A case report of cutaneous melanocytoma with CRTC1‐TRIM11 fusion: Is CMCT distinct from clear cell sarcoma of soft tissue?

Pathological diagnosis of dermal melanocytic tumors is often problematic owing to histological resemblance. Recently, cutaneous melanocytoma with CRTC1‐TRIM11 (CMCT) was added to this category. However, only six cases have been reported so far. We herein present a case of a 77‐year‐old Japanese man with CMCT. The patient presented a nodule in the right thigh and underwent surgical resection. Histological examination indicated a well‐demarcated 6 × 5 mm‐sized tumor nodule in the dermis and subcutis. The tumor was amelanotic, consisting of uniform nests and fascicles of spindled, or epithelioid cells. The melanocytic nature was evident by immunohistochemistry. The CRTC1‐TRIM11 fusion was detected by TRIM11 immunostaining, chromogenic in situ hybridization, and RT‐PCR/direct sequencing. He has been free from the tumor for 1 year after additional resection. The main differential diagnosis of CMCT includes primary and metastatic dermal malignant melanomas (MM) and dermal/subcutaneous clear cell sarcoma (CCS). Additionally, histological overlap with paraganglioma‐like dermal melanocytic tumor was considered. Although some investigators argue that CMCT is a variant of CCS, we think it should be separated from CCS, and subcutaneous/dermal CCS should be confined to tumors with EWSR1‐ATF1/ CREB1 fusion. However, longer follow‐up and more case studies are needed for revealing the true prognosis of CMCT.     

Accuracy and reliability of continuous blood glucose monitoring during pediatric cardiopulmonary bypass

Journal of Artificial Organs - The purpose of this study was to assess the accuracy and reliability of a continuous blood glucose monitoring system (artificial endocrine pancreas; STG-55, Nikkiso,...     

Development of metal-resin composite restorative material. Part 5: Evaluation of the bonding between Ag-Sn particle and 4-META coupling agent of the metal-resin composite

This study evaluated the oxide characteristics on a Ag-Sn particle surface modified by acid and heat in order to understand the bonding mechanism. Nine different Ag-Sn particles including standard Sn, SnO and SnO2 were evaluated by X-ray Photoelectron Spectroscopy (XPS). The particles were also used for preparing the composite to test the flexural properties following the ISO 4049. A high correlation between flexural strength of the composites and Sn3d binding energy of their filler particles was found. Different oxide forms (SnO and SnO2) showed different adhesive abilities to bond with 4-META, regarding the difference in flexural strength of the composite. The highest flexural strength composite showed Sn3d binding energy of its filler at 486.4 eV, which was the SnO binding area. This implies that SnO was responsible for a good bond between particle surface and 4-META coupling agent.     

Development of casting investment preventing blackening of noble metal alloys Part 2. Application of developed investment for type 4 gold alloy

The objective of this study was to evaluate the efficacy of the developed investment for the prevention of blackening of a cast Type 4 gold and to analyze the oxides on its surface in relation to the blackening of the alloy. The experimental investments were prepared using a gypsum-bonded investment in which boron (B) or aluminum (Al) was added as a reducing agent. A Type 4 gold alloy was cast into the mold made of the prepared investment. The effect of the additives was evaluated from the color difference (deltaE*) between the as-cast surface and the polished surface of the cast specimen. B and Al were effective to prevent the blackening of a Type 4 gold alloy and the color of the as-cast surface approached that of the polished surface with increasing B and Al content. The prevention of the blackening of the gold alloy can be achieved by restraining the formation of CuO.     

Development of metal-resin composite restorative materia. Part 1. Experimental composite using silver-tin alloy as filler and 4-META as coupling agent

Metal-resin composites, using metal particles instead of inorganic particles as the filler and 4-META as the coupling agent, were experimentally prepared under 20 different conditions (five different concentrations of 4-META, and four different contents of metal particles). The flexural strength of the prepared metal-resin composites was in the range of about 14.5-61.3 MPa. The flexural strength was significantly influenced by the 4-META concentration, the metal particle content and their interaction. The highest strength was estimated at 2-3 mass% of 4-META concentration and 92.0-93.5 mass% metal filler content. The flexural modulus of the metal resin composite ranged approximately from 7.8 GPa to 15.5 GPa. The flexural modulus of the metal resin composite significantly increased with the metal particle content. The effect of the 4-META concentration on the flexural modulus was not significant.     

Development of casting investment preventing blackening of noble metal alloys part 1. Application of developed investment for Ag-Pd-Cu-Au alloy

The objective of this study is to develop a casting investment that prevents the blackening of the cast surface of noble metal alloys. The experimental investments were prepared using a gypsum-bonded investment in which the metallic powders such as boron (B), silicon (Si), aluminum (Al) and titanium (Ti) were added as oxidizing agents. An Ag-Pd-Cu-Au alloy was cast into the mold made of the prepared investment. The effect of the addition of each metal powder was evaluated from the color difference between the as-cast surface and the polished surface of the cast specimen. The color of the as-cast surface approached that of the polished surface with increasing B and Al content. A lower mean value in the color difference was obtained at 0.25-1.00 mass% B content. B and Al are useful as an additive in a gypsum-bonded investment to prevent the blackening of an Ag-Pd-Cu-Au alloy. The effects of Si and Ti powder addition could not be found.     

Intraluminal exfoliated cancer cells and effectiveness of bowel ligatures during sigmoidectomy for sigmoid colon cancer

Purposes

To establish the efficiency of bowel ligatures in colon cancer surgery, focusing on the extent to which exfoliated cancer cells are shed in the colonic lumen during sigmoidectomy.

Methods

Twenty consecutive patients who underwent sigmoidectomy for sigmoid colon cancer were prospectively randomized into two groups: the “ligatures group”, in which bowel ligatures were placed, 3, 5, 10 cm from the tumor proximally and distally before dissection; and the “no ligatures group”, in which the corresponding sites were ligated only immediately before taking the specimen out. Each colonic segment ligated was irrigated with saline and samples were sent for blind cytological examination.

Results

Cancer cells were found in the colonic segment where the tumor was located, in 18 of 20 samples. The frequency of free cancer cells decreased from 50 to 0 % (p < 0.04) in the distal 3–5 cm colonic segment and from 80 to 20 % (p < 0.03) in the proximal colonic segment after performing bowel ligatures. Free cancer cells were confirmed in 1 of 10 samples at both colonic segments 5–10 cm from the tumor, even after bowel ligatures.

Conclusions

Intraluminal exfoliated cancer cells could be eliminated by placing bowel ligatures during sigmoidectomy. Measures should be considered to eliminate exfoliated cancer cells during colectomy, even after placing bowel ligatures.     

Prognostic Factors and Causes of Death in Patients Cured of Esophageal Cancer

Background

The number of patients cured of esophageal cancer after esophagectomy is gradually increasing owing to advances in surgical techniques, perioperative management, and adjuvant therapies. This study assessed the clinical course and sought to identify the prognostic factors of these patients.

Methods

A series of 220 consecutive patients who underwent esophagectomy and survived for more than 5 years with no relapse were enrolled. Survival analysis was performed using 25 variables including patient characteristics and operative and perioperative factors. Potential prognostic factors were identified by univariate and multivariate analyses, and the development of other primary cancers and the causes of death were retrospectively reviewed.

Results

The overall 10-, 15-, and 20-year survival rates were 71.6, 50.1, and 32.2 %, respectively, with a median survival time of 180 months (range, 61–315 months). The negative independent prognostic factors identified were age at surgery [hazard ratio (HR), 1.05; P < .01], being male (HR, 2.62; P = .02), pulmonary comorbidities (HR, 2.03; P = .02), synchronous presence of other cancers (HR, 2.35; P < .01), colonic/jejunal interposition (HR, 1.76; P = .03), perioperative blood transfusion (HR, 1.92; P = .02), development of pulmonary complications (HR, 1.71; P = .02), and adjuvant radiotherapy (HR, 2.13; P = .01). Pulmonary diseases and other primary cancers were found to be the most common causes of death.

Conclusions

Careful follow-up including the surveillance of other primary cancers is required for long-term survivors of esophageal cancer after esophagectomy.     

Beneficial Effects of Tonsillectomy for Mesangial Immunoglobulin A (IgA) Deposition and Clinical Outcome in Five Kidney Transplant Patients With Recurrent IgA Nephropathy: Case Report

Introduction

Tonsillectomy has been applied for recurrent immunoglobulin (Ig)A nephropathy (IgAN) in kidney transplantation recipients, but allograft histologic changes after this treatment remain unclear.

Methods

Five patients with recurrent IgAN underwent tonsillectomy for persistent proteinuria (average, 397.2 mg/d; >6 months). Six repeated biopsies were taken 33.8 ± 17.1 months after treatment. Glomerular IgA deposition was detected by immunofluorescence staining on frozen tissue. Histologic and clinical data have been collected.

Results

An average of 11.2 months (range, 6–20) after tonsillectomy, proteinuria decreased to 60.8 ± 49.3 mg/d. Serum creatinine (SCr) slightly decreased (1.33 ± 0.31 before vs 1.24 ± 0.29 after treatment; P > .05). In 5 of the 6 repeated biopsy samples month after tonsillectomy, there was decreased mesangial IgA deposition. Glomerular crescent and endothelial proliferation were no longer found, although there was increased focal sclerosis and adhesion. After tonsillectomy, there were increased interstitial fibrosis and tubular atrophy, with no significant differences in Banff scores.

Conclusions

Tonsillectomy can reverse not only persistent proteinuria, but also mesangial IgA deposition in patients with recurrent IgAN. Tonsillectomy may have both favorable clinical and histologic effects in recurrent IgAN after kidney transplantation.