A Case of Fascioliasis Treated Successfully Without Sequelae in a Japanese Expatriate Living in Jakarta

A 46-year-old Japanese female expatriate living in Jakarta presented with intermittent fever lasting for a month. Although she was considered at low risk of Fasciola spp. infection because she lived in an upper-class residential area of the city, the patient presented with eosinophilia after consuming organic raw vegetables; in addition, contrast-enhanced computed tomography detected microabscesses in a tractlike pattern in the liver. These findings led to an early diagnosis of fascioliasis, which was successfully treated without sequelae. In any patient with a history of consuming raw vegetables, fascioliasis should be suspected regardless of where the patient has lived

Enhanced Expression of Long Non-Coding RNA HOTAIR Is Associated with the Development of Gastric Cancer

<div><p>The long non-coding RNA HOTAIR has been reported to be a poor prognostic biomarker in a variety of malignant tumors. However, little is known about the association of HOTAIR with gastric cancer. We examined the expression of HOTAIR in 68 gastric cancer samples using quantitative real-time RT-PCR and analyzed its correlation with the clinical parameters. The functional role of HOTAIR was examined by generating human gastric cancer cell lines with increased or suppressed HOTAIR expression. The anchorage -independent growth was assessed by soft agar assay. The increased or suppressed HOTAIR expressing gastric cancer cells were injected into the tail vein or peritoneal cavity of immunodeficient mice to examine the effect of this molecule on metastasis and peritoneal dissemination. The expression of HOTAIR was significantly higher in cancer lesions than in adjacent non-cancerous tissues in human gastric cancers. In the diffuse type of gastric cancer, the High-HOTAIR group (HOTAIR/GAPDH > 1) showed significantly more venous invasion, frequent lymph node metastases and a lower overall survival rate compared to the Low-HOTAIR group (HOTAIR/GAPDH < 1). Colony formation on the soft agar was enhanced in a HOTAIR-dependent manner. HOTAIR-expressing MKN74 formed more liver metastasis compared to control when they were injected into the tail vein of mice. In addition, reduced expression of HOTAIR in KATO III suppressed peritoneal dissemination. These results suggest that HOTAIR plays a pivotal role in the development of gastric cancer.</p> </div

The association of HOTAIR expression with liver metastasis.

<p><b>A</b>, The effect of HOTAIR on metastasis was investigated by tail vein assay. 1.0 x 10⁵ of HOTAIR expressing cells (MKN-HOTAIR, n=9) and control cells (MKN-EV, n=9) were injected into the tail vein of mice. MKN-HOTAIR cells more frequently showed liver metastases (<i>P</i>=0.01) compared to MKN-EV cells (left panel). In addition, the numbers (middle panel) and sizes of the metastatic liver tumors (right panel) were significant larger with MKN-HOTAIR cells than with MKN-EV cells (<i>P</i>=0.03 and <i>P</i>=0.019, respectively). <b>B</b>, The metastatic tumors could be clearly recognized macroscopically (arrow). <b>C</b>, The tumor cells formed glands and were thought to be derived from the injected human gastric cancer cell lines (left panel, HE, orginal magnification x40). These tumor cells showed intense immunoreactivity for human cytokeratin (right panel).</p

Generation of increased and decreased HOTAIR expressing gastric carcinoma cells and compared relative expression between cell lines and human gastric tissues.

<p><b>A</b>, Relative HOTAIR expression levels in gastric cancer cell lines were analyzed by qRT-PCR analysis. MKN-HOTAIR cells expressed about 10 fold higher levels of HOTAIR than parental MKN74 cells and MKN-EV. On the other hand, the expression of HOTAIR in KATO-shHOTAIR cells was reduced by 30 to 70% compared to parental KATO III and KATO-EV cells. <b>B</b>, The bar graph demonstrated the relative expression of HOTAIR in gastric cancer cell lines, normal and carcinoma tissues of the stomach analyzed in this study. Expression of HOTAIR was normalized to that of GAPDH. Values are expressed relative to 1.00 for expression in parental MKN74 cells.</p

Anchorage-independent cell growth in HOTAIR expressing or down-regulated gastric carcinoma cells.

<p>Potential of anchorage-independent growth of gastric cancer cells was assessed by soft agar assay. MKN-HOTAIR cells formed significantly larger numbers of colonies than MKN-EV cells (<i>P</i>=0.009) (<b>A</b>), while KATO-shHOTAIR cells showed significantly fewer colonies than KATO-EV cells in HOTAIR expression manner (EV versus sh- HOTAIR2, <i>P</i>= 0.016 and EV versus sh-HOTAIR3, <i>P</i>= 0.0035) (<b>B</b>).</p

HOTAIR expression and the peritoneal dissemination of gastric carcinoma cells.

<p><b>A</b>, Peritoneal dissemination was significantly reduced (1/5, <i>P</i>=0.009) when HOTAIR was inactivated in KATO III cells by shRNA transduction, while all control cells formed peritoneal dissemination (5/5). <b>B</b>, The mouse with peritoneal dissemination showed bloody ascites (left panel) and nodules (arrow in right panel) in the peritoneal cavity. <b>C</b>, The nodules in the peritoneal cavity consisted of cancer cells, and some of them had mucin like a signet ring cell carcinoma. They were thought to be derived from the injected human gastric cancer cell lines (HE, original magnification x 100) since these cells showed intense immunoreactivity for human cytokeratin (right panel) .</p

The expression of HOTAIR in human gastric carcinoma tissues.

<p><b>A</b>, HOTAIR expression levels of cancerous and adjacent noncancerous tissues from the gastric cancer patients were examined by qRT-PCR and normalized by the GAPDH expression level. The expression levels of HOTAIR were significantly higher in carcinoma lesions compared to those of non-cancerous lesions (<i>P</i>= 0.019). <b>B</b> and <b>C</b>, The human gastric cancer tissues were further classified according to the HOTAIR expression level into a High-HOTAIR group (HOTAIR / GAPDH >1.0) and Low-HOTAIR group (HOTAIR /GAPDH < 1.0) in the intestinal (B) and diffuse type (C) of gastric cancer, respectively.</p

The correlation between HOTAIR expression level and prognosis of gastric cancer patients.

<p><b>A</b>, In the intestinal type of gastric cancer, no significant relation was seen between the HOTAIR expression and overall survival, although the High-HOTAIR group tended to show shorter survival than the Low-HOTAIR group. <b>B</b>, the High-HOTAIR group showed significantly shorter survival than the Low-HOTAIR group in the diffuse type of gastric cancer (<i>P</i>=0.018).</p