No significant differences were observed in age, sex, body mass index, American Society of Anesthesiologists physical status classification, serum level of carcinoembryonic antigen, surgical procedure, extent of LN dissection, and number of dissected LNs. Pathological findings showed no significant differences in tumor location, macroscopic type, histologic type, and lymphovascular invasion. However, significant differences were observed in tumor maximum diameter at the cut-off level of 40 mm (Group A: ≤40 mm,
n
= 10 and >40 mm,
n
= 23; Group B: ≤40 mm,
n
= 0 and >40 mm,
n
= 14;
P
= 0.02).
Conclusion
In the elderly patients, LN metastasis in advanced gastric cancer of ≤40 mm in diameter was limited to be within the perigastric area. Gastrectomy with only perigastric LN dissection may be adopted in these patients.
Background
Although chemotherapy is the first recommended treatment of unresectable gastric cancer, a pathological complete response is a rare event.
Case presentation
A 58-year-old male was ...diagnosed as gastric cancer with a bulky tumor, lymphadenopathy, and suspicious peritoneal dissemination. The patient underwent chemotherapy with S-1 and cisplatin. After three courses of chemotherapy, a computed tomography showed dramatic improvements in gastric wall thickening, shrinkage of lymphadenopathy, and disappearance of disseminated peritoneal lesion. The patient underwent potentially curative resection by total gastrectomy with D2 lymph node dissection. Histological examination revealed the absence of malignant cells not only in the resected specimen but also in the harvested lymph nodes. At present, more than 7 years after the initial surgery, the patient is still alive without any recurrence.
Conclusions
We obtained a pathological complete response by chemotherapy with S-1 and cisplatin for advanced gastric cancer. Although a pathological complete response is a rare event, it would be associated with the long-term survival of patients with advanced gastric cancer.
A 77-year-old woman visited our hospital with a history of upper abdominal pain. She had undergone extended cholecystectomy for gallbladder cancer 36 months earlier, and 28 months after the ...operation, a gastric metastasis was found and she was initiated on treatment with S-1. Abdominal computed tomography revealed a perforation in the gastric antrum and continuous escape of free air from the same area. We made the diagnosis of perforating peritonitis and performed emergency laparotomy. Because there was a large perforation in the anterior wall of the gastric antrum, we performed distal gastrectomy and B-Ⅱ reconstruction. The postoperative course was uneventful and the patient was discharged on the 17th day. We report a case of gastric metastasis from gallbladder cancer complicated by perforating peritonitis.
A 52-year-old man consulted his doctor with complaints of lower abdominal pain for 1 year. Blood and urine analyses showed urinary occult blood but no anemia or elevated tumor markers. Computed ...tomography and magnetic resonance imaging revealed a 75 × 62 mm retroperitoneal tumor with no metastasis. The tumor was in contact with the left common iliac artery and the left ureter was compressed, resulting in hydronephrosis. The patient was referred to our hospital after the placement of a left ureteral stent. Biopsy was difficult due to tumor localization ; therefore, retroperitoneal tumor resection was performed. Histopathology revealed a pleomorphic rhabdomyosarcoma. There was a localized recurrence after 3 years. We performed tumor resection and postoperative radiation therapy at 50 Gy. The clinical course was favorable, with no recurrence or metastasis for 6 years since the first surgery.
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