37 results on '"Shibahara, Junji"'
Search Results
2. Endoscopic Treatment of Colo-Colonic Intussusception in a Patient with Peutz-Jeghers Syndrome
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Fujima, Takeshi, Saito, Daisuke, Shibuta, Hidenori, Ogihara, Ryota, Morikubo, Hiromu, Ozaki, Ryo, Tokunaga, Sotaro, Minowa, Shintaro, Mitsui, Tatsuya, Miura, Miki, Hayashida, Mari, Watanabe, Yoshiko, Miyoshi, Jun, Matsuura, Minoru, Shibahara, Junji, Ukiyama, Etsuji, and Hisamatsu, Tadakazu
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A 19-year-old man with a history of Peutz-Jeghers syndrome (PJS) and two previous partial small bowel resections because of intussusception presented with lower abdominal pain. Computed tomography (CT) showed concentric multilayer and cord-like structures in the transverse colon. Colo-colonic intussusception was suspected and he was hospitalized. After two therapeutic enemas were unsuccessful, a colonoscopy was performed. The intussusception was reduced and a 40-mm transverse colon polyp with a thick stalk was resected. After the procedure, his abdominal pain was relieved and he was discharged on the sixth hospital day. This case and several previous reports suggest that PJS polyps with tumor diameter exceeding 30 mm and location in the transverse or sigmoid colon can cause intussusception. Endoscopic treatment should be considered for these lesions.
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- 2023
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3. Atezolizumab and Bevacizumab Combination Therapy and Sequential Conversion Hepatectomy for Advanced Fibrolamellar Hepatocellular Carcinoma Presenting Pseudoprogression
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Matsuki, Ryota, Okano, Naohiro, Hasui, Nobuhiro, Kawaguchi, Shohei, Momose, Hirokazu, Kitahama, Keiichiro, Nagahama, Kiyotaka, Kogure, Masaharu, Suzuki, Yutaka, Nagashima, Fumio, Shibahara, Junji, Mori, Hideaki, and Sakamoto, Yoshihiro
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- 2022
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4. Intratumoral oncolytic herpes virus G47∆ for residual or recurrent glioblastoma: a phase 2 trial
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Todo, Tomoki, Ito, Hirotaka, Ino, Yasushi, Ohtsu, Hiroshi, Ota, Yasunori, Shibahara, Junji, and Tanaka, Minoru
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This investigator-initiated, phase 2, single-arm trial primarily assessed the efficacy of G47∆, a triple-mutated, third-generation oncolytic herpes simplex virus type 1, in 19 adult patients with residual or recurrent, supratentorial glioblastoma after radiation therapy and temozolomide (UMIN-CTR Clinical Trial Registry UMIN000015995). G47Δ was administered intratumorally and repeatedly for up to six doses. The primary endpoint of 1-yr survival rate after G47∆ initiation was 84.2% (95% confidence interval, 60.4–96.6; 16 of 19). The prespecified endpoint was met and the trial was terminated early. Regarding secondary endpoints, the median overall survival was 20.2 (16.8–23.6) months after G47∆ initiation and 28.8 (20.1–37.5) months from the initial surgery. The most common G47∆-related adverse event was fever (17 of 19) followed by vomiting, nausea, lymphocytopenia and leukopenia. On magnetic resonance imaging, enlargement of and contrast-enhancement clearing within the target lesion repeatedly occurred after each G47∆ administration, which was characteristic to this therapy. Thus, the best overall response in 2 yr was partial response in one patient and stable disease in 18 patients. Biopsies revealed increasing numbers of tumor-infiltrating CD4+/CD8+lymphocytes and persistent low numbers of Foxp3+cells. This study showed a survival benefit and good safety profile, which led to the approval of G47∆ as the first oncolytic virus product in Japan.
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- 2022
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5. Membranous nephropathy with masked polyclonal IgG deposits associated with primary Sjögren's syndrome.
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Nagahama, Kiyotaka, Isomura, Aya, Shimoyamada, Hiroaki, Masuko, Shintaro, Shimoda, Sachiko, Karube, Miho, Komagata, Yoshinori, Kaname, Shinya, and Shibahara, Junji
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- 2021
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6. Recurrent FOSrearrangement in proliferative fasciitis/proliferative myositis
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Makise, Naohiro, Mori, Taisuke, Motoi, Toru, Shibahara, Junji, Ushiku, Tetsuo, and Yoshida, Akihiko
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Proliferative fasciitis (PF) and proliferative myositis (PM) are rare benign soft tissue lesions, usually affecting the extremities of middle-aged or older adults. Presenting as poorly circumscribed masses, they histologically show bland spindle cell proliferation in a myxoid to fibrous background and a hallmark component of large epithelioid “ganglion-like” cells in various numbers, which may lead to their misdiagnosis as sarcoma. PF/PM has been long considered as reactive, akin to nodular fasciitis; however, its pathogenesis has remained unknown. In this study, we analyzed the FOS status in 6 PF/PMs (5 PFs and 1 PM). Five PF/PMs occurred in adults, all showing diffuse strong expression of c-FOS primarily in the epithelioid cells, whereas spindle cell components were largely negative. Using fluorescence in situ hybridization (FISH), all 5 c-FOS-immunopositive tumors showed evidence of FOSgene rearrangement in the epithelioid cells. RNA sequencing in 1 case detected a FOS-VIMfusion transcript, which was subsequently validated by reverse transcriptase-polymerase chain reaction, Sanger sequencing, and VIMFISH. The one pediatric PF case lacked c-FOS expression and FOSrearrangement. c-FOS immunohistochemistry was negative in 45 cases of selected mesenchymal tumor types with epithelioid components that may histologically mimic PF/PM, including pleomorphic sarcoma with epithelioid features and epithelioid sarcoma. Recurrent FOSrearrangement and c-FOS overexpression in PF/PM suggested these lesions to be neoplastic. FOS abnormality was largely restricted to the epithelioid cell population, clarifying the histological composition of at least 2 different cell types. c-FOS immunohistochemistry may serve as a useful adjunct to accurately distinguish PF/PM from mimics.
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- 2021
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7. Recurrent FOSrearrangement in proliferative fasciitis/proliferative myositis
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Makise, Naohiro, Mori, Taisuke, Motoi, Toru, Shibahara, Junji, Ushiku, Tetsuo, and Yoshida, Akihiko
- Abstract
Proliferative fasciitis (PF) and proliferative myositis (PM) are rare benign soft tissue lesions, usually affecting the extremities of middle-aged or older adults. Presenting as poorly circumscribed masses, they histologically show bland spindle cell proliferation in a myxoid to fibrous background and a hallmark component of large epithelioid “ganglion-like” cells in various numbers, which may lead to their misdiagnosis as sarcoma. PF/PM has been long considered as reactive, akin to nodular fasciitis; however, its pathogenesis has remained unknown. In this study, we analyzed the FOS status in 6 PF/PMs (5 PFs and 1 PM). Five PF/PMs occurred in adults, all showing diffuse strong expression of c-FOS primarily in the epithelioid cells, whereas spindle cell components were largely negative. Using fluorescence in situ hybridization (FISH), all 5 c-FOS-immunopositive tumors showed evidence of FOSgene rearrangement in the epithelioid cells. RNA sequencing in 1 case detected a FOS-VIMfusion transcript, which was subsequently validated by reverse transcriptase-polymerase chain reaction, Sanger sequencing, and VIMFISH. The one pediatric PF case lacked c-FOS expression and FOSrearrangement. c-FOS immunohistochemistry was negative in 45 cases of selected mesenchymal tumor types with epithelioid components that may histologically mimic PF/PM, including pleomorphic sarcoma with epithelioid features and epithelioid sarcoma. Recurrent FOSrearrangement and c-FOS overexpression in PF/PM suggested these lesions to be neoplastic. FOS abnormality was largely restricted to the epithelioid cell population, clarifying the histological composition of at least 2 different cell types. c-FOS immunohistochemistry may serve as a useful adjunct to accurately distinguish PF/PM from mimics.
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- 2021
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8. Myoepithelioma-like Hyalinizing Epithelioid Tumor of the Foot Harboring an OGT-FOXO1Fusion
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Yorozu, Takashi, Nagahama, Kiyotaka, Morii, Takeshi, Maeda, Daichi, Yoshida, Akihiko, Mori, Taisuke, Hayashi, Akimasa, and Shibahara, Junji
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- 2021
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9. Regression of Tumor Thrombus in the Suprahepatic Vena Cava of Hepatocellular Carcinoma and Conversion Hepatectomy Induced by Lenvatinib
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Matsuki, Ryota, Okano, Naohiro, Arai, Takaaki, Yoshiike, Shinya, Kogure, Masaharu, Suzuki, Yutaka, Shibahara, Junji, Furuse, Junji, and Sakamoto, Yoshihiro
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- 2021
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10. Mirror syndrome due to anti-Jra alloimmunization
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Tanaka, Kei, Hosoi, Kenichiro, Yoshiike, Shinya, Nagahama, Kiyotaka, Tanigaki, Shinji, Shibahara, Junji, Ohnishi, Hiroaki, and Kobayashi, Yoichi
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We report a case of fetal hydrops and mirror syndrome in a pregnancy with anti-Jra alloimmunization.
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- 2020
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11. Tumor Budding in Intrahepatic Cholangiocarcinoma
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Tanaka, Mariko, Yamauchi, Naoko, Ushiku, Tetsuo, Shibahara, Junji, Hayashi, Akimasa, Misumi, Kento, Yasunaga, Yoichi, Morikawa, Teppei, Kokudo, Takashi, Arita, Junichi, Sakamoto, Yoshihiro, Hasegawa, Kiyoshi, and Fukayama, Masashi
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Supplemental Digital Content is available in the text.Intrahepatic cholangiocarcinoma (ICC) is an extremely aggressive carcinoma. Useful predictors for the patients’ prognosis after surgery have not been fully established. From the University of Tokyo Hospital pathology archives, we reviewed 107 cases of ICC, 54 cases of perihilar cholangiocarcinoma, and 40 cases of extrahepatic cholangiocarcinoma (ECC); we also investigated the significance of tumor budding in ICC, in comparison with perihilar cholangiocarcinoma and ECC. The tumor-budding frequencies were different by tumor location: 40.2% (43/107) in ICC, 70.4% (38/54) in perihilar cholangiocarcinoma, and 60.0% (24/40) in ECC. Tumor budding in ICC was associated with many pathologic indicators associated with invasion, such as major vascular invasion (P=0.012) and Union for International Cancer Control stage (P=0.007). Univariate and multivariate Cox regression analyses revealed tumor budding as a powerful prognostic factor for both recurrence-free survival (RFS) and overall survival (OS) in ICC by univariate (RFS: hazard ratio [HR]: 2.666; 95% confidence interval [CI]: 1.517-4.683, OS: HR: 4.206; 95% CI: 2.447-7.230) and by multivariate analyses (RFS: HR: 3.038; 95% CI: 1.591-5.973, OS: HR: 4.547, 95% CI: 2.348-8.805). Tumor budding was also a significant prognostic factor of perihilar cholangiocarcinoma, but not of ECC. When ICC was divided into 2 subtypes, type 1 (hilar) and type 2 (peripheral), tumor budding was the strong prognostic factor in type 2 ICC, but not in type 1 ICC, suggesting that some differences in biological behavior exist between type 1 ICC and perihilar cholangiocarcinoma. Tumor budding is prognostically important in ICC, and its pathogenetic role in biliary tract carcinomas might be different by anatomic location.
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- 2019
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12. A case of delayed exacerbation of interstitial lung disease after discontinuation of temsirolimus.
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Matsuki, Rei, Okuda, Kenichi, Mitani, Akihisa, Yamauchi, Yasuhiro, Tanaka, Goh, Kume, Haruki, Homma, Yukio, Hinata, Munetoshi, Hayashi, Akimasa, Shibahara, Junji, Fukayama, Masashi, and Nagase, Takahide
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Temsirolimus is an inhibitor of mammalian target of rapamycin and interstitial lung disease (ILD) is known to be one of the adverse events associated with temsirolimus, which usually improves rapidly after discontinuation of the drug and rarely worsens thereafter. Herein, we report a case of delayed exacerbation of ILD after discontinuation of temsirolimus for metastatic renal cell carcinoma in an 86-year-old male with chronic ILD. The patient developed gradually worsening dyspnea five weeks after an initiation of temsirolimus and was admitted to our facility. On his admission, although a pulmonary function test revealed a decreased diffusion capacity, there was no obvious progression of ILD on HRCT scan. His dyspnea once improved after discontinuation of temsirolimus, but it recurred and acute exacerbation of ILD was diagnosed 40 days after his last administration of temsirolimus. He received high-dose steroid therapy, however, he deteriorated and died. Histopathological examination of the lungs at autopsy revealed overlapping diffuse alveolar damage with chronic interstitial changes. In the present case, since there were no specific factors that could have caused acute exacerbation of ILD except for temsirolimus, it was considered to contribute to the exacerbation of underlying ILD. In conclusion, physicians should be aware of the possibility of temsirolimus-induced ILD not only while the medication is administered, but also even after it is discontinued. It is important to carefully interview the patient and to recognize the value of physiological tests, such as respiratory function tests and blood gas analysis, as well as imaging findings on HRCT. [ABSTRACT FROM AUTHOR]
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- 2017
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13. Primary hepatic schwannoma: A case report.
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Yamamoto, Masaki, Hasegawa, Kiyoshi, Arita, Junichi, Maeno, Ryohei, Akamatsu, Nobuhisa, Kaneko, Junichi, Watadani, Takeyuki, Okura, Naoki, Hayashi, Akimasa, Shibahara, Junji, Sakamoto, Yoshihiro, Ohtomo, Kuni, Fukayama, Masashi, and Kokudo, Norihiro
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Introduction A hepatic schwannoma is extremely rare and difficult to diagnose preoperatively. Presentation of case We report the case of a 47-year-old male patient who was referred to our hospital for the close investigation of a hepatic tumor which had not been detected two years earlier. An enhanced computed tomography revealed a well-circumscribed and encapsulated tumor with a size of 50 mm which was adjacent to the inferior vena cava (IVC) and the right hepatic vein. The tumor was heterogeneously enhanced until the equilibrium phase. A magnetic resonance image showed a hypointense area on a T1-weighted image and a hyperintense area on a T2-weighted image. These findings differed from those of common malignant hepatic tumors, such as hepatocellular carcinoma and colorectal liver metastases. The tumor was most likely a mucus-producing tumor or a liquefactive degenerated adenocarcinoma. Although we could not confirm an exact diagnosis of the tumor, we performed a surgical resection in view of the possibility of malignancy. The patient underwent a limited liver resection with resection of the IVC. Histologically, the tumor was diagnosed as a benign schwannoma comprised of Antoni A and B areas. The nuclear palisading formation of the tumor showed Verocay bodies. Discussion 15 cases of hepatic schwannoma are reviewed to clarify the typical radiological features. The radiological findings of the present case were consistent with those of the hepatic schwannoma when considering retrospectively. Conclusion A precise preoperative diagnosis of hepatic schwannoma is difficult, and liver resection is recommended when a hepatic schwannoma is suspected. [ABSTRACT FROM AUTHOR]
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- 2016
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14. Pathological Complete Response in Conversion Hepatectomy Induced by Lenvatinib for Advanced Hepatocellular Carcinoma
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Matsuki, Ryota, Kawai, Kirio, Suzuki, Yutaka, Kogure, Masaharu, Nakazato, Tetsuya, Naruge, Daisuke, Okano, Naohiro, Seki, Satowa, Ohmori, Yoshihiko, Kawamura, Naohiro, Kamma, Hiroshi, Hisamatsu, Tadakazu, Shibahara, Junji, Mori, Toshiyuki, Furuse, Junji, and Sakamoto, Yoshihiro
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- 2020
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15. CPT2 downregulation adapts HCC to lipid-rich environment and promotes carcinogenesis via acylcarnitine accumulation in obesity
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Fujiwara, Naoto, Nakagawa, Hayato, Enooku, Kenichiro, Kudo, Yotaro, Hayata, Yuki, Nakatsuka, Takuma, Tanaka, Yasuo, Tateishi, Ryosuke, Hikiba, Yohko, Misumi, Kento, Tanaka, Mariko, Hayashi, Akimasa, Shibahara, Junji, Fukayama, Masashi, Arita, Junichi, Hasegawa, Kiyoshi, Hirschfield, Hadassa, Hoshida, Yujin, Hirata, Yoshihiro, Otsuka, Motoyuki, Tateishi, Keisuke, and Koike, Kazuhiko
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ObjectiveMetabolic reprogramming of tumour cells that allows for adaptation to their local environment is a hallmark of cancer. Interestingly, obesity-driven and non-alcoholic steatohepatitis (NASH)-driven hepatocellular carcinoma (HCC) mouse models commonly exhibit strong steatosis in tumour cells as seen in human steatohepatitic HCC (SH-HCC), which may reflect a characteristic metabolic alteration.DesignNon-tumour and HCC tissues obtained from diethylnitrosamine-injected mice fed either a normal or a high-fat diet (HFD) were subjected to comprehensive metabolome analysis, and the significance of obesity-mediated metabolic alteration in hepatocarcinogenesis was evaluated.ResultsThe extensive accumulation of acylcarnitine species was seen in HCC tissues and in the serum of HFD-fed mice. A similar increase was found in the serum of patients with NASH-HCC. The accumulation of acylcarnitine could be attributed to the downregulation of carnitine palmitoyltransferase 2 (CPT2), which was also seen in human SH-HCC. CPT2 downregulation induced the suppression of fatty acid β-oxidation, which would account for the steatotic changes in HCC. CPT2 knockdown in HCC cells resulted in their resistance to lipotoxicity by inhibiting the Src-mediated JNK activation. Additionally, oleoylcarnitine enhanced sphere formation by HCC cells via STAT3 activation, suggesting that acylcarnitine accumulation was a surrogate marker of CPT2 downregulation and directly contributed to hepatocarcinogenesis. HFD feeding and carnitine supplementation synergistically enhanced HCC development accompanied by acylcarnitine accumulation in vivo.ConclusionIn obesity-driven and NASH-driven HCC, metabolic reprogramming mediated by the downregulation of CPT2 enables HCC cells to escape lipotoxicity and promotes hepatocarcinogenesis.
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- 2018
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16. Increased PDGFRB and NF-κB signaling caused by highly prevalent somatic mutations in intracranial aneurysms
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Shima, Yasuyuki, Sasagawa, Shota, Ota, Nakao, Oyama, Rieko, Tanaka, Minoru, Kubota-Sakashita, Mie, Kawakami, Hirochika, Kobayashi, Mika, Takubo, Naoko, Ozeki, Atsuko Nakanishi, Sun, Xiaoning, Kim, Yeon-Jeong, Kamatani, Yoichiro, Matsuda, Koichi, Maejima, Kazuhiro, Fujita, Masashi, Noda, Kosumo, Kamiyama, Hiroyasu, Tanikawa, Rokuya, Nagane, Motoo, Shibahara, Junji, Tanaka, Toru, Rikitake, Yoshiyuki, Mataga, Nobuko, Takahashi, Satoru, Kosaki, Kenjiro, Okano, Hideyuki, Furihata, Tomomi, Nakaki, Ryo, Akimitsu, Nobuyoshi, Wada, Youichiro, Ohtsuka, Toshihisa, Kurihara, Hiroki, Kamiguchi, Hiroyuki, Okabe, Shigeo, Nakafuku, Masato, Kato, Tadafumi, Nakagawa, Hidewaki, Saito, Nobuhito, and Nakatomi, Hirofumi
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Intracranial aneurysms (IAs) are a high-risk factor for life-threatening subarachnoid hemorrhage. Their etiology, however, remains mostly unknown at present. We conducted screening for sporadic somatic mutations in 65 IA tissues (54 saccular and 11 fusiform aneurysms) and paired blood samples by whole-exome and targeted deep sequencing. We identified sporadic mutations in multiple signaling genes and examined their impact on downstream signaling pathways and gene expression in vitro and an arterial dilatation model in mice in vivo. We identified 16 genes that were mutated in at least one IA case and found that these mutations were highly prevalent (92%: 60 of 65 IAs) among all IA cases examined. In particular, mutations in six genes (PDGFRB, AHNAK, OBSCN, RBM10, CACNA1E, and OR5P3), many of which are linked to NF-κB signaling, were found in both fusiform and saccular IAs at a high prevalence (43% of all IA cases examined). We found that mutant PDGFRBs constitutively activated ERK and NF-κB signaling, enhanced cell motility, and induced inflammation-related gene expression in vitro. Spatial transcriptomics also detected similar changes in vessels from patients with IA. Furthermore, virus-mediated overexpression of a mutant PDGFRBinduced a fusiform-like dilatation of the basilar artery in mice, which was blocked by systemic administration of the tyrosine kinase inhibitor sunitinib. Collectively, this study reveals a high prevalence of somatic mutations in NF-κB signaling pathway–related genes in both fusiform and saccular IAs and opens a new avenue of research for developing pharmacological interventions.
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- 2023
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17. Distinct Clinicopathologic and Genetic Features of 2 Histologic Subtypes of Intrahepatic Cholangiocarcinoma
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Hayashi, Akimasa, Misumi, Kento, Shibahara, Junji, Arita, Junichi, Sakamoto, Yoshihiro, Hasegawa, Kiyoshi, Kokudo, Norihiro, and Fukayama, Masashi
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Supplemental Digital Content is available in the text.Previous studies have identified 2 clinically significant morphologic subtypes of intrahepatic cholangiocarcinoma (ICC) on the basis of anatomic location and/or histologic appearances. Recognizing that these classification schemes are not always applicable practically, this study aimed to establish a novel classification system based on mucin productivity and immunophenotype and to determine the rationale of this classification by examining the clinicopathologic and genetic characteristics of the 2 subtypes defined by this method. We retrospectively investigated 102 consecutive ICC cases and classified them on the basis of mucin productivity and immunophenotype (S100P, N-cadherin, and NCAM). We found that 42 and 56 cases were classified as type 1 and type 2 ICCs, respectively, and only 4 cases were of indeterminate type. Type 1 ICC, generally characterized by mucin production and diffuse immunoreactivity to S100P, arose less frequently in chronic liver diseases and showed higher levels of serum CEA and CA 19-9 than did type 2 ICC, which generally showed little mucin production and exhibited immunoreactivity to N-cadherin and/or NCAM. Type 1 ICC was characterized by several pathologic features, including higher frequencies of perineural invasion and lymph node metastasis. Although the log-rank test demonstrated that type 1 ICC had significantly worse survival, the multivariate Cox regression analysis showed no prognostic significance of this histologic subtype. Genetic analyses revealed that KRASmutation was significantly more frequent in type 1 ICC, whereas IDHmutation and FGFR2translocation were restricted to type 2 ICC. In conclusion, the present classification of ICC based on mucin productivity and immunophenotype identified 2 subtypes with clinicopathologic significance.
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- 2016
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18. Clinicopathologic Characteristics of Hepatocellular Carcinoma With Reactive Ductule-like Components, a Subset of Liver Cancer Currently Classified as Combined Hepatocellular-Cholangiocarcinoma With Stem-Cell Features, Typical Subtype
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Shibahara, Junji, Hayashi, Akimasa, Misumi, Kento, Sakamoto, Yoshihiro, Arita, Junichi, Hasegawa, Kiyoshi, Kokudo, Norihiro, and Fukayama, Masashi
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The aim of this study was to elucidate the clinicopathologic characteristics of hepatocellular carcinoma with reactive ductule-like components (HCC-RD), corresponding to combined hepatocellular-cholangiocarcinoma (CHC) with stem cell features, typical subtype. Retrospective clinicopathologic analysis was performed on HCCs surgically treated at the University of Tokyo Hospital between 1995 and 2013. RD components were defined as neoplastic ductular structures composed of small “stem/progenitor-like” cells. There were 46 HCC-RDs, comprising about 3% of all HCCs. Thirty-eight cases of CHC, classical type (classical CHC), were identified during the study period. When compared with conventional HCC, HCC-RD was characterized by younger patient age (P=0.016), higher frequency of female patients (P<0.001), and higher serum α-fetoprotein levels (P=0.005). Serum carbohydrate antigen 19-9 elevation was also more frequently observed in HCC-RD than in conventional HCC (P=0.002). Histologically, clear cell constituents and interstitial fibrosis were more frequent in HCC-RD than in conventional HCC (P=0.003 and <0.001, respectively). When compared with HCC-RD and conventional HCC, classical CHC was characterized by a poorly differentiated HCC component, frequent vascular invasion, and lymph node metastasis (P<0.05). There was little prognostic difference between HCC-RD and conventional HCC, whereas overall and disease-free survival in classical CHC was significantly worse than in conventional HCC. In conclusion, although HCC-RDs do have some unique clinicopathologic characteristics, they have no prognostic significance, and it is not reasonable to include these tumors in the CHC category.
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- 2016
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19. Primary undifferentiated high-grade pleomorphic sarcoma/malignant fibrous histiocytoma arising from the mandible.
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Mori, Yoshiyuki, Motoi, Toru, Ida, Komei, Shibahara, Junji, Saijo, Hideto, Susami, Takafumi, and Takato, Tsuyoshi
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Abstract: A patient who had a primary undifferentiated high-grade pleomorphic sarcoma/malignant fibrous histiocytoma that apparently arose in the mandible, but showed uncertain differentiation on histopathological examination, is described. Our regimen, a combination of pre- and postoperative chemotherapy and surgical resection, produced a good outcome. [Copyright &y& Elsevier]
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- 2014
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20. Intraductal oncocytic papillary neoplasm of the bile duct: clinicopathologic and immunohistochemical characteristics of 6 cases.
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Tanaka, Mariko, Fukushima, Noriyoshi, Noda, Naohiro, Shibahara, Junji, Kokudo, Norihiro, and Fukayama, Masashi
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PAPILLARY carcinoma ,CHOLANGIOCARCINOMA ,IMMUNOHISTOCHEMISTRY ,EPITHELIAL cells ,TUMOR growth - Abstract
Summary: Intraductal oncocytic papillary neoplasm is known as a distinct subtype of intraductal papillary mucinous neoplasm of the pancreas. Similar neoplasms of the bile duct are rarely reported, and their disease characteristics are not well established. In this study, we examined 6 cases of biliary neoplasms consisting of oncocytic cells with almost exclusively intraductal growth. The patients were 5 women and 1 man of 51 to 68 years. Grossly, 4 appeared to be cystic neoplasms with papillary projections located in the liver and the other two were papillary neoplasms of the dilated hilar bile duct that ranged from 1.5 to 16 cm in size. The most prominent neoplastic cells were cuboidal epithelial cells that showed abundant eosinophilic granular cytoplasm with strongly positive staining for antimitochondrial antibody. Four neoplasms were mixed with minor components of nononcocytic cells. All neoplasms showed arborized papillary and/or cribriform formations except one, which showed a villous architecture. All neoplasms were adenocarcinomas accompanied by a microscopic minimally invasive carcinoma. The oncocytic neoplastic cells, as well as the nononcocytic cells, produced gastric-type mucin (MUC5AC and MUC6) and showed claudin18 and HepPar-1 positivity. Five patients lived disease-free for 10 to 112 months after resection, and 1 died of tumor recurrence at 26 months postoperatively. The present series of biliary tumors are intraductal papillary neoplasms with oncocytic features and can be clinicopathologically regarded as counterparts of pancreatic intraductal oncocytic papillary neoplasm. Our results also suggest that oncocytic changes occur in epithelial cells of biliary tracts that show a predominant gastric phenotype. [Copyright &y& Elsevier]
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- 2009
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21. Papillary glioneuronal tumor with minigemistocytic components and increased proliferative activity.
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Ishizawa, Takashi, Komori, Takashi, Shibahara, Junji, Ishizawa, Keisuke, Adachi, Jun-ichi, Nishikawa, Ryo, Matsutani, Masao, and Hirose, Takanori
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TUMORS ,CELLS ,CYTOPLASM ,PROTOPLASM - Abstract
Summary: Papillary glioneuronal tumor (PGNT) is a rare and new type of glioneuronal neoplasm of the central nervous system. It is characterized by pseudopapillary structures composed of hyalinized vessels rimmed by cuboidal glial cells and the proliferation of neuronal cells. We report a peculiar PGNT arising in the parietal lobe of a 67-year-old man, which was characterized by proliferation of minigemistocytic cells as well as typical components. The minigemistocytic cells had eccentric nuclei and plump eosinophilic cytoplasm that was filled with glial filaments. The Ki-67 labeling index was as high as 10% in the minigemistocytic areas. Recently, the presence of oligodendroglial-like component was suggested in PGNT. Considering that oligodendroglioma sometimes accompanies minigemistocytic components, the minigemistocytic cells in PGNT were suggested to be a part of oligodendroglial differentiation. Although PGNT is defined as an indolent glioneuronal tumor, the presence of minigemistocytic components with the high Ki-67 labeling index may indicate more aggressive nature. [Copyright &y& Elsevier]
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- 2006
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22. The Niche Component Periostin Is Produced by Cancer-Associated Fibroblasts, Supporting Growth of Gastric Cancer through ERK Activation
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Kikuchi, Yoshinao, Kunita, Akiko, Iwata, Caname, Komura, Daisuke, Nishiyama, Takashi, Shimazu, Kazuhiro, Takeshita, Kimiko, Shibahara, Junji, Kii, Isao, Morishita, Yasuyuki, Yashiro, Masakazu, Hirakawa, Kosei, Miyazono, Kohei, Kudo, Akira, Fukayama, Masashi, and Kashima, Takeshi G.
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Overexpression of periostin (POSTN), an extracellular matrix protein, has been observed in several cancers. We investigated the importance of POSTN in gastric cancer. Genome-wide gene expression analysis using publicly available microarray data sets revealed significantly high POSTN expression in cancer tissues from stage II–IV gastric cancer, compared with background normal tissues. The POSTN/vimentin mRNA expression ratio was highly associated with gene groups that regulate the cell cycle and cell proliferation. IHC showed that periglandular POSTN deposition, comprising linear deposition abutting the glandular epithelial cells in normal mucosa, disappeared during intestinal gastric cancer progression. Stromal POSTN deposition was also detected at the invasive front of intestinal-type and diffuse-type cancers. In situhybridization confirmed POSTN mRNA in cancer-associated fibroblasts, but not in tumor cells themselves. POSTN enhanced the in vitrogrowth of OCUM-2MLN and OCUM-12 diffuse-type gastric cancer cell lines, accompanied by the activation of ERK. Furthermore, coinoculation of gastric cancer cells with POSTN-expressing NIH3T3 mouse fibroblast cells facilitated tumor formation. The OCUM-2MLN orthotopic inoculation model demonstrated that tumors of the gastric wall in Postn−/−mice were significantly smaller than those in wild-type mice. Ki-67 and p-ERK positive rates were both lower in Postn−/−mice. These findings suggest that POSTN produced by cancer-associated fibroblasts constitutes a growth-supportive microenvironment for gastric cancer.
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- 2014
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23. Claudin-18 Is an Early-Stage Marker of Pancreatic Carcinogenesis
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Tanaka, Mariko, Shibahara, Junji, Fukushima, Noriyoshi, Shinozaki, Aya, Umeda, Makoto, Ishikawa, Shumpei, Kokudo, Norihiro, and Fukayama, Masashi
- Abstract
Pancreatic ductal neoplasms exhibit gastric epithelium–like characteristics. In this study, we evaluated the expression of claudin-18 (CLDN18), a gastric epithelium–associated claudin, in pancreatic intraepithelial neoplasias (PanINs), intraductal papillary mucinous neoplasms (IPMNs), mucinous cystic neoplasms (MCNs), and pancreatic ductal adenocarcinomas (PDACs) using immunohistochemistry. We observed a high level of expression of CLDN18 in PanINs (31/32, 97%), IPMNs (61/65, 95%), and MCNs (4/5, 80%) using ordinary tissue section analysis. Furthermore, we observed a high level of CLDN18 expression in PDACs (109/156, 70%) using tissue microarray analysis. However, the normal pancreatic duct or the ductal metaplasia of the acinar cells was not immunoreactive. Comparative analysis of CLDN18 and phenotypic markers in IPMNs revealed that simultaneous expression of CLDN18 and intestinal markers frequently occurred, even in intestinal-type IPMNs. CLDN18 variant 2 mRNA was expressed and was similarly upregulated by phorbol 12–myristate 13–acetate (PMA) treatment in pancreatic cancer cell lines and in a gastric cancer cell line. An inhibitor of pan-PKC (GF109203X) completely suppressed this upregulation in pancreatic cancer cells. These results indicate that CLDN18, a marker for the early carcinogenetic process, is commonly expressed in precursor lesions of PDAC. Activation of the PKC pathway might be involved in CLDN18 expression associated with pancreatic carcinogenesis.
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- 2011
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24. Soft-tissue Hemangioblastoma of the Retroperitoneum
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Yoshida, Akihiko, Oda, Rie, Shibahara, Junji, Fukayama, Masashi, and Tsuda, Hitoshi
- Abstract
A 71-year-old woman was found to have a solid retroperitoneal mass measuring 7×6 cm on a computed tomography scan. The tumor was not connected to the spinal cord or large nerves. It was resected and showed the typical histology of hemangioblastoma, that is, numerous capillaries and stromal cells with focal cytoplasmic vacuolization. Immunohistochemical study revealed that the tumor stromal cells were positive for S-100 protein, neuron-specific enolase, and inhibin-α, supporting the diagnosis. In addition, the tumor cells labeled for carbonic anhydrase IX and brachyury. The diffuse strong carbonic anhydrase IX expression suggested that soft-tissue hemangioblastoma may share with central nervous system hemangioblastoma the tumorigenic mechanism involving the von Hippel-Lindau gene product and hypoxia-inducible factor. The brachyury expression observed in this case, albeit focal and weak, may implicate embryonic hemangioblasts as a potential line of differentiation, as was proposed in central nervous system hemangioblastoma. The patient is well 4 years after the surgery without any recurrence. A review of the literature revealed that soft-tissue hemangioblastoma is typically a solid tumor found in older females and often involves the retroperitoneumpelvis.
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- 2010
25. Lymphomatoid Granulomatosis Involving Central Nervous System Successfully Treated With Rituximab Alone
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Ishiura, Hiroyuki, Morikawa, Masato, Hamada, Masashi, Watanabe, Takuro, Kako, Shinichi, Chiba, Shigeru, Motokura, Toru, Hangaishi, Akira, Shibahara, Junji, Akahane, Masaaki, Goto, Jun, Kwak, Shin, Kurokawa, Mineo, and Tsuji, Shoji
- Abstract
OBJECTIVE To report the successful treatment of a patient with lymphomatoid granulomatosis (LYG), a rare Epstein-Barr virus–positive lymphoproliferative disorder, using rituximab (anti-CD20 monoclonal antibody). The prognosis for LYG has been reported to be poor, and no satisfactory treatment has been established. Because central nervous system (CNS) involvement of LYG has been known to show poor prognosis, the establishment of an effective treatment for CNS LYG with mild adverse effects is desired. DESIGN Case report. SETTING University hospital. PATIENT A 48-year-old Japanese man presenting with slowly progressive spastic paraparesis diagnosed as LYG involving the CNS and lungs. INTERVENTIONS The patient was treated with rituximab (375 mg/m2, once weekly for 1 month) alone. MAIN OUTCOME MEASURE Improvement of the lesions on imaging. RESULTS The neurological signs resolved and the lesions in the CNS and lungs were mostly diminished after the rituximab monotherapy without any adverse effects. The patient stayed in remission for 18 months. CONCLUSION Rituximab monotherapy was effective in treating the patient; hence, rituximab should be considered as the initial treatment against LYG involving the CNS.Arch Neurol. 2008;65(5):662-665--
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- 2008
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26. Podoplanin is expressed in subsets of tumors of the central nervous system
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Shibahara, Junji, Kashima, Takeshi, Kikuchi, Yoshinao, Kunita, Akiko, and Fukayama, Masashi
- Abstract
Immunohistochemical analyses with the monoclonal antibody D2-40 were performed to ascertain the expression of podoplanin (a.k.a. T1-alpha, gp36, or aggrus) in tumors of the central nervous system (CNS) and to determine the diagnostic utility of the antibody. The analyses were performed on 325 tumors of various histologic types. The chief finding was almost constant immunoreactivity in ependymal tumors (37/40, 92.5%), choroid plexus papillomas (8/8, 100%), and meningiomas (100/100, 100%). The reactivity was considered “tissue-specific,” as the corresponding normal tissue of each tumor was also found to express podoplanin. In addition, expression, not committed to the lineages, was found in many other tumor types, including astrocytic tumors, medulloblastomas, and hemangioblastomas, with variable frequency and intensity. The way of expression was not fully understood, but the expression in astrocytic tumors seemed to be associated with pronounced fibrous properties or malignant phenotype, as was shown by high-frequent expression in pilocytic astrocytomas (12/12, 100%) and glioblastomas (29/35, 82.9%). The present study has shown that podoplanin is expressed in several types of CNS tumors with variable frequency and intensity. Given the widespread expression of podoplanin, the antibody D2-40 is of little use in diagnostic practice for CNS tumors.Immunohistochemical analyses with the monoclonal antibody D2-40 were performed to ascertain the expression of podoplanin (a.k.a. T1-alpha, gp36, or aggrus) in tumors of the central nervous system (CNS) and to determine the diagnostic utility of the antibody. The analyses were performed on 325 tumors of various histologic types. The chief finding was almost constant immunoreactivity in ependymal tumors (37/40, 92.5%), choroid plexus papillomas (8/8, 100%), and meningiomas (100/100, 100%). The reactivity was considered “tissue-specific,” as the corresponding normal tissue of each tumor was also found to express podoplanin. In addition, expression, not committed to the lineages, was found in many other tumor types, including astrocytic tumors, medulloblastomas, and hemangioblastomas, with variable frequency and intensity. The way of expression was not fully understood, but the expression in astrocytic tumors seemed to be associated with pronounced fibrous properties or malignant phenotype, as was shown by high-frequent expression in pilocytic astrocytomas (12/12, 100%) and glioblastomas (29/35, 82.9%). The present study has shown that podoplanin is expressed in several types of CNS tumors with variable frequency and intensity. Given the widespread expression of podoplanin, the antibody D2-40 is of little use in diagnostic practice for CNS tumors.
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- 2006
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27. Secondary glioblastoma with advanced neuronal immunophenotype
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Shibahara, Junji and Fukayama, Masashi
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We describe an unusual progression of astrocytoma into secondary glioblastoma exhibiting advanced neuronal immunophenotype. A tumor of the left frontal lobe of a 35-year-old man was diagnosed as astrocytoma. The tumor was treated by partial removal with postoperative chemoradiotherapy, followed by extensive removal of the residual regrowing tumor 5 month later. A secondary tumor was discovered and partially resected 8 years later, but the patient died 11 months following the operation due to extensive tumor progression showing subarachnoidal and intraventricular dissemination. The secondary tumor was small cell-predominant, highly proliferative tumor with an extremely high MIB-1 labeling index (80%). Unexpectedly, most of the tumor cells were positive for neuronal markers (synaptophysin and NeuN), but not for glial fibrillary acidic protein (GFAP). Retrospective examination of the original tumor revealed not only diffuse GFAP expression, but also neuronal marker expressions in small numbers of tumor cells that were hard to discriminate from the other cells on hematoxylin-eosin (HE) stain. This way of malignant progression of astrocytoma was quite unusual. Although the secondary tumor was classified as glioblastoma according to World Health Organization (WHO) classification (2000), it might be categorized into new variants of malignant glioneuronal tumors proposed recently.
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- 2005
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28. Loss of Fhit Expression in Squamous Cell Carcinoma and Premalignant Lesions of the Larynx
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Yuge, Tadashi, Shibahara, Junji, Nibu, Kenichi, Tayama, Niro, Kondo, Kenji, and Sugasawa, Masashi
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The tumor suppressor gene FHIT (fragile histidine triad) at chromosomal position 3p14.2 is altered by deletions in human tumors. The frequency and specificity of its inactivation vary among carcinomas, but few articles have referred to premalignant lesions such as dysplasia. We studied the expression of FHIT in a series of squamous cell carcinomas and premalignant lesions of the larynx. We observed 36 laryngeal carcinoma biopsy specimens and 70 dysplasia biopsy specimens. We studied FHIT expression in carcinoma and dysplasia with the immunohistochemical ABC (avidin–biotinylated peroxidase complex) method. Loss of FHIT protein was observed in 42% of the squamous cell carcinomas and 23% of the premalignant lesions. There was no significant difference among the three grades of dysplasia in FHIT expression. These findings of loss of FHIT protein expression, not only in squamous cell carcinoma, but also in premalignant lesions, indicate that FHIT alterations play an important role in the early events of carcinogenesis.
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- 2005
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29. Global and non‐random CpG‐island methylation in gastric carcinoma associated with Epstein‐Barr virus
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Chong, Ja‐Mun, Sakuma, Kazuya, Sudo, Makoto, Ushiku, Tetsuo, Uozaki, Hiroshi, Shibahara, Junji, Nagai, Hideo, Funata, Nobuaki, Taniguchi, Hirokazu, Aburatani, Hiroyuki, and Fukayama, Masashi
- Abstract
DNA hypermethylation may play a primary role in the genesis of Epstein‐Barr virus (EBV)‐associated gastric carcinoma (GC) (EB‐VaGC). Methylation‐specific PCR targeting CpG‐islands demonstrated markedly increased methylation of specific genes, such as p14, p15and p16genes, in EBVaGC in vivo. A high frequency of methylation was observed in an EBVaGC strain of severe combined immunodeficiency mice, and the expression of methylated genes in the strain was apparently lower than the expression of the unmethylated genes in EBV‐negative GC strains. Although over‐expression of DNA methyltransferases(DNMTs) is known to be associated with some human cancers, real‐time PCR demonstrated that DNMTsexpression was suppressed in EBVaGC. The DNA methylation of specific genes, independently of DNMTsexpression, may be important in the development of EBVaGC. (Cancer Sci 2003; 94: 76–80)
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- 2003
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30. Reduced Expression and Promoter Methylation p16Gene in Epstein‐Barr Virus‐associated Gastric Carcinoma
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Osawa, Toshiya, Chong, Ja‐Mun, Sudo, Makoto, Sakuma, Kazuya, Uozaki, Hiroshi, Shibahara, Junji, Nagai, Hideo, Funata, Nobuaki, and Fukayama, Masashi
- Abstract
Epstein‐Barr virus (EBV)‐associated gastric carcinoma (EBVaGC) is a unique type of gastric carcinoma (GC), which is considered to develop in a different pathway from EBV‐negative GC. To evaluate a possible role of p16, an inhibitor of G1/S transition of the cell cycle, in the carcinogenesis of EBVaGC, pl6‐immunohistochemistry and methylation‐specific PCR analysis (MSP) were applied to surgically resected gastric carcinomas. When the percentage of p16‐positive cells in more than 1000 carcinoma cells was expressed as p16 labeling index (p16‐LI), it ranged from 2.5 to 88.1 (mean 42.9±24.4) in 70 gastric carcinomas. EBVaGC showed significantly lower values (n=15, 26.1±22.1) than EBV‐negative GC (n=55, 47.5±23.2) (P=0.0036). Fresh frozen tissues of 55 gastric carcinomas (16 EBVaGC and 39 EBV‐negative GC) were further subjected to MSP, to evaluate abnormal methylation of the promoter region of the p16gene. The frequency of methylation was significantly higher in EBVaGC (14/16) than in EBV‐negative GC (9/39) (<0.0001). The methylation‐positive carcinomas showed significantly lower p16‐LI (35.9±21.6) than the unmethylated ones (55.2±22.7) (P=0.0014). Thus, a marked decrease of p16 expression, caused by the aberrant methylation of the p16gene promoter, is closely associated with the development of EBVaGC.
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- 2002
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31. Interleukin-1beta expression in human gastric carcinoma with Epstein-Barr virus infection.
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Chong, Ja-Mun, Sakuma, Kazuya, Sudo, Makoto, Osawa, Toshio, Ohara, Etsuko, Uozaki, Hiroshi, Shibahara, Junji, Kuroiwa, Kenji, Tominaga, Shin-Ichi, Hippo, Yoshitaka, Aburatani, Hiroyuki, Funata, Nobuaki, and Fukayama, Masashi
- Abstract
The KT tumor is a transplantable strain of a human Epstein-Barr virus (EBV)-associated gastric carcinoma (EBVaGC), established in severe combined immunodeficiency (SCID) mice, with which the cytokine expression of EBVaGC can be investigated without interference from the infiltrating lymphocytes. As a part of a high-density oligonucleotide array (GeneChip) analysis of EBVaGC, the interleukin-1beta (IL-1beta) gene was the only cytokine gene that showed markedly higher expression in the KT tumor cells than in two tumor strains of EBV-negative GC. The results were confirmed by Northern blotting, Western blotting, and enzyme-linked immunosorbent assay. Furthermore, we demonstrated a positive signal for IL-1beta mRNA in the carcinoma cells of a surgically resected EBVaGC, but not in EBV-negative GC, by in situ hybridization. In vitro, IL-1beta increased the cell growth of a GC cell line, TMK1. Thus, IL-1beta may act as an autocrine growth factor in EBVaGC.
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- 2002
32. Interleukin-1ß Expression in Human Gastric Carcinoma with Epstein-Barr Virus Infection
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Chong, Ja-Mun, Sakuma, Kazuya, Sudo, Makoto, Osawa, Toshio, Ohara, Etsuko, Uozaki, Hiroshi, Shibahara, Junji, Kuroiwa, Kenji, Tominaga, Shin-ichi, Hippo, Yoshitaka, Aburatani, Hiroyuki, Funata, Nobuaki, and Fukayama, Masashi
- Abstract
ABSTRACTThe KT tumor is a transplantable strain of a human Epstein-Barr virus (EBV)-associated gastric carcinoma (EBVaGC), established in severe combined immunodeficiency (SCID) mice, with which the cytokine expression of EBVaGC can be investigated without interference from the infiltrating lymphocytes. As a part of a high-density oligonucleotide array (GeneChip) analysis of EBVaGC, the interleukin-1ß (IL-1ß) gene was the only cytokine gene that showed markedly higher expression in the KT tumor cells than in two tumor strains of EBV-negative GC. The results were confirmed by Northern blotting, Western blotting, and enzyme-linked immunosorbent assay. Furthermore, we demonstrated a positive signal for IL-1ß mRNA in the carcinoma cells of a surgically resected EBVaGC, but not in EBV-negative GC, by in situ hybridization. In vitro, IL-1ß increased the cell growth of a GC cell line, TMK1. Thus, IL-1ß may act as an autocrine growth factor in EBVaGC.
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- 2002
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33. DNMT3A overexpression is associated with aggressive behavior and enteroblastic differentiation of gastric adenocarcinoma.
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Kataoka, Isao, Funata, Sayaka, Nagahama, Kiyotaka, Isogaya, Kazunobu, Takeuchi, Hirohisa, Abe, Nobutsugu, and Shibahara, Junji
- Abstract
Gastric adenocarcinoma (GA) with enteroblastic differentiation is a subset of gastric cancer with poor prognosis. RNA-Seq data of The Cancer Genome Atlas of GA (TCGA-STAD) revealed a positive correlation between SALL4, a representative enteroblastic marker, and DNMT3A expression. Here, we conducted immunohistochemical analysis of GA to clarify the clinicopathological significance of DNMT3A expression and its correlation with enteroblastic differentiation. Of the 346 cases of solitary GA analyzed, 120 (34.7%) showed unequivocal DNMT3A nuclear expression. DNMT3A expression was associated with Lauren's intestinal type, papillary and tubular architectures, high frequency of lymphatic and vascular invasion, and lymph node metastasis (each, P < 0.01). Log-rank test revealed that DNMT3A-positive cases recurred more frequently with a predilection for liver metastasis (P < 0.01) and showed poorer overall and recurrence-free survival (each, P < 0.05). With respect to surrogate markers of molecular subtypes, DNMT3A-positive cases more frequently showed p53 overexpression (P < 0.001). Consistent with the results of TCGA data analysis, DNMT3A-positive cases exhibited enteroblastic morphology (18.3% vs. 0.9%, P < 0.001) and expressed enteroblastic markers, SALL4 (32.5% vs. 3.1%, P < 0.001) and glypican-3 (22.5% vs. 4.4%, P < 0.001) more frequently than did DNMT3A-negative cases. Additionally, GAs showing enteroblastic differentiation, morphologically or immunohistochemically, expressed DNMT3A with significantly higher frequency and intensity than did conventional GAs (P < 0.001). Our findings suggest DNMT3A as a potential therapeutic target for this conventional therapy-refractory cancer subtype. • A subset of gastric adenocarcinomas (GA) showed overexpression of DNMT3A. • DNMT3A-positive cases were associated with aggressiveness and poor prognosis. • DNMT3A expression frequency was increased in GA with enteroblastic differentiation. [ABSTRACT FROM AUTHOR]
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- 2020
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34. A Case of Metastatic Uterine Tumor Originating from Small-Cell Lung Cancer (SCLC) Mimicking Uterine Sarcoma
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Fujima, Mariko, Kobayashi, Yoichi, Watanabe, Momoe, Shibuya, Hiromi, Matsumoto, Hironori, Nishigaya, Yoshiko, Momomura, Mai, Yoshiike, Shinya, Nagahama, Kiyotaka, Shibahara, Junji, and Suzuki, Atsushi
- Abstract
Metastatic uterine tumors originating from extragenital cancers are a rare clinical occurrence. We report a case of metastatic uterine cancer derived from small-cell lung cancer (SCLC) that necessitated surgical treatment. The patient was a 59 y/o female who had undergone chemotherapy for stage IIIB SCLC. A 15 cm uterine tumor lesion was initially detected on CT scans. The patient had previously been diagnosed with uterine fibroids, but compared to the most recent CT scans taken one and a half months earlier, imaging diagnosis revealed a sudden increase in the size of the tumor when compared to the 8 cm myoma fibroid noted previously. Additional work-up with MRI scans revealed T2-enhanced images of a tumor that had almost completely invaded the myometrium; the tumor presented with marked diffusion-weighted enhancement, and a flow void was noted within the tumor. A differential diagnosis of uterine sarcoma was considered, but due to the lack of focal hemorrhage or necrosis findings on MRI imaging, the possibility of differential diagnosis of metastatic SCLC was also noted. As the patient was experiencing abdominal symptoms including abdominal distension and tenderness due the tumor, a simple hysterectomy and bilateral salpingo-oophorectomy were performed to palliate the symptoms. During the surgical procedures, intra-abdominal findings noted peritoneal dissemination while intraoperative cell cytology diagnosis of ascites revealed small-cell cancer. The final histopathological diagnosis likewise revealed metastatic small-cell cancer from the primary lung cancer. The clinical status of the lung cancer was evaluated as progressive disease (PD), and a change in chemotherapy regimen was necessitated. Further disease progression was noted on CT scans at 2 and a half months after surgery, and with gradual systemic disease progression, the patient died of disease at 3 months postsurgery. Initial evaluation of rapidly enlarging uterine tumors should include a differential diagnosis of uterine sarcoma; additionally, it is necessary to also consider the rare possibility of metastatic disease as in the present case with a clinical history of extragenital malignancy.
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- 2021
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35. Severe Hypokinesis Caused by AntiMa2 Encephalitis Associated with Bilateral Carcinoma In Situof the Testis
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Matsumoto, Lumine, Yamamoto, Tomotaka, Higashihara, Mana, Sugimoto, Izumi, Kowa, Hisatomo, Nakamura, Koichiro, Goto, Jun, Shibahara, Junji, Dalmau, Josep, and Tsuji, Shoji
- Published
- 2006
36. W1001 Indocyanine Green-Fluorescent Imaging for Real-Time Identification of Small Liver Cancers During Surgery.
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Ishizawa, Takeaki, Fukushima, Noriyoshi, Shibahara, Junji, Masuda, Koichi, Tamura, Sumihito, Aoki, Taku, Hasegawa, Kiyoshi, Beck, Yoshifumi, Bandai, Yasutsugu, Fukayama, Masashi, and Kokudo, Norihiro
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- 2009
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37. Aspergillus thyroiditis in a living donor liver transplant recipient.
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Matsui, Yuichi, Sugawara, Yasuhiko, Tsukada, Kunihisa, Kishi, Yoji, Shibahara, Junji, and Makuuchi, Masatoshi
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MYCOSES ,ASPERGILLOSIS ,THYROID diseases ,LIVER transplantation - Abstract
Summary: Aspergillosis is increasingly recognized as an important nosocomial pathogen in immunocompromised patients. Infection is difficult to diagnose and typically has a fatal outcome. We describe a liver transplant patient with fulminant hepatic failure, who had persistent fever of undetected origin postoperatively and an increased (1–3)-beta-d glucan level. Gallium-67 citrate scanning showed abnormal uptake in the thyroid bilaterally. Fine needle biopsy of the thyroid revealed thyroidal invasion of Aspergillosis. Total thyroidectomy was performed and the C reactive protein level decreased to 1.01mg/dl. The patient died of liver sepsis due to Pseudomonas aeruginosa. (1–3)-beta-d Glucan monitoring and systematic radionuclide images are useful modalities for early diagnosis of Aspergillosis. [Copyright &y& Elsevier]
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- 2006
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