The Tohoku Journal of Experimental Medicine
Online ISSN : 1349-3329
Print ISSN : 0040-8727
ISSN-L : 0040-8727
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Volume 229, Issue 4
April
Displaying 1-8 of 8 articles from this issue
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Essay
Regular Contributions
  • The -308G/A Polymorphism of the Tumor Necrosis Factor-alpha Gene Is Associated with the Risk of Upper Aerodigestive Tract Cancer: A Meta-analysis
    Jiayi Wang, Xin Jin, Hui Wang, Jiantang Yang, Lili Wang, Lei Lei, Xiao ...
    Article type: research-article
    2013 Volume 229 Issue 4 Pages 245-254
    Published: 2013
    Released on J-STAGE: April 17, 2013
    DOIhttps://doi.org/10.1620/tjem.229.245
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    Tumor necrosis factor-alpha (TNF-α) has been proposed to contribute to the development of upper aerodigestive tract (UADT) cancer that is characterized by poor prognosis. The G-to-A nucleotide change at -308 of the TNF-α gene (-308G/A polymorphism) can increase the expression level of TNF-α and thus may affect the genetic susceptibility of UADT cancer. The association between the -308G/A polymorphism and UADT cancer has been widely studied, but the results published are quite controversial. To obtain a more precise conclusion, we performed a meta-analysis including 1,751 patients and 3,345 controls. The results indicated that the AA genotype of the -308G/A polymorphism had a 54%-increased risk of UADT cancer, compared with the G carriers (GG and GA genotypes) [odds ratio (OR) = 1.54, 95% confidence interval (CI): 1.07-2.21]. After stratified by ethnicity, the AA genotype was associated with increased risk of UADT cancers in South Asians (OR = 33.18 and 95% CI: 1.92-573.62 for AA vs. GA+GG) but not in Caucasians or East Asians. After stratified by tumor site, the -308G/A polymorphism was associated with increased risks of oropharynx cancer (OR = 2.68 and 95% CI: 1.34-5.35 for AA vs. GA+GG) but not associated with esophagus or larynx cancer. After stratified by histological type, the -308G/A polymorphism was associated with increased risks of squamous cell carcinoma (OR = 1.81 and 95% CI: 1.15-2.84 for AA vs. GA+GG) but not associated with adenocarcinoma. Our results indicate that the -308G/A polymorphism might contribute to an increased risk of UADT cancer susceptibility.
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  • Polymorphisms of Angiotensin Converting Enzyme and Nitric Oxide Synthase 3 Genes as Risk Factors of High-Altitude Pulmonary Edema: A Case-Control Study and Meta-Analysis
    Qing-Qing Wang, Lei Yu, Guo-Rong Huang, Lu Zhang, Ya-Qiong Liu, Tai-Wu ...
    Article type: research-article
    2013 Volume 229 Issue 4 Pages 255-266
    Published: 2013
    Released on J-STAGE: April 19, 2013
    DOIhttps://doi.org/10.1620/tjem.229.255
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    High-altitude pulmonary edema (HAPE) is a non-cardiogenic type of pulmonary edema developing altitudes >2,500 m. Angiotensin converting enzyme (ACE) and nitric oxide synthase 3 (NOS3) play important roles in regulating pulmonary vascular tone. To assess associations between genetic variants in the ACE and NOS3 genes and HAPE risk, 27 HAPE patients and 108 matched controls were genotyped and analyzed. The indicated HAPE association of the NOS3 G894T (Glu298Asp) single nucleotide polymorphism (SNP), which may change NO production, was further evaluated by a meta-analysis of six studies involving 399 HAPE patients and 495 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were determined with fixed-effects models. Stratification analyses of ethnicity and geographic location were performed. Significant associations were observed for the dominant model in two ACE tag SNPs influencing serum ACE concentrations (rs8066114 polymorphism: GG+CG vs. CC; rs4461142 polymorphism: TT+CT vs. CC). Furthermore, Single-locus analysis indicated significantly different distributions of G allele frequency between the cases (29.63%) and controls (17.13%) for the ACE rs8066114 polymorphism. The case-control distributions of genotype frequencies and T allele frequency of NOS3 G894T (Glu298Asp) polymorphism were significantly higher in the cases than controls, and the NOS3 G894T (Glu298Asp) SNP showed elevated HAPE risk under the dominant model (TT+GT vs. GG). Meta-analysis showed overall association of NOS3 G894T SNP with HAPE risk under the allele contrast and dominant genetic models, which remained significant for Asians. In conclusion, ACE rs8066114 and rs4461142 and NOS3 rs1799983 (G894T) polymorphisms may be associated with increased HAPE risk in Asians.
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Case
  • Non-functioning Adrenocortical Carcinoma Arising in an Adrenal Rest: Immunohistochemical Study of an Adult Patient
    Hiroshi Yokoyama, Tomotaro Adachi, Kazuna Tsubouchi, Masatoshi Tanaka, ...
    Article type: case-report
    2013 Volume 229 Issue 4 Pages 267-270
    Published: 2013
    Released on J-STAGE: April 19, 2013
    DOIhttps://doi.org/10.1620/tjem.229.267
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    Adrenal rest is uncommon in adults, and usually represents a small lesion incidentally detected during surgery or autopsy. The adrenal rest can be detected anywhere along the path of embryonic migration of adrenal cortex, including celiac axis, genitals and broad ligament, and may be formed with the separation of cortical fragments by the migration of medullary elements from the sympathochromaffin tissue into the preformed cortical primordium. In addition, even primary adrenocortical carcinoma is a rare tumor with incidence 0.5-2 per million annually; therefore, adrenocortical carcinoma arising in adrenal rests is extremely rare. We encountered a patient with non-functioning ectopic adrenocortical carcinoma in retroperitoneum. A 34-year-old female presented with an incidentally discovered retroperitoneal mass revealed by abdominal ultrasound in her regular health examinations. She did not have any clinical abnormalities and underwent hand-assisted laparoscopic resection of the tumor. A dark-brown tumor, measuring 65×56×45 mm, was identified in the retroperitoneal space between lower pole of right kidney and inferior vena cava. Histologically, the tumor was predominantly composed of compact eosinophilic cells forming nest-like arrangements and diffusely positive for the steroidogenic factor-1. The tumor met four of the criteria of Weiss used in histological diagnosis of adrenocortical carcinoma (eosinophillic cytoplasm, nuclear atypia, atypical mitosis, and sinusoidal invasion). The tumor cells were immunohistochemically positive for 17α-hydroxylase, dehydroepiandrosterone sulfotransferase and 3β-hydroxysteroid dehydrogenase, each of which is involved in the synthesis of adrenocortical steroids. Therefore, based on these findings, we diagnosed this tumor as ectopic adrenocortical carcinoma arising in adrenal rest of retroperitoneum.
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Regular Contributions
  • Hemodialysis Leads to Better Survival in Patients with Diabetes or High Comorbidity, Compared to Peritoneal Dialysis
    Jae Hyun Chang, Ji Yoon Sung, Shin Young Ahn, Kwang-Pil Ko, Han Ro, Ji ...
    Article type: research-article
    2013 Volume 229 Issue 4 Pages 271-277
    Published: 2013
    Released on J-STAGE: April 19, 2013
    DOIhttps://doi.org/10.1620/tjem.229.271
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    Peritoneal dialysis (PD) has some advantages, such as hemodynamic stability and volume regulation, compared with hemodialysis (HD). However, the influence of the dialysis modality on survival is still controversial. This study assessed the mortality of incident patients undergoing HD versus PD using a propensity score approach. This study enrolled 873 subjects who began dialysis therapy at Gachon University Gil Hospital in Korea between January 2000 and June 2009. A propensity score comprising demographic, clinical, and laboratory variables was used to select a 1:1 matched cohort. The overall 1-, 2-, 3-, and 5-year survival rates for the HD patients (n = 212) were 95.1, 89.6, 82.5, and 65.3%, respectively, whereas the equivalent survival rates for the PD patients (n = 212) were 93.6, 83.1, 73.9, and 48.4%, respectively (P = 0.002 by log rank test). In patients without diabetes or patients with a low modified Charlson comorbidity index (MCCI), including hypertension, cardiovascular disease, liver disease, etc., there was no difference in mortality between PD and HD. However, PD was associated with a higher mortality for diabetic patients (HR, 2.86; 95% CI, 1.73-4.74) and for patients with a high MCCI (HR, 2.54; 95% CI 1.57-4.10). These data suggest that survival for PD may be comparable with that for HD in incident dialysis patients without diabetes or high MCCI and that HD could be more beneficial in patients with diabetes or high MCCI in this propensity score-matched cohort.
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  • A Diagnosis of Depression Should Be Considered in Patients with Multiple Physical Symptoms in Primary Care Clinics
    Kyoko Yamamoto, Seiji Shiota, Shigeki Ohno, Akiko Kuroda, Aoi Yoshiiwa ...
    Article type: research-article
    2013 Volume 229 Issue 4 Pages 279-285
    Published: 2013
    Released on J-STAGE: April 20, 2013
    DOIhttps://doi.org/10.1620/tjem.229.279
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    Although the vast majority of depressed patients visit primary health care clinics, they often remain undiagnosed and untreated. Therefore, early detection in primary care settings is important. There is a high correlation between number of physical symptoms and the presence of depression, yet little has been reported regarding this relationship in Japanese primary care clinics. We examined number of physical symptoms and depression in a department of general medicine of a Japanese hospital. We included patients with unexplained symptoms after multiple tests to rule out organic diseases. Twenty-one common symptoms were assessed using a symptom checklist. Depression was diagnosed using the Patient Health Questionnaire-9, a self-administered questionnaire designed to diagnose depression. Among 386 patients, 105 (27.2%) (average age: 49.7 ± 20.9 years, 28 men and 77 women) met the criteria for depression. Among the 21 symptoms, 14 were significantly more frequent in patients with depression than in those without depression. When patients had neither general fatigue, nor sleep disturbance nor appetite loss, none met the criteria for depression. Number of symptoms was significantly higher in patients with compared with those without depression. The prevalence of depression increased with number of symptoms: 2% (2/100) for 0 or 1 symptom, 42.4% (42/99) for four to five symptoms and 68.7% (22/32) for more than nine symptoms. Japanese primary care physicians can often rule out depression when patients have neither general fatigue, nor sleep disturbance nor appetite loss. A diagnosis of depression should be considered in patients who report multiple physical symptoms.
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Perspective
  • The Great East-Japan Earthquake and Devastating Tsunami: An Update and Lessons from the Past Great Earthquakes in Japan since 1923
    Akemi Ishigaki, Hikari Higashi, Takako Sakamoto, Shigeki Shibahara
    Article type: Perspective
    2013 Volume 229 Issue 4 Pages 287-299
    Published: 2013
    Released on J-STAGE: April 13, 2013
    DOIhttps://doi.org/10.1620/tjem.229.287
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    Japan has a long history of fighting against great earthquakes that cause structural damage/collapses, fires and/or tsunami. On March 11, 2011 at 14:46 (Friday), the Great East-Japan Earthquake (magnitude 9.0) attacked the Tohoku region (northeastern Japan), which includes Sendai City. The earthquake generated a devastating tsunami, leading to unprecedented disasters (~18,500 victims) in coastal areas of Iwate, Miyagi and Fukushima prefectures, despite the fact that people living in the Tohoku region are well trained for tsunami-evacuation procedures, with the mindset of “Tsunami, ten-den-ko.” This code means that each person should evacuate individually upon an earthquake. Sharing this rule, children and parents can escape separately from schools, houses or workplaces, without worrying about each other. The concept of ten-den-ko (individual evacuation) is helpful for people living in coastal areas of earthquake-prone zones around the world. It is also important to construct safe evacuation centers, because the March 11th tsunami killed people who had evacuated to evacuation sites. We summarize the current conditions of people living in the disaster-stricken areas, including the consequences of the Fukushima nuclear accident. We also describe the disaster responses as the publisher of the Tohoku Journal of Experimental Medicine (TJEM), located in Sendai, with online support from Tokyo. In 1923, the Great Kanto Earthquake (magnitude 7.9) evoked a massive fire that destroyed large areas of Tokyo (~105,000 victims), including the print company for TJEM, but the Wistar Institute printed three TJEM issues in 1923 in Philadelphia. Mutual aid relationships should be established between distant cities to survive future disasters.
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Regular Contributions
  • Expression of CD133 in Neuroendocrine Neoplasms of the Digestive Tract: A Detailed Immunohistochemical Analysis
    Khalilullah Mia-Jan, Jijgee Munkhdelger, Mi-Ra Lee, Sun-Young Ji, Tae ...
    Article type: Regular Contributions
    2013 Volume 229 Issue 4 Pages 301-309
    Published: 2013
    Released on J-STAGE: April 23, 2013
    DOIhttps://doi.org/10.1620/tjem.229.301
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    Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are potentially malignant with variable biologic behavior that originates from neuroendocrine cells of digestive tract. Recently, the existence of cancer stem cells (CSC) was demonstrated in tumors of gastrointestinal tract. CD133 is a transmembrane glycoprotein that serves as a CSC marker in various malignancies. However, the expression of CD133 in neuroendocrine neoplasms (NEN) of digestive tract has not been studied. We evaluated tissue expression of CD133 by immunohistochemistry in 90 NENs of digestive tract with their matched non-neoplastic mucosa including stomach (n = 15), small intestine (n = 7), appendix (n = 3), colon (n = 8), rectum (n = 41), pancreas (n = 2), gallbladder (n = 4) and liver (n = 10). Tumors were divided according to 2010 WHO classification. CD133 was expressed in 30.3% (17/56) of well-differentiated neuroendocrine tumors (NET), 26.1% (6/23) of poorly-differentiated neuroendocrine carcinomas (NEC) and 63.6% (7/11) of mixed adenoneuroendocrine carcinoma (MANECs). MANEC refers to existence of both adenocarcinoma and NEC together, each one comprising at least 30% of the tumor. CD133 was expressed in cytoplasm, luminal-side of cell membrane, or both and the staining pattern correlated with tumor growth pattern. CD133 expression was not significantly correlated with tumor grade, site, expression of neuroendocrine markers (chromogranin-A and synaptophysin) and patients’ survival. Thus, CD133 expression may lack prognostic significance in GEP-NETs. Importantly, CD133 was not detectable in non-neoplastic neuroendocrine cells of digestive system including pancreatic islets. In conclusion, CD133 is expressed in poorly-differentiated NECs and well-differentiated NETs of the digestive tract.
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