Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 61
Filtrar
1.
J Med Case Rep ; 18(1): 222, 2024 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-38704583

RESUMO

BACKGROUND: The greater omentum comprises peritoneal, adipose, vascular, and lymphoid tissues. Most omental malignancies are metastatic tumors, and the incidence of primary tumors is rare. We report on a prior omental smooth muscle tumor case in an adult male patient. CASE PRESENTATION: A 54-year-old Japanese male patient with no relevant medical history was diagnosed with an abdominal mass during a routine medical checkup. Subsequent contrast-enhanced computed tomography revealed a mass of approximately 3 cm in size in the greater omentum, and a laparotomy was performed. A 27 × 25 × 20 mm raised lesion was found in the omentum. Microscopically, spindle cells were observed and arranged in whorls and fascicles. Individual tumor cells had short spindle-shaped nuclei with slightly increased chromatin and were characterized by a slightly eosinophilic, spindle-shaped cytoplasm. The mitotic count was less than 1 per 50 high-power fields. The tumor cells showed positive immunoreactivity for α smooth muscle actin, HHF35, and desmin on immunohistochemical examination. The Ki-67 labeling index using the average method was 1.76% (261/14806). No immunoreactivity was observed for any of the other tested markers. We considered leiomyoma owing to a lack of malignant findings. However, primary omental leiomyoma has rarely been reported, and it can be difficult to completely rule out the malignant potential of smooth muscle tumors in soft tissues. Our patient was decisively diagnosed with a primary omental smooth muscle tumor considering leiomyoma. Consequently, the patient did not undergo additional adjuvant therapy and was followed up. The patient was satisfied with treatment and showed neither recurrence nor metastasis at the 13-month postoperative follow-up. DISCUSSION AND CONCLUSION: We encountered a primary smooth muscle tumor of the greater omentum with no histological findings suggestive of malignancy in an adult male patient. However, omental smooth muscle tumors are extremely difficult to define as benign, requiring careful diagnosis. Further case reports with long-term follow-up and case series are required to determine whether a true omental benign smooth muscle tumor (leiomyoma) exists. In addition, proper interpretation of the Ki-67 labeling index should be established. This case study is a foundation for future research.


Assuntos
Leiomioma , Omento , Neoplasias Peritoneais , Tumor de Músculo Liso , Tomografia Computadorizada por Raios X , Humanos , Masculino , Omento/patologia , Pessoa de Meia-Idade , Leiomioma/patologia , Leiomioma/cirurgia , Leiomioma/diagnóstico por imagem , Leiomioma/diagnóstico , Tumor de Músculo Liso/patologia , Tumor de Músculo Liso/diagnóstico , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/cirurgia , Neoplasias Peritoneais/secundário , Diagnóstico Diferencial
2.
Pathol Int ; 74(5): 252-261, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38477638

RESUMO

Inadequate specimen quality or quantity hinders comprehensive genomic profiling in identifying actionable mutations and guiding treatment strategies. We investigated the optimal conditions for pancreatic cancer specimen selection for comprehensive genomic profiling. We retrospectively analyzed 213 pancreatic cancer cases ordered for comprehensive genomic profiling and compared results from pancreatic biopsy, liver biopsy of pancreatic cancer metastases, pancreatectomy, liquid, and nonliver metastatic organ specimens. We examined preanalytical conditions, including cellularity (tumor cell count/size). The successfully tested cases were those that underwent comprehensive genomic profiling tests without any issues. The successfully tested case ratio was 72.8%. Pancreatic biopsy had the highest successfully tested case ratio (87%), with a high tumor cell percentage, despite the small number of cells (median, 3425). Pancreatic biopsy, liver biopsy of pancreatic cancer metastases, and non-liver metastatic organ had higher successfully tested case ratios than that for pancreatectomy. Liver biopsy of pancreatic cancer metastases and pancreatectomy cases with tumor size (mm2) × tumor ratio (%) > 150 and >3000, respectively, had high successfully tested case ratios. The success of comprehensive genomic profiling is significantly influenced by the tumor cell ratio, and pancreatic biopsy is a potentially suitable specimen for comprehensive genomic profiling.


Assuntos
Neoplasias Pancreáticas , Humanos , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/diagnóstico , Feminino , Masculino , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Biópsia , Idoso de 80 Anos ou mais , Adulto , Perfilação da Expressão Gênica/métodos , Genômica/métodos , Pâncreas/patologia , Pancreatectomia , Biomarcadores Tumorais/genética
3.
Environ Res ; 251(Pt 1): 118637, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38462082

RESUMO

In this study, we aimed to use the loss of happy life expectancy (LHpLE), an indicator that enables risk assessment considering wellbeing, to compare the risks of environmental carcinogenic chemicals in Japan. First, we surveyed Japanese people to determine their emotional happiness by age and sex and evaluated whether cancer incidence reduced emotional happiness. Questionnaires were administered to a general population panel and a panel of patients with cancer in 2022, recruiting a predetermined number of responses of 5000 and 850, respectively. Second, using the survey data, LHpLE was calculated for radon, arsenic, and fine particulate matter (aerodynamic diameter <2.5 µm; PM2.5) and compared to psychological distress, considering increased mortality and decreased emotional happiness due to these risks. We discovered no significant decrease in emotional happiness due to cancer incidence and no significant associations between emotional happiness and cancer type, history, or stage. LHpLE was calculated to be 6.4 × 10-3 years for radon, 2.6 × 10-3 years for arsenic, 1.1 × 10-2 years (2012 exposure) and 8.6 × 10-4 years (2020 exposure) for PM2.5, and 9.7 × 10-1 years for psychological distress. The fraction of losses caused by these carcinogenic chemicals to HpLE exceeded 10-5, suggesting that risk reduction for these chemicals is important in environmental policies. The LHpLE indicator allows for comparing different types of risks, such as environmental chemicals and psychological distress. This is the first study to compare chemical risks using the LHpLE indicator.


Assuntos
Carcinógenos Ambientais , Felicidade , Expectativa de Vida , Humanos , Japão/epidemiologia , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Adulto , Carcinógenos Ambientais/toxicidade , Medição de Risco , Neoplasias/induzido quimicamente , Neoplasias/epidemiologia , Arsênio/análise , Arsênio/toxicidade , Exposição Ambiental/efeitos adversos , Adulto Jovem , Material Particulado/análise , Radônio/análise , Idoso de 80 Anos ou mais , Incidência , Poluentes Atmosféricos/análise , Adolescente
4.
Virchows Arch ; 2024 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-38472412

RESUMO

Thyroid carcinomas exhibit various genetic alterations, including the RET and NTRK fusion genes that are targets for molecular therapies. Thus, detecting fusion genes is crucial for devising effective treatment plans. This study characterized the pathological findings associated with these genes to identify the specimens suitable for genetic analysis. Thyroid carcinoma cases positive for the fusion genes were analyzed using the Oncomine Dx Target Test. Clinicopathological data were collected and assessed. Among the 74 patients tested, 8 had RET and 1 had NTRK3 fusion gene. Specifically, of the RET fusion gene cases, 6 exhibited "BRAF-like" atypia and 2 showed "RAS-like" atypia, while the single case with an NTRK3 fusion gene presented "RAS-like" atypia. Apart from one poorly differentiated thyroid carcinoma, most cases involved papillary thyroid carcinomas (PTCs). Primary tumors showed varied structural patterns and exhibited a high proportion of non-papillary structures. Dysmorphic clear cells were frequently observed. BRAF V600E immunoreactivity was negative in all cases. Interestingly, some cases exhibited similarities to diffuse sclerosing variant of PTC characteristics. While calcification in lymph node metastases was mild, primary tumors typically required hydrochloric acid-based decalcification for tissue preparation. This study highlights the benefits of combining morphological and immunohistochemical analyses for gene detection and posits that lymph node metastases are more suitable for genetic analysis owing to their mild calcification. Our results emphasize the importance of accurate sample processing in diagnosing and treating thyroid carcinomas.

5.
Arch Esp Urol ; 76(9): 633-642, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38053418

RESUMO

Prostate cancer remains a significant global health challenge. Traditionally anchored by the Gleason score/Grade Group (GS/GG), the landscape of prostate cancer diagnosis is undergoing transformative steps, particularly in the domain of biopsy procedures. GS/GG continues to be pivotal in malignancy grading, but recent technological strides have augmented the diagnostic relevance of biopsies. Integral to this progression is the adoption of advanced imaging techniques, especially magnetic resonance imaging, which has refined biopsy accuracy and efficiency. A deep understanding of prostate cancer pathology reveals a cribriform pattern and intraductal carcinoma of the prostate as independent forms of malignancy, suggesting a potentially aggressive disease course. Furthermore, the distinct behaviour of ductal adenocarcinoma and small cell carcinoma of the prostate, compared with acinar adenocarcinoma, necessitates their accurate differentiation during biopsy. The genomic era ushers in a renewed emphasis on tissue samples obtained from prostate biopsies, especially as mutations in genes, such as BRCA1/2, and paves the way for precision medicine. This review encapsulates the evolving dynamics of prostate biopsy, from technological advancements to the profound implications on prostate cancer management and therapy.


Assuntos
Carcinoma Intraductal não Infiltrante , Neoplasias da Próstata , Masculino , Humanos , Próstata/patologia , Proteína BRCA1 , Proteína BRCA2 , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/terapia , Neoplasias da Próstata/patologia , Biópsia , Carcinoma Intraductal não Infiltrante/patologia , Gradação de Tumores
6.
Arch. esp. urol. (Ed. impr.) ; 76(9): 633-642, 28 nov. 2023. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-228262

RESUMO

Prostate cancer remains a significant global health challenge. Traditionally anchored by the Gleason score/Grade Group (GS/GG), the landscape of prostate cancer diagnosis is undergoing transformative steps, particularly in the domain of biopsy procedures. GS/GG continues to be pivotal in malignancy grading, but recent technological strides have augmented the diagnostic relevance of biopsies. Integral to this progression is the adoption of advanced imaging techniques, especially magnetic resonance imaging, which has refined biopsy accuracy and efficiency. A deep understanding of prostate cancer pathology reveals a cribriform pattern and intraductal carcinoma of the prostate as independent forms of malignancy, suggesting a potentially aggressive disease course. Furthermore, the distinct behaviour of ductal adenocarcinoma and small cell carcinoma of the prostate, compared with acinar adenocarcinoma, necessitates their accurate differentiation during biopsy. The genomic era ushers in a renewed emphasis on tissue samples obtained from prostate biopsies, especially as mutations in genes, such as BRCA1/2, and paves the way for precision medicine. This review encapsulates the evolving dynamics of prostate biopsy, from technological advancements to the profound implications on prostate cancer management and therapy (AU)


Assuntos
Humanos , Masculino , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Biópsia/métodos , Reprodutibilidade dos Testes
7.
Mar Pollut Bull ; 194(Pt B): 115440, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37657257

RESUMO

To reduce microplastic (MP) discharge into the aquatic environment, it is necessary to properly identify its sources and amounts. Here, specific MP sources, i.e., personal care products (PCPs), fibers from clothes, and tire-wear particles (TWPs) were focused, and MP generations from these sources in the Tokyo Bay watershed, Japan, were estimated based on statistical data on production and reported emission factors of the MP sources and executing considering uncertainty on the data. Potential annual MP emission into Tokyo Bay was estimated to be 10.2 ± 1.6, 38 ± 22, and 1500-1800 tons for PCPs, fibers, and TWPs, respectively. Emissions into Tokyo Bay by assuming MP density and diameter was estimated. For fiber, the fraction to potential emission was estimated at 1.0-2.8 %. This study contributes to determining potential discharge pathways. This will assist in the application of appropriate measures to reduce MP discharge into water bodies.


Assuntos
Microplásticos , Plásticos , Japão , Tóquio , Baías
8.
Histopathology ; 83(4): 657-663, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37501641

RESUMO

AIMS: Lenvatinib is a multikinase inhibitor used for treating unresectable or metastatic cancers, including thyroid cancer. As total thyroidectomy followed by radioactive iodine therapy is a commonly recommended initial treatment for thyroid cancer, histological findings of the thyroid after lenvatinib therapy remain unclear. Therefore, the aim of this study was to analyse in-vivo changes in patients who underwent thyroidectomy after lenvatinib therapy. METHODS AND RESULTS: We screened 167 patients with thyroid cancer [papillary thyroid cancer (PTC), n = 102; follicular thyroid cancer (FTC), n = 26; anaplastic thyroid cancer (ATC), n = 39] who underwent lenvatinib therapy. Among these patients, six underwent thyroidectomy (lenvatinib-treated group: PTC, n = 3; FTC, n = 1; ATC, n = 2), and the specimens were examined. Five patients with PTC who did not receive lenvatinib therapy were included for comparison (untreated group). Microvessel density (MVD) was evaluated in both groups. The PTC and FTC specimens showed relatively more ischaemic changes than ATC specimens. Coagulative necrosis and ischaemic changes in cancer cells were frequently observed. ATC specimens showed fibrosis and mild cell damage. As hypothyroidism is a common side effect of lenvatinib therapy, non-cancerous thyroid tissues were also examined. Histological findings included mild lymphocytic infiltration, lymphoid follicular formation, histiocytic reaction and follicular epithelial destruction. The MVD in lenvatinib-treated tissues was significantly lower than that in untreated tissues. CONCLUSIONS: Lenvatinib therapy probably induces relatively specific ischaemic changes in thyroid cancer cells. Moreover, inflammatory cell infiltration and decreased MVD occur to varying degrees in non-cancerous thyroid tissue and may be related to hypothyroidism, a side effect of lenvatinib.


Assuntos
Adenocarcinoma Folicular , Carcinoma Anaplásico da Tireoide , Neoplasias da Glândula Tireoide , Humanos , Neoplasias da Glândula Tireoide/tratamento farmacológico , Neoplasias da Glândula Tireoide/patologia , Radioisótopos do Iodo/uso terapêutico , Adenocarcinoma Folicular/tratamento farmacológico , Adenocarcinoma Folicular/patologia , Compostos de Fenilureia/efeitos adversos , Câncer Papilífero da Tireoide/tratamento farmacológico
9.
Hum Pathol ; 135: 99-107, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36738975

RESUMO

Cribriform pattern and intraductal carcinoma of the prostate (IDC-P) are widely accepted as poor prognostic factors in prostate cancer. However, it remains unclear to what extent the presence of these morphological features in prostate biopsy specimens, as diagnosed by hematoxylin-eosin-stained specimens only, affects the clinicopathological impact. In this study, we summarized the characteristics of the cribriform pattern and IDC-P in 850 prostate biopsy cases. The results showed a statistically significant increase in the incidence of cribriform pattern and IDC-P as grade group (GG) increased (especially in cases ≥ GG4, Chi-square test P < 0.001). The independent risk factors for cribriform pattern and IDC-P in biopsy specimens in the multivariate logistic regression analysis were the former GG, presence of IDC-P, lesion length of the highest GG core, latter GG, presence of the cribriform pattern, number of biopsies obtained, and number of highest GG core. Overall, 125 cases in which radical prostatectomy was conducted after biopsy were selected for further analysis. Multivariate logistic regression analysis using biopsy and surgical specimens confirmed that the presence of the cribriform pattern and IDC-P in biopsy specimens were independent risk factors for lymph node metastasis (odds ratios [95% confidence interval] were 6.54 [1.15-37.05] for the cribriform pattern and 23.71 [1.74-322.42] for IDC-P). The presence of the cribriform pattern and/or IDC-P in a biopsy specimen was a significant factor, even if only partially present, indicating lymph node metastasis. However, further validation is required to predict poor prognostic factors more accurately.


Assuntos
Adenocarcinoma , Carcinoma Intraductal não Infiltrante , Próstata , Neoplasias da Próstata , Humanos , Masculino , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Adenocarcinoma/patologia , Carcinoma Intraductal não Infiltrante/patologia , Metástase Linfática/patologia , Prostatectomia , Gradação de Tumores , Próstata/cirurgia , Estudos Retrospectivos , Biópsia , Pessoa de Meia-Idade , Idoso , Resultado do Tratamento
10.
Diagn Pathol ; 18(1): 5, 2023 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-36639698

RESUMO

BACKGROUND: Uterine adenosarcoma is a rare malignant tumor that accounts for 8% of all uterine sarcomas, and less than 0.2% of all uterine malignancies. However, it is frequently misdiagnosed in clinical examinations, including pathological diagnosis, and imaging studies owing to its rare and non-specific nature, which is further compounded by the lack of specific diagnostic markers. CASE PRESENTATION: We report a case of uterine adenosarcoma for which a comprehensive genomic profiling (CGP) test provided a chance to reach the proper diagnosis. The patient, a woman in her 60s with a history of uterine leiomyoma was diagnosed with an intra-abdominal mass post presentation with abdominal distention and loss of appetite. She was suspected to have gastrointestinal stromal tumor (GIST); the laparotomically excised mass was found to comprise uniform spindle-shaped cells that grew in bundles with a herringbone architecture, and occasional myxomatous stroma. Immunostaining revealed no specific findings, and the tumor was diagnosed as a spindle cell tumor/suspicious adult fibrosarcoma. The tumor relapsed during postoperative follow-up, and showed size reduction with chemotherapy, prior to regrowth. CGP was performed to identify a possible treatment, which resulted in detection of a JAZF1-BCORL1 rearrangement. Since the rearrangement has been reported in uterine sarcomas, we reevaluated specimens of the preceding uterine leiomyoma, which revealed the presence of adenosarcoma components in the corpus uteri. Furthermore, both the uterine adenosarcoma and intra-abdominal mass were partially positive for CD10 and BCOR staining. CONCLUSION: These results led to the conclusive identification of the abdominal tumor as a metastasis of the uterine adenosarcoma. The JAZF1-BCORL1 rearrangement is predominantly associated with uterine stromal sarcomas; thus far, ours is the second report of the same in an adenosarcoma. Adenosarcomas are rare and difficult to diagnose, especially in atypical cases with scarce glandular epithelial components. Identification of rearrangements involving BCOR or BCORL1, will encourage BCOR staining analysis, thereby potentially resulting in better diagnostic outcomes. Given that platinum-based chemotherapy was proposed as the treatment choice for this patient post diagnosis with adenosarcoma, CGP also indirectly contributed to the designing of the best-suited treatment protocol.


Assuntos
Adenossarcoma , Leiomioma , Neoplasias Uterinas , Feminino , Humanos , Adenossarcoma/diagnóstico , Adenossarcoma/genética , Adenossarcoma/patologia , Proteínas Correpressoras , Diagnóstico Diferencial , Proteínas de Ligação a DNA , Genômica , Leiomioma/diagnóstico , Proteínas Repressoras/genética , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/genética , Neoplasias Uterinas/patologia , Idoso
11.
Intern Med ; 62(2): 261-267, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-35768220

RESUMO

There has been a significant shift in epidemiology and renal outcomes of infection-related glomerulonephritis (IRGN) in recent years. The renal prognosis of IRGN is often poor in adults, especially in the elderly and diabetics. We herein report an elderly diabetic patient with IRGN due to streptococcal infection complicated by hemophagocytic syndrome and cytomegalovirus nephritis, which is uncommon among non-transplant patients. Infection control and steroids did not recover the patient's renal function. For elderly IRGN patients with diabetes, a further investigation of the most effective treatment for related renal outcomes is needed.


Assuntos
Diabetes Mellitus , Glomerulonefrite , Linfo-Histiocitose Hemofagocítica , Infecções Estreptocócicas , Adulto , Humanos , Idoso , Citomegalovirus , Linfo-Histiocitose Hemofagocítica/complicações , Linfo-Histiocitose Hemofagocítica/diagnóstico , Glomerulonefrite/complicações , Glomerulonefrite/diagnóstico , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/diagnóstico
12.
Respirol Case Rep ; 10(9): e01004, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35950141

RESUMO

Malignant pericardial mesothelioma (MPM) is a rare tumour that arises from the mesothelial cells of the pericardium. No standard treatment has been established owing to a poor treatment response; therefore, MPM has a poor prognosis. We herein report a rare case of MPM in a 70-year-old man that was diagnosed immunohistopathologically using cell block sections of pericardial fluid and in which long-term survival for more than 3 years was achieved with only periodic pericardial drainage. Immunohistopathological staining investigations, especially BRCA1-associated protein 1 (BAP1) immunostaining using cell block sections of pericardial effusion, are effective in making a diagnosis of MPM. Well-differentiated papillary mesothelioma (WDPM) with BAP1 loss progresses to MPM in the long term, showing that BAP1 loss may induce phenotypical evolution of WDPM. BAP1 loss may also progress to malignant mesothelioma in situ and then to invasive mesothelioma. BAP1 immunohistochemistry should be considered for the early diagnosis of MPM.

13.
BMJ Open ; 12(4): e054716, 2022 04 05.
Artigo em Inglês | MEDLINE | ID: mdl-35383063

RESUMO

OBJECTIVES: This study aimed to determine cause-specific years of life lost (YLL) changes between predisaster and postdisaster in disaster-affected municipalities, compared with the national average. We estimated the YLL in Soma and Minamisoma cities (the subject area) in Fukushima, Japan, where the tsunami and the nuclear accident hit in 2011. PARTICIPANTS: We used vital registration records from a national survey conducted between January 2006 and December 2015. We analysed 6369 death data in the predisaster period (2006-2010) and 6258 death data in the postdisaster period (2011-2015). METHODS: We incorporated vital statistics data as follows: age-based, sex-based and International Classification of Diseases, 10th Revision-based cause-specific deaths and calculated YLLs by ages 0, 40, 65 and 75 and sex for attributable causes of death for heart diseases, cerebrovascular diseases, pneumonia, all cancers and specific cancers; breast cancer, colorectal cancer, leukaemia, lung cancer, stomach cancer and uterine cancer for predisaster and postdisaster in the subject area. RESULTS: YLL attributed to heart diseases for males showed no decrease and YLL postdisaster was 0.37 years larger than that of the national average at age 0. The difference was -0.17 (95% uncertainty interval: -0.40 to 0.05) years at age 65. It decreased for females; the difference was 0.37 (0.18-0.57) years after the disaster. YLL decrease (that is, difference) in cerebrovascular diseases at age 0 was 0.27 (0.09-0.44) years and 0.18 (0.04-0.32) years; however, the YLLs postdisaster were still 0.24 and 0.25 years larger than those for the national average for males and females, respectively. YLL attributed to cancer did not increase even after the nuclear disaster. CONCLUSIONS: We specified the causes of death to be reduced in disaster-affected areas in the future. This study emphasised the importance of understanding how the health situation changed for the whole society of the area from a comprehensive perspective, rather than focusing only on small mortality increases.


Assuntos
Acidente Nuclear de Fukushima , Doenças não Transmissíveis , Idoso , Causas de Morte , Cidades , Feminino , Humanos , Lactente , Recém-Nascido , Expectativa de Vida , Estudos Longitudinais , Masculino
14.
Pathol Int ; 71(8): 491-499, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34015161

RESUMO

Endometrial neuroendocrine carcinoma is a rare disease with unknown clinicopathological and molecular characteristics. Therefore, we conducted the present study to elucidate the clinicopathological and molecular characteristics of endometrial neuroendocrine carcinoma, as compared to conventional endometrial carcinoma, and to determine the origin of the former. We analyzed 22 endometrial neuroendocrine carcinomas and 22 conventional endometrial neoplasia cases with respect to clinical, histological and genetic features. Of these, 21/22 neuroendocrine carcinoma cases were admixed carcinomas, with 15 admixed with endometrioid adenocarcinoma. Genetic analysis of hotspot mutations in 50 cancer-related genes revealed that the neuroendocrine carcinoma group carried mutations in PIK3CA (12/22 cases; 54%) and PTEN (8/22 cases; 36%), commonly encountered in endometrioid adenocarcinoma. Comparative statistical analysis of neuroendocrine carcinoma and conventional endometrial neoplasia cases showed a significant trend only in PIK3CA mutation. Moreover, in six mixed-type neuroendocrine carcinoma cases, macrodissection was used to separate the neuroendocrine carcinoma and endometrioid adenocarcinoma components for next-generation sequencing, which revealed several mutations common among the two. These findings suggest that endometrial neuroendocrine carcinoma could originate from conventional endometrial neoplasia, especially endometrioid adenocarcinoma.


Assuntos
Carcinoma Neuroendócrino , Classe I de Fosfatidilinositol 3-Quinases , PTEN Fosfo-Hidrolase , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Carcinoma Endometrioide/patologia , Carcinoma Neuroendócrino/etiologia , Carcinoma Neuroendócrino/patologia , Classe I de Fosfatidilinositol 3-Quinases/genética , Classe I de Fosfatidilinositol 3-Quinases/metabolismo , Neoplasias do Endométrio/patologia , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Mutação , PTEN Fosfo-Hidrolase/genética , PTEN Fosfo-Hidrolase/metabolismo
15.
J Radiat Res ; 62(Supplement_1): i101-i106, 2021 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-33978180

RESUMO

It is crucial to evaluate ethical issues regarding evacuation orders, especially after a nuclear disaster. After the Fukushima accident in 2011, the Japanese government ordered the affected people to evacuate. The evacuation orders have now been lifted in many areas. A risk trade-off analysis between benefits and risk associated with returning home would help in evaluating the justification for the lifting of the evacuation order in the aftermath of a nuclear disaster. Here, we performed a risk trade-off analysis among people returning home after the lifting of an evacuation order between an increase in emotional happiness (positive effect) and loss of life expectancy due to additional radiation exposure (negative effect), using a happy life expectancy (HpLE) indicator. Emotional happiness was estimated using questionnaires distributed among the affected people who lived in municipalities where evacuation orders were lifted. Loss of life expectancy was estimated under a scenario that returnees received 20 mSv in the year of return and subsequent radiation exposure. Increase in emotional happiness due to returning home was ~1-2 orders of magnitude higher among women aged 20, 40 and 65 years than the loss of life expectancy due to additional radiation exposure. This finding has implications for the justification for the lifting of evacuation orders.


Assuntos
Acidente Nuclear de Fukushima , Felicidade , Expectativa de Vida , Exposição à Radiação , Medição de Risco , Emoções , Feminino , Humanos , Pessoa de Meia-Idade
16.
Health Informatics J ; 27(2): 1460458221996420, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33878956

RESUMO

Disasters can hinder access to health information among cancer patients. However, little is known regarding overall health information exposure (HIE), its barriers and its impacts on attitudes toward healthcare among cancer patients in the long-term aftermath of disasters. The aims of this study were threefold: assess the extent of HIE; identify associations between family composition and a non-engagement with HIE; and examine the effects of HIE on attitudes toward healthcare among local cancer patients-5 years after the 2011 triple disaster (earthquake, tsunami, and nuclear disaster) in Fukushima, Japan. We conducted self-administered surveys with all cancer and non-cancer surgery department outpatients at Minamisoma Municipal General Hospital (MMGH), Minamisoma City, from October 2016 to January 2017. In total, 404 patients (263 cancer patients and 141 non-cancer patients) voluntarily participated in the study. The results revealed that a regular level of HIE occurred among 90.5% of the cancer patients. In cancer patients, family composition was not significantly associated with HIE, and HIE was not associated with attitude toward healthcare. In conclusion, most cancer patients visiting the MMGH surgical department were regularly engaged in HIE.


Assuntos
Desastres , Acidente Nuclear de Fukushima , Neoplasias , Atitude , Estudos Transversais , Atenção à Saúde , Humanos , Japão , Neoplasias/terapia
17.
Microb Risk Anal ; 19: 100162, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33778137

RESUMO

The 2020 Olympic/Paralympic Games have been postponed to 2021, due to the COVID-19 pandemic. We developed a model that integrated source-environment-receptor pathways to evaluate how preventive efforts can reduce the infection risk among spectators at the opening ceremony of Tokyo Olympic Games. We simulated viral loads of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emitted from infectors through talking/coughing/sneezing and modeled temporal environmental behaviors, including virus inactivation and transfer. We performed Monte Carlo simulations to estimate the expected number of newly infected individuals with and without preventive measures, yielding the crude probability of a spectator being an infector among the 60,000 people expected to attend the opening ceremony. Two indicators, i.e., the expected number of newly infected individuals and the newly infected individuals per infector entry, were proposed to demonstrate the extent of achievable infection risk reduction levels by implementing possible preventive measures. A no-prevention scenario produced 1.5-1.7 newly infected individuals per infector entry, whereas a combination of cooperative preventive measures by organizers and the spectators achieved a 99% risk reduction, corresponding to 0.009-0.012 newly infected individuals per infector entry. The expected number of newly infected individuals was calculated as 0.005 for the combination of cooperative preventive scenarios with the crude probability of a spectator being an infector of 1 × 10-5. Based on our estimates, a combination of cooperative preventions between organizers and spectators is required to prevent a viral spread at the Tokyo Olympic/Paralympic Games. Further, under the assumption that society accepts < 10 newly infected persons traced to events held during the entire Olympic/Paralympic Games, we propose a crude probability of infectors of < 5 × 10-5 as a benchmark for the suppression of the infection. This is the first study to develop a model that can assess the infection risk among spectators due to exposure pathways at a mass gathering event.

18.
PeerJ ; 8: e9730, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32904404

RESUMO

BACKGROUND: Risk communication is widely accepted as a significant factor for policy makers, academic researchers, and practitioners in diverse fields. However, there remains a lack of comprehensive knowledge about how risk communication is currently conducted across fields and about the way risk communication is evaluated. METHODOLOGY: This study systematically searched for materials from three scholarly search engines and one journal with a single search term of "risk communication." The eligibility assessment selected peer-reviewed articles published in English that evaluated risk communication activities. Emphasis was placed on articles published in recent years accounting for about half of the pre-selected ones. Data on field of study, intervention timing, target audience, communication type, and objectives/evaluation indicators was extracted from the articles. Patterns of objectives/evaluation indicators used in risk communication activities were compared with those of the definitions and purposes of risk communication stated by relevant organizations. Association analysis was conducted based on study fields and objectives/evaluation indicators. RESULTS: The screening process yielded 292 articles that were published between 2011 and 2017 in various fields, such as medicine, food safety, chemical substances, and disasters/emergencies. The review process showed that many activities were performed in the medical field, during non-/pre-crisis periods. Recent activities primarily targeted citizens/Non-Profit Organizations (NPOs), and was disseminated in the form of large group or mass communication. While "knowledge increase," "change in risk perception and concern alleviation," and "decision making and behavior change" were commonly addressed in practice, "trust-building" and "reduction in psychological distress" were rarely focused. The analysis also indicated that the medical field tends to perform risk communication at the individual or small group level, in contrast to the food safety field. Further, risk communications in the non-/pre-crisis period are more likely to aim at "changes in risk perception and concern alleviation" than those in the crisis period. Risk communications that aim at "changes in risk perception and concern alleviation" are likely to be presented in a large group or mass communication, whereas those that aim at "decision making and behavior change" are likely to be conducted at the individual or small group level. CONCLUSION: An overview of recent activities may provide those who engage in risk communication with an opportunity to learn from practices in different fields or those conducted in different intervention timings. Devoting greater attention to trust building and reduction in psychological distress and exploring non-citizen/NPO stakeholders' needs would be beneficial across academic and professional disciplines.

19.
PLoS One ; 14(6): e0218377, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31199845

RESUMO

Prediction of heavy metal bioavailability in intact soil is important to manage soil pollution risks. We developed a regression model for representative Japanese soils to judge their potential vulnerability to cadmium (Cd) pollution. We added four rates of Cd to 17 sample soils to mimic artificial contamination. After aging the contaminated soils, we measured Cd's bioavailability using the diffusive gradients in thin-films (DGT) technique. We then evaluated the relationships between bioavailability of Cd ([CdDGT]) and intact soil properties by statistical analyses. Cation exchange capacity (CEC) and pH emerged as significant factors to explain the cadmium bioavailability in Japanese soils. Specifically, lower CEC and lower pH were associated with higher [CdDGT], which poses a higher risk for soil ecosystems. The correlation between pH and [CdDGT] had a high dependence on [CdAdd], whereas that for CEC did not. Regression analysis also showed that the interaction between intact soil pH and spiked concentration ([CdAdd]) had a significant contribution to [CdDGT]. The regression model developed was rationally supported by a biotic ligand model. This simplified but realistic model would be useful in estimating the vulnerability of representative Japanese soils and determining the risk for Japanese soils in relation to Cd contamination.


Assuntos
Cádmio/análise , Monitoramento Ambiental , Poluição Ambiental , Poluentes do Solo/análise , Solo/química , Algoritmos , Disponibilidade Biológica , Japão , Ligantes , Metais Pesados/análise , Modelos Teóricos
20.
J Radiol Prot ; 39(3): 854-871, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31181542

RESUMO

Following the Fukushima incident, radiation doses from external exposure accounted for the majority of the total doses. Although countermeasures are being implemented, with the aim of reducing radiation exposure, little information is available on the effects of decontamination on individual doses among the residents of radioactively contaminated areas. To evaluate the effectiveness of the decontamination measures in reducing individual doses, and to examine the influence of the timing of decontamination and the district, data were analysed for 18 392 adults and 3 650 children in Minamisoma City, Fukushima, who participated in a voluntary screening programme using individual radiation dosimeters (Glass Badge) between June 2013 and September 2016. The dose reduction rates (DRR) were calculated for one year by comparing the first and last three-month measurement results between areas with and without decontamination. Using a regression approach and Monte Carlo simulation, the dose reduction rate by decontamination eliminating the effect of physical decay (DRRd') was also estimated as a function of the timing of the decontamination and the dose at the time of starting the decontamination. The annual DRR in areas with decontamination for both adults and children were significantly higher than those in areas without decontamination, depending on the timing of decontamination: 31%-36% for 2013-14 for adults in decontamination areas and 33%-35% for children in decontamination areas, compared to 12%-23% and 13%-23% for adults and children in areas without decontamination, respectively. There was a positive correlation between DRRd' and individual doses, and DRRd' was estimated at 30%-40% for adults and children with doses of 3 mSv y-1 in 2013 and 2014. This study demonstrated that decontamination does lower individual doses from external exposure. The higher the dose at the time of starting the decontamination, the greater the dose reduction rate by decontamination, regardless of the timing of the decontamination. Our study confirms that decontamination was useful for high-dose areas in the later phases of the incident.


Assuntos
Descontaminação/métodos , Exposição Ambiental/análise , Acidente Nuclear de Fukushima , Doses de Radiação , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Cidades , Feminino , Humanos , Lactente , Recém-Nascido , Japão , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Método de Monte Carlo , Dosímetros de Radiação , Monitoramento de Radiação/métodos , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...