Shinichi Okazaki

Immunohistochemical localization in human tissues of GPI-80, a novel glycosylphosphatidyl inositol-anchored protein that may regulate neutrophil extravasation

Abstract. We molecular-cloned a novel 80-kDa human glycosyl-phosphatidyl inositol (GPI)-anchored protein, designated GPI-80, that may regulate neutrophil extravasation. To identify the possible role of GPI-80 in vivo, we examined the immunohistochemical localization of GPI-80 in various human tissues. Our data show that GPI-80 is mainly located in polymorphonuclear leukocytes (PMNs), endothelial cells of the vessels, parietal cells and mucous neck cells of the stomach, goblet cells of the jejunum, and alveolar macrophages of the lung. The pathomechanisms of these positive findings in the gastric glands and the intestinal glands are not well elucidated and further studies will be needed.

Expression of glucocorticoid receptors in non‐neoplastic lymphoid follicles and B cell type malignant lymphomas

Objective: To evaluate the expression of human glucocorticoid receptors (hGRs), such as hGR (4H2), hGR-α, and hGR-β, in non-neoplastic lymphoid follicles and B cell type malignant lymphomas. Methods: The expression of hGRs in non-neoplastic lymphoid follicles and malignant lymphomas, including diffuse large cell lymphoma, mantle cell lymphoma, and follicular lymphoma, was examined immunohistochemically. HGR (4H2) expression was confirmed by double immunostaining of tissues and in isolated cells from tonsillar germinal centres, and by immunoelectronmicroscopy. Results: In secondary lymphoid follicles of any non-neoplastic diseases—such as chronic tonsillitis, reactive lymphadenitis, and Kimura’s disease—the germinal centre cells often expressed hGR (4H2) and hGR-α. Double immunocytochemical staining of isolated germinal centre cells showed that the majority of hGR (4H2) positive cells were CD20 positive B cells, and that follicular dendritic cells also expressed hGR. Immunoelectronmicroscopy revealed the presence of nuclear hGR (4H2) in the binucleated follicular dendritic cells and germinal centre cells. The frequency of hGR (4H2) expression in diffuse large B cell lymphoma was higher, that in mantle cell lymphoma was lower, and that in follicular lymphoma was intermediate among the types of malignant lymphoma. The hGR (4H2) expression was less frequent in cases of grade I follicular lymphoma. Conclusions: There are differences in hGR expression between the germinal centre and the mantle zone in non-neoplastic lymphoid follicles, and differences of hGR (4H2) expression among the types of malignant lymphoma and grades of follicular lymphoma, which probably contribute to the different steroid sensitivities.

Clinical Investigation of Surgical Closure of Tracheoesophageal Shunt

The purpose of this study was to elucidate the appropriate time for closing a tracheoesophageal shunt for a safe and non-invasive surgical procedure, after acquiring another type of vocal rehabilitation. A tracheoesophageal shunt is globally considered to be the most useful tool for excellent vocal rehabilitation; nevertheless, it must be closed for several reasons. In some cases, surgical closure of a tracheoesophageal shunt is difficult due to poor histological conditions around the shunt. We herein propose a new strategy of vocal rehabilitation to utilize a tracheoesophageal shunt effectively. Materials and methods: Between 1995 and 2014, 46 patients underwent voice prosthesis insertion surgery. Nine (eight laryngeal cancer patients, one thyroid cancer patient) of these patients underwent surgical closure of a tracheoesophageal shunt. We investigated their cancer treatments, reasons for closing the tracheoesophageal shunt, period of voice prosthesis insertion, operative method, number of operations, and outcome. Results: The reasons for closing the tracheoesophageal shunt were aspiration pneumonia and acquisition of esophageal voice in 4 patients each. Regarding the period of voice prosthesis speech, 6 patients had used it for approximately 3 years and 3 patients for more than 7 years. Approximately all 3-year users underwent a non-invasive surgical procedure, such as triple-layered suture, and their operation succeeded the first time. Conversely, the more than 7-year users required an invasive surgical procedure, such as a pedicle flap, and had to undergo more than one operation. Conclusion: In the present study, tracheoesophageal shunt closure could be performed within 3 years via a safe and non-invasive surgical procedure. We recommend that the operation for a tracheoesophageal shunt be undertaken at a relatively early stage after total laryngectomy. Such patients should acquire esophageal voice within 3 years and undergo surgical closure of the tracheoesophageal shunt as soon as possible.