Abstract Clinicopathological parameters derived from initial transurethral resection of bladder tumor (TUR-Bt) have limitations in predicting tumor progression in bladder cancer. Reduced folate ...carrier 1 (RFC1) and equilibrative nucleoside transporter 1 (ENT1) are solute carrier (SLC) transporters supporting cellular uptake of endogenous bioactive substances and anti-cancer drugs. The aim of this study was to elucidate the role of SLC transporters in bladder cancer and investigate the potential of RFC1 and ENT1 expression as immunohistochemical markers for high-grade malignancy. We compared T-stage with the immunohistochemical expression of RFC1 and ENT1 and other clinicopathological parameters; moreover, we also used multiple logistic regression model to assess relative contributions for T-stage in bladder cancer (n = 130). Concurrently, 57 TUR-Bt-derived imprint cytological samples were stained to evaluate the implication of cytological analysis. Elevated expression levels of RFC1 and ENT1 were significantly correlated with higher T-stage (p < .0001) and efficiently predicted tumor progression, compared with other clinicopathological parameters (RFC1, p = .0325; ENT1, p = .0171). Independent variables of optimal model for predicting T-stage were gender, age, histological grade, expression levels of RFC1 and ENT1. Cytological analysis was consistent with immunostained-tissue data. We reveal RFC1 and ENT1 as potential immunohistocytochemical markers for high-grade malignancy in bladder cancer.
Papillary fibroelastoma (PFE) is a benign tumor that arises mostly from left-sided valves. PFE can cause stroke, and surgical resection may be needed. Lambl's excrescence (LE) is a filiform valvular ...lesion and is considered a possible cause of stroke. A 79-year-old man with light-headedness and left-sided hemiparesis was diagnosed with stroke. Transesophageal echocardiography (TEE) revealed a round-shaped mobile mass in the left ventricular outflow tract (LVOT), which was considered the cause of the stroke. Surgical resection was performed transaortically, and during surgery, a mass was incidentally detected on the noncoronary cusp (NCC), which was also resected followed by aortic valve replacement. Pathology confirmed that the mass in the LVOT was a PFE and that the filiform mass on the NCC was LE. We herein report a rare case of PFE in the LVOT and coexisting LE on the NCC. A careful examination via TEE helps to identify other possible causes of stroke hidden behind the obvious cause.
Aims
Alpha‐fetoprotein (AFP)‐producing gastric cancer (GC) is an aggressive tumour with high rates of liver metastasis and poor prognosis, and for which a validated chemotherapy regimen has not been ...established. Drug uptake by solute carrier (SLC) transporters is proposed as one of the mechanisms involved in sensitivity to chemotherapy. In this study, we aimed to develop important insights into effective chemotherapeutic regimens for AFP‐producing GC.
Methods and results
We evaluated immunohistochemically the expression levels of a panel of SLC transporters in 20 AFP‐producing GCs and 130 conventional GCs. SLC transporters examined were human equilibrative nucleoside transporter 1 (hENT1), organic anion transporter 2 (OAT2), organic cation transporter (OCT) 2, OCT6 and organic anion‐transporting polypeptide 1B3 (OATP1B3). The rates of high expression levels of hENT1 (hENT1high) and OAT2 (OAT2high) were statistically higher in AFP‐producing GC, compared with conventional GC. When analysing hENT1 and OAT2 in combination, hENT1high/OAT2high was the most particular expression profile for AFP‐producing GC, with a greater significance than hENT1 or OAT2 alone. However, no significant differences in OCT2, OCT6 or OATP1B3 levels were detected between AFP‐producing and conventional GCs. However, immunoreactivity for hENT1, OAT2 and OCT6 tended to be increased in GC tissues compared with non‐neoplastic epithelia.
Conclusions
Because hENT1 and OAT2 are crucial for the uptake of gemcitabine and 5‐fluorouracil, respectively, our results suggest that patients with AFP‐producing GC could potentially benefit from gemcitabine/fluoropyrimidine combination chemotherapy. Increased expression of hENT1, OAT2 and OCT6 may also be associated with the progression of GC.
To determine the anatomic patterns of tumor distribution in radical prostatectomy specimens from nonpalpable prostate cancer.
Tumor maps directly traced from histologic slides of 62 radical ...prostatectomy specimens were superimposed by a computer-assisted imaging technique to create an idealized prostate gland at three levels: apex, mid-prostate, and base. To investigate specific patterns of tumor distribution, the sites of tumor in each quadrant were compared according to risk group stratification. The tumor extent was compared with the patterns of positivity in routine sextant biopsies.
Among all patients, the tumor frequency was 85.5% in the mid-gland, 82.3% in the apex, and 48.4% in the base. Analysis by quadrant showed that tumors were significantly denser in the apex to mid-prostate. The primary extent of these tumors appeared to lie predominantly in the anterior half of the gland. Biopsy yields at the apex and mid-prostate appeared low compared with the frequency of cancers at these levels. No patterns specific to the different risk groups were found, but no tumors within the anterior base were found in the low-risk group.
The primary extent of nonpalpable tumors appeared to lie predominantly in the anterior half of the gland at the apex to mid-prostate levels. Additional biopsy cores taken from more anterior regions of the gland may enhance the detection of nonpalpable cancers further.
To study an autopsy case of troglitazone-induced fulminant hepatitis.
A 58-year-old man contracted severe hepatitis 2 months after administration of troglitazone for the treatment of type 2 diabetes. ...Liver damage progressed gradually, even after withdrawal of the agent. Despite intensive therapy, the hepatitis became fulminant and the patient died 8 weeks after the onset of liver damage. Autopsy revealed massive hepatic necrosis and cholestasis with inflammatory cell infiltration. The pathological findings and the positive result of the drug-induced lymphocyte stimulation test for troglitazone indicated that the liver damage was mediated by hypersensitivity to troglitazone.
One report has attributed troglitazone-induced liver damage in less severe cases to idiosyncratic reactions. However, the present case indicates that troglitazone can induce hypersensitivity resulting in fulminant hepatitis. Careful monitoring of serum liver enzymes during troglitazone therapy is therefore essential.
A patient (56 years old) who developed ulcerative colitis (UC) in 11 achieved remission with oral mesalazine. In January 20XX, the patient (63 years old) visited our hospital for diarrhea and bloody ...stools. Colonoscopy (CS) findings resulted in a diagnosis of total UC and remission was achieved with high-dose steroid therapy (prednisolone). In November 20XX+8 (64 years old), worsening diarrhea and bloody stools prompted CS, which led to a diagnosis of relapsed UC. Oral prednisolone (PSL) 30 mg was administered but the disease was refractory to treatment. We considered immunosuppressive therapy but given the advanced age of the patient (64 years old) and COVID-19 pandemic, VED therapy was chosen as the safer option. In the tenth week of VED therapy, a medical examination revealed clinical remission. After approx. 1 year of VED therapy, CS revealed a healed mucosa after the patient experienced no infections, including COVID-19, and no adverse events. VED is considered a very safe therapeutic that acts selectively on gut immunity and does not cause systemic immune suppression. Given an increasing number of elderly patients with UC and the ongoing COVID-19 pandemic, there is a growing need for VED.
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