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Optimal resection of gastric bronchogenic cysts based on anatomical continuity with adherent gastric muscular layer: A case report

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World Journal of Gastrointestinal Surgery 2023年第6期15卷 1216-1223页

作者： Masayoshi Terayama Koshi Kumagai Hiroshi Kawachi Rie Makuuchi Masaru Hayami Satoshi Ida Manabu Ohashi Takeshi Sano Souya Nunobe Department of Gastroenterological Surgery Gastroenterological CenterCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyo 135-8550Japan Department of Pathology Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyo 135-8550Japan

BACKGROUND Bronchogenic cysts are congenital lesions requiring radical resection because of malignant potential.However,a method for the optimal resection of these cysts has not been completely elucidated.CASE SUMMARY Herein,we presented three patients with bronchogenic cysts that were located adjacent to the gastric wall and resected laparoscopically.The cysts were detected incidentally with no symptoms and the preoperative diagnosis was challenging to obtain via radiological examinations.Based on laparoscopic findings,the cyst was attached firmly to the gastric wall and the boundary between the gastric and cyst walls was difficult to identify.Consequently,resection of cysts alone caused cystic wall injury in Patient 1.Meanwhile,the cyst was resected completely along with a part of the gastric wall in Patient 2.Histopathological examination revealed the final diagnosis of bronchogenic cyst and revealed that the cyst wall shared the muscular layer with the gastric wall in Patients 1 and 2.In Patient 3,the cyst was located adjacent to the gastric wall but histopathologically originated from diaphragm rather than stomach.All the patients were free from recurrence.CONCLUSION The findings of this study state that a safe and complete resection of bronchogenic cysts required the adherent gastric muscular layer or full-thickness dissection,if bronchogenic cysts are suspected via pre-and/or intraoperative findings.

关键词： Bronchogenic cysts Laparoscopic resection Gastric wall Muscular layer Case report

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New application of endocytoscope for histopathological diagnosis of colorectal lesions

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World Journal of Gastrointestinal Endoscopy 2022年第8期14卷 495-501页

作者： Fumihiro Inoue Daizen Hirata Mineo Iwatate Santa Hattori Mikio Fujita Wataru Sano Tamotsu Sugai Hiroshi Kawachi Kazuhito Ichikawa Yasushi Sano Gastrointestinal Center and Institute of Minimally-invasive Endoscopic Care(i-MEC) Sano HospitalKobe 655-0031HyogoJapan Molecular Diagnostic Pathology Iwate Medical University School of MedicineShiwa-gun 028-3694IwateJapan Department of Pathology Cancer Institute Hospital of Japanese Foundation for Cancer ResearchKoto 135-8550TokyoJapan Department of Pathology Noda HospitalNoda 270-0237ChibaJapan

BACKGROUND The endocytoscope with ultra-high magnification(x 520)allows us to observe the cellular structure of the colon epithelium during colonoscopy,known as virtual histopathology.We hypothesized that the endocytoscope could directly observe colorectal histopathological specimens and store them as endocyto-pathological images by the endoscopists without a microscope,potentially saving the burden on histopathologists.AIM To assess the feasibility of endocyto-pathological images taken by an endoscopist as adequate materials for histopathological diagnosis.METHODS Three gastrointestinal pathologists were invited and asked to diagnose 40 cases of endocyto-pathological images of colorectal specimens.Each case contained seven endocyto-pathological images taken by an endoscopist,consisting of one loupe image,three low-magnification images,and three ultra-high magnification images.The participants chose hyperplastic polyp or low-grade adenoma for 20 cases of endocyto-pathological images(10 hyperplastic polyps,and 10 Low-grade adenomas in conventional histopathology)in study 1 and high-grade adenoma/shallow invasive cancer or deep invasive cancer for 20 cases[10 tumor in situ/T1a and 10 T1b]in study 2.We investigated the agreement between the histopathological diagnosis using the endocyto-pathological images and conventional histopathological diagnosis.RESULTS Agreement between the endocyto-pathological and conventional histopathological diagnosis by the three gastrointestinal pathologists was 100%(95%CI:94.0%–100%)in studies 1 and 2.The interobserver agreement among the three gastrointestinal pathologists was 100%,and theκcoefficient was 1.00 in both studies.CONCLUSION Endocyto-pathological images were adequate and reliable materials for histopathological diagnosis.

关键词： Cancer Colon Endocytoscopy Histopathology Specimen

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Therapeutic target for nephrotic syndrome: Identification of novel slit diaphragm associated molecules

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World Journal of Nephrology 2014年第3期3卷 77-84页

作者： Yoshiyasu Fukusumi Naoko Miyauchi Taeko Hashimoto Akira Saito Hiroshi Kawachi Department of Cell Biology Institute of Nephrology Niigata University Graduate School of Medical and Dental Sciences Niigata 951-8510 Japan

The slit diaphragm bridging the neighboring foot processes functions as a final barrier of glomerular capillary wall for preventing the leak of plasma proteins into primary urine.It is now accepted that the dysfunction of the sit diaphragm contributes to the development of proteinuria in several glomerular diseases.Nephrin,a gene product of NPHS1,a gene for a congenital nephrotic syndrome of Finnish type,constitutes an extracellular domain of the slit diaphragm.Podocin was identified as a gene product of NPHS2,a gene for a familial steroid-resistant nephrotic syndrome of French.Podocin binds the cytoplasmic domain of nephrin.After then,CD2 associated protein,NEPH1 and transient receptor potential-6 were also found as crucial molecules of the slit diaphragm.In order to explore other novel molecules contributing to the development of proteinuria,we performed a subtraction hybridization assay with a normal rat glomerular RNA and a glomerular RNA of rats with a puromycin aminonucleoside nephropathy,a mimic of a human minimal change type nephrotic syndrome.Then we have found that synaptic vesicle protein 2B,ephrin-B1 and neurexin were already downregulated at the early stage of puromycin amino-nucleoside nephropathy,and that these molecules were localized close to nephrin.It is conceivable that these molecules are the slit diaphragm associated molecules,which participate in the regulation of the barrier function.These molecules could be targets to establish a novel therapy for nephrotic syndrome.

关键词：毛细血管壁肾小球治疗方法临床分析

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Meta-analysis of lymph node metastasis in Siewert type Ⅰ and Ⅱ T1 adenocarcinomas

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World Journal of Meta-Analysis 2016年第6期4卷 118-123页

作者： Hiroki Osumi Junko Fujisaki Masami Omae Tomoki Shimizu Toshiyuki Yoshio Akiyoshi Ishiyama Toshiaki Hirasawa Tomohiro Tsuchida Yorimasa Yamamoto Hiroshi Kawachi Noriko Yamamoto Masahiro Igarashi Departments of Gastroenterology and Pathology Cancer Institute Hospital Japanese Foundation for Cancer Research Departments of Pathology Cancer Institute Hospital Japanese Foundation for Cancer Research

AIM To evaluate the incidence of lymph node metastasis(LNM) and its risk factors in patients with Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas.METHODS We enrolled 85 patients [69 men, 16 women; median age(range), 67(38-84) years] who had undergone esophagectomy or proximal gastrectomy for Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas. Predictive risk factors of LNM included age, sex, location of the tumor center, confirmed Barrett's esophageal adenocarcinoma, tumor size, macroscopic tumor type, pathology, invasion depth, presence of ulceration, and lymphovascular invasion. Multivariate logistic regression analysis was used to identify factors predicting LNM. We also evaluated the frequencies of LNM for Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas in meta-data analysis.RESULTS LNMs were found in 11 out of 85 patients(12.9%, 95%CI: 5.8-20.0). Only 1 of the 15 patients(6.6%, 95%CI: 0.0-19.2) who had a final diagnosis of pT1a adenocarcinoma had a positive LNM, whereas 10 ofthe 70 patients(14.2%, 95%CI: 6.0-22.4) with a final diagnosis of pT1b adenocarcinoma had positive LNM. Furthermore, only one of the 30 patients(3.3%, 95%CI: 0.0-9.7) with a tumor invasion depth within 500 μm from muscularis mucosae had positive LNM. Poor differentiation and lymphovascular invasion were independently associated with a risk of LNM. In meta-data analysis, 12 of the 355 patients(3.3%, 95%CI: 1.5-5.2) who had a final diagnosis of pT1a adenocarcinoma had a positive LNM, whereas 91 of the 438 patients(20.7%, 95%CI: 16.9-24.5) with a final diagnosis of pT1b adenocarcinoma had positive LNM. CONCLUSION We consider endoscopic submucosal dissection(ESD) is suitable for patients with Siewert type Ⅰ and type Ⅱ T1 a adenocarcinomas. For patients with T1b adenocarcinoma, especially invasion depth is within 500 μm from muscularis mucosae with no other risk factor for LNM, diagnostic ESD could be a treatment option according to the overall status of patients and the presence of comorbidities.

关键词： Siewert type Ⅰ and type Ⅱ adenocarcinomas Lymph node metastasis

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雷公藤多苷对不可逆性肾小球硬化模型系膜损伤的抑制作用

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中国中药杂志 2005年第5期30卷 361-365页

作者：万毅刚孙伟清水不二雄顾刘宝铃木浩一唐泽环河内裕南京大学医学院附属鼓楼医院江苏南京210008 南京中医药大学附属医院肾科江苏南京210029 新潟大学大学院医歯学総合研究科附属肾研究施设分子病态学分野日本新潟9518510 江苏省老年医学研究所内分泌实验室江苏南京210008

目的观察雷公藤多苷(GTW)对不可逆性肾小球硬化模型系膜损伤的抑制作用,阐明其在体内延缓肾小球硬化的分子药理机制。方法运用2次注射单克隆抗体(mAb)1223的方法,建立大鼠不可逆性肾小球硬化模型,以经口灌胃GTW(50mg·kg-1BW)干预42d,... 详细信息

目的观察雷公藤多苷(GTW)对不可逆性肾小球硬化模型系膜损伤的抑制作用,阐明其在体内延缓肾小球硬化的分子药理机制。方法运用2次注射单克隆抗体(mAb)1223的方法,建立大鼠不可逆性肾小球硬化模型,以经口灌胃GTW(50mg·kg-1BW)干预42d,并设立对照组。比较24h尿蛋白排泄量(Upro)、肾功能(Scr,BUN)以及肾小球形态学(LM,IF)变化,并检测(RTPCR)模型鼠肾组织中I型胶原(collagentypeI)、转化生长因子(TGFβ)mRNA表达水平。结果GTW抑制肾小球硬化模型鼠Upro和系膜增殖。肾小球总细胞数GTW组(65.67±3.43),对照组(87.02±2.41),P<0.05;细胞外基质积分GTW组(1.20±0.06),对照组(2.77±0.23),P<0.05;α平滑肌肌动蛋白积分GTW组(1.75±0.33),对照组(2.62±0.15),P<0.05;I型胶原积分GTW组(1.68±0.31),对照组(2.06±0.24),P<0.05。GTW使肾小球硬化模型鼠肾组织中collagentypeI,TGFβmRNA表达水平下调53.5%和14.7%,与对照组比较,二者差异均有显著性(P<0.05)。结论GTW抑制肾小球硬化模型鼠Upro和系膜增殖的作用是通过减少细胞因子mRNA的表达来实现的。

关键词：肾小球硬化对照组雷公藤多苷 mRNA表达抑制作用 TGF-β Ⅰ型胶原模型不可逆性下调

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