ACUTE ULTRASTRUCTURAL CHANGES OF THE TRABECULAR MESHWORK AFTER SELECTIVE LASER TRABECULOPLASTY AND LOW POWER ARGON LASER TRA- BECULOPLASTY

Purpose: To compare the histopathological changes in the human trabecular meshwork after low power argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT) with a Q-switched, frequency-doubled, neodymium:yttrium-alumini-um-garnet (Nd:YAG) laser. Methods: In gonioscopically normal trabecular meshwork of three patients awaiting enucleation due to malignant melanoma of the choroid SLT and ALT were per-

Expression of cyclooxygenase-2 is associated with p53 accumulation in premalignant and malignant gallbladder lesions

AIM： To examine the relationship between cyclooxygenase-2 （COX-2） overexpression and p53 accumulation in gallbladder carcinoma and its precursor lesions.METHODS： Sixty-eight gallbladder tissue samples comprising 14 cases of normal gallblader epithelium, 27 cases of dysplasia （11 low-grade dyplasia and 16 high-grade dysplasia） and 27 adenocarcinomas were evaluated by immunohistochemistry for COX-2 expression and p53 accumulation. The relationship among COX-2 expression, p53 accumulation and clinicopathological characteristics was analysed.RESULTS： COX-2 was expressed in 14.3% of normal gallbladder epithelium, 70.3% of dysplastic epite hlium, and 59.2% of adenocarcinomas. When divided into low- and high-grade dysplasia, COX-2 was positive in 5 （45.4%） cases of low-grade and 2d （87.5%） of high- grade dysplasia （P = 0.019）. Accumulation of p53 was detected in 5 （32.2%） cases of high-grade dysplasia and in 23 （48.2%） of carcinomas. No p53 accumulation was found in normal epithelium or low-grade dysplasia. COX-2 overexpression was observed in 27 of 28 （94.4%） cases with p53-accumulation in comparison with 20 （40.0%） out of 50 cases without p53 accumulation （P 〈 0.001）.CONCLUSION： The significant differences in COX-2 expression among normal epithelium, low-grade dysplasia and high-grade dysplasia suggest that overexpression of COX-2 enzyme is an early event in gallbladder carcinogenensis. Furthermore, since accumulation of p53 correlates with COX-2 expression, COX-2 overexpression observed in gallbladder high-grade dysplasia and carcinoma might be partly due to the dysfunction of p53.

Clinico-pathological aspects of colorectal serrated adenomas

AIM： To study the association of colorectal serrated adenomas （SAs） with invasive carcinoma, local recurrence, synchronicity and metachronicity of lesions. METHODS： A total of 4536 polyps from 1096 patients over an eight-year period （1987-1995） were retrospectively examined. Adenomas showing at least 50% of serrated architecture were called SAs by three reviewing pathologists. RESULTS： Ninety-one （2%） of all polyps were called SAs, which were found in 46 patients. Invasive carcinomas were seen in 3 out of 46 （6.4%） patients, of whom one was a case of familial adenomatous polyposis （FAP）. A male preponderance was noted and features of a mild degree of dysplasia were seen in majority （n=75, 83%） of serrated adenomas. Follow-up ranged 1-12 years with a mean time of 5.75 years. Recurrences of SAs were seen in 3 （6.4%） cases, synchronous SAs in 16 （34.8%） cases and metachronous SAs in 9 （19.6%） cases. CONCLUSION： Invasive carcinoma arising in serrated adenoma is rare, accounting for 2 （4.3%） cases studied in this series.

Wells’syndrome possibly caused by hematologic malignancy,influenza vaccination or ibrutinib:A case report

BACKGROUND Wells’ syndrome(eosinophilic cellulitis) is an uncommon eosinophilic dermatosis of uncertain pathogenesis,characterized by clinical polymorphism and suggestive but nonspecific histopathologic traits.Its course is recurrent,and response to therapy is unpredictable.In a case in which the patient has a number of potential triggers for the manifestation of Wells’ syndrome skin rash,the treating physician must decide or must make an assumption in order to establish the most likely clinical scenario.This is important for the patient’s future treatment plans.CASE SUMMARY We describe the clinical case of a 46-year-old female with chronic lymphocytic leukemia who had already received treatment for several months with ibrutinib.She was diagnosed with Wells’ syndrome 10 d after an influenza vaccination containing thimerosal.Based on the literature,the patient was treated with a course of oral steroids.Resolution of clinical symptoms and rash were observed in response to the treatment.Ibrutinib was not discontinued.CONCLUSION The etiology of Wells’ syndrome remains unknown.Clinically,it resembles bacterial cellulitis.Lack of response to antibiotic treatment should lead the physician to consider a diagnosis of Wells’ syndrome.Treating the underlying condition is important and may lead to resolution of the syndrome.However,the most common and effective treatment to limit the course of the disease are systemic steroids.

Single-cell transcriptome profiling of human HSCs during development:new insights into HSC ontogeny

A study recently published in Nature reported a single-cell transcriptome map of human hematopoietic stem cells(HSCs)and a gene expression signature that distinguishes nascent HSCs from non-HSCs during prenatal development.1 This transcriptome map provides an important tool for further elucidation of human HSC ontogeny and could also serve as a guide for generation of transplantable HSCs ex vivo,1 to widen the therapeutic application of HSCs.

AP4 induces JNK1 and a miR-22-3p/FOSL1 feed-forward loop to activate AP-1 and promote colorectal cancer metastasis

Dear Editor,Colorectal cancer(CRC)is the third most deadly can-cer worldwide[1].The mortality of CRC has remained high due to limited treatment options for metastatic CRC(mCRC)[2].Epithelial-mesenchymal transition(EMT)is an important contributor to mCRC[2].The c-MYC proto-oncogene(MYC)-induced transcription factor AP4(TFAP4/AP4)isadriverofEMT,therebypresumablyfacil-itates mCRC[3,4].The mitogen-activated protein kinase(MAPK)/c-JunN-terminalkinase(JNK)/activatorprotein-1(AP-1)pathway has been implicated in the regulation of EMT and mCRC[5].