Seijin Nadano

In situ characterization of dendritic cells occurring in the islets of nonobese diabetic mice during the development of insulitis.

Type 1 diabetes mellitus in nonobese diabetic (NOD) mice, a well-known model of human type 1 diabetes, has been considered to be caused by the destruction of insulin-producing &bgr; cells in the islets of the pancreas by self-reactive T cells. Antigen-presenting cells like dendritic cells (DCs) and macrophages are expected to be involved in the processes from their role in generating regulatory or effector T cells. These immunohistochemical studies revealed that CD11c-positive DCs already appeared in the islets of NOD mice as early as 4 weeks old when lymphocytes were not yet infiltrated in the islet, and thus insulitis was not developed. DCs were first observed to locate around swollen parainsular vessels. From age 7 weeks onward to age 13 weeks, more DCs were present in parainsular areas where lymphocytes had also accumulated, and the number of DCs in the islets as well as lymphocytes increased. However, at the end stage of insulitis from age ∼17 weeks onward, the number of DCs in the islets decreased. In contrast, accumulation of DCs in the para-and periislets was not observed in 7-and 17-week-old ICR female mice that do not develop type 1 diabetes. Double-staining studies using confocal laser scanning microscopy showed that the CD11c-positive DCs coexpress both major histocompatibility (MHC) class II and costimulatory molecules, CD80 and CD86. Electron-microscopy studies further demonstrated that cell bodies and processes of the DCs make close contact with lymphocytes. These results suggest that DCs infiltrated into the pancreatic islets are capable of stimulating T cells by the MHC class II–antigenic peptide complex, together with costimulatory molecules, which eventually lead to the &bgr;-cell destruction in NOD mice.

Des-gamma-carboxy prothrombin identified by P-11 and P-16 antibodies reflects prognosis for patients with hepatocellular carcinoma

Serum des‐γ‐carboxy prothrombin (DCP) is an established tumor marker in patients with hepatocellular carcinoma (HCC), which can be identified by using MU‐3 antibody. The MU‐3 antibody mainly reacts with the 9–10 glutamic acid residues of DCP (conventional DCP). Since other variants of DCP with fewer glutamic acid residues can be detected using P‐11 and P‐16 antibodies (code name: NX‐PVKA), we examined the clinical characteristics associated with NX‐PVKA, and whether NX‐PVKA is a useful measure in HCC patients.

Primary extranodal non-Hodgkin’s lymphoma of the common bile duct manifesting as obstructive jaundice: Report of a case

Primary non-Hodgkin’s lymphoma (NHL) of the common bile duct (CBD) manifesting as obstructive jaundice is extremely rare: to our knowledge, only 22 cases of primary NHL arising from the CBD have been reported. The patient in this case report was a 63-year-old man who presented with obstructive jaundice. Abdominal sonography, positron emission tomography, and computed tomography showed a mass with abnormal 18-fluorodeoxyglucose uptake in pancreatic head. Magnetic resonance cholangiopancreatography demonstrated a strictured segment of the CBD with proximal bile duct dilatation. We performed pancreaticoduodenectomy for a presumptive diagnosis of pancreatic head carcinoma or cholangiocarcinoma of the CBD. However, the histological diagnosis was a primary, diffuse, large B-cell lymphoma of the CBD. He received three courses of combination chemotherapy, including rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). The patient remains well, without evidence of tumor recurrence, 8 months after surgery. In summary, primary NHL of the CBD, despite its rarity, should be considered in the differential diagnosis of obstructive jaundice. An accurate histopathologic diagnosis and complete surgical resection, followed by combination chemotherapy plus rituximab may be effective.

Characteristics of geographic distributions and route of infection for hepatitis B virus genotype D in Ehime area in western Japan

Aims:  Hepatitis B virus genotype D (HBV/D) is rare in Japan, and has been shown to circulate in Ehime prefecture in western Japan. HBV/D is suspected to have been transferred into Ehime from Russia as a result of the Japanese–Russian War. This study examined the current geographic spread and infectious route for HBV/D in Ehime.

Multicenter cooperative case survey of hepatitis B virus reactivation by chemotherapeutic agents

The purpose of this multicenter cooperative study was to elucidate the clinical features of hepatitis B virus (HBV) reactivation by chemotherapeutic agents and the patient outcomes after HBV reactivation by a retrospective review of accumulated patients’ medical records.

A case of metachronous multiple pancreatic cancer that sets up 9 years after the initial operation for pancreatic cancer with osteoclast-like giant cell tumor of the pancreas

66歳，男性．平成11年，膵癌にて膵体尾部切除を施行し，組織型は類破骨細胞型巨細胞癌であった．経過観察中の平成20年2月にCA19-9の上昇を認め，PET/CTにおいて残存膵頭部の腫瘤及び同部位へのFDG集積所見より膵癌再発を疑われ，当院紹介となった．術前の造影CTにおける進展度はT4（TS2，CH（-），DU（-），S（+），RP（+），PV（+），A（-），PL（-），OO（-））N2M0，Stage IVbであった．膵頭十二指腸切除に臨んだが，開腹時に腹腔動脈周囲神経叢への浸潤を認め，切除不能と判断し，試験開腹で終了した（組織診断：tubular adenocarcinoma）．その後はgemcitabineによる化学療法を施行している．本症例は膵破骨細胞型巨細胞癌の術後9年目にして管状腺癌（tubular adenocarcinoma）を発症した極めて稀な症例と考える．