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Abstract

Clinical Neuropathology, Vol. 36 – No. 4/2017 (183-187)

Synchronous ganglioneuroma and schwannoma of the vagal inferior ganglion

Shaolong Yang¹, Danhui Zhao², Jie Wei², and Peifeng Li²#³

¹Department of Pathology, Zhengzhou Railway Vocational and Technical College, Zhengzhou, ²State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi’an, and ³Department of Pathology, General Hospital of Jinan Military Command, Jinan, China
Neurogenic neoplasms resulting from autonomic nerves are considerably rare. In this paper, we report a case of a 41-year-old woman with composite tumor of synchronous ganglioneuroma and schwannoma in the vagal inferior ganglion. Ultrasonography and computed tomography showed a well-defined mass, which extruded from the internal and external carotid arteries. Two tumors were closely attached but with an evident boundary. The small tumor was composed of spindle cells and numerous mature ganglion cells, and the large one consisted entirely of differentiated neoplastic Schwann cells. Results showed that these tumors were a schwannoma arising in a ganglioneuroma of the vagal inferior ganglion. Our case is the first to demonstrate the occurrence of schwannoma in benign ganglioneuroma. We also provided clinical and pathological evidence that such transformation can occur spontaneously. Correspondence to:
Peifeng Li, MM
Department of Pathology, School of Basic Medicine
Fourth Military Medical University
Changle West Road #169, Xi’an 710032, China
Email: [email protected]

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 57 – No. 2/2019 (101-109)

Effect of purple grape juice on the pharmacokinetics of digoxin:  Results of a food-drug interaction study 

Xia Song¹, Yang Ju², Hui Zhao³, and Wen Qiu¹

¹Department of Clinical Pharmacy, ²Department of Drug Research and Development, and ³Department of Drug Regulatory, Lanzhou University Second Hospital, Lanzhou, Gansu, China
Objective: Digoxin is a glycosidic, cardiotonic plant extract with a narrow therapeutic window. The purpose of the study was to investigate the effects of purple grape juice on the pharmacokinetics of digoxin in rats. Materials and methods: A randomized, controlled, single- and multiple-dose study was conducted to evaluate the pharmacokinetic profiles of orally and intravenously administered digoxin. The plasma concentration of digoxin was determined by radioimmunoassay using a gamma counter, and a Caco-2 cell transport model was used to investigate the potential mechanism by which purple grape juice affects the pharmacokinetics of digoxin. Results: The results show that multiple-dose purple grape juice caused a remarkable increase in the AUC, C<sub>max</sub>, and Ka of orally administered digoxin (p < 0.05); only a single dose increased the digoxin AUC<sub>0–∞</sub> by 72.80% (p < 0.05). Other parameters were not significantly affected. The study of intravenously administered digoxin found no significant difference in the pharmacokinetic characteristics of the two dosing groups (p > 0.05). The Caco-2 transwell experiments indicated that both the pure purple grape juice and its ethyl acetate extract significantly inhibited digoxin basolateral-to-apical (B→A) transport at concentrations of 10%, 30%, and 50% with dose dependency. These results confirmed that the improvement in bioavailability of digoxin resulted from the inhibition of P-gp by purple grape juice at the level of the gastrointestinal wall. Conclusion: Purple grape juice can increase the bioavailability of orally administered digoxin, especially with multiple doses. This information suggests that co-administration of oral digoxin and purple grape juice may require a dose adjustment. Correspondence to:
Wen Qiu, PD 
Lanzhou University Second Hospital
Cuiying men Road 82#, Lanzhou 730030, China
Email: [email protected]

Abstract

Jian Zhang¹,², Junyue Huang¹, Bin Zhou³, Limin Tian⁴,⁵, Zhigang Ma⁶, Wenhui Huang¹, and Hui Zhao¹,⁴

¹Department of Nephrology, Gansu Provincial Hospital, ²The Second Hospital & Clinical Medical School, Lanzhou University, ³The Blood Purification Center of Gansu Provincial Hospital, ⁴College of Integrated Traditional Chinese and Western Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou, ⁵Department of Endocrinology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, and ⁶Department of Nephrology, The Second Affiliated Hospital of The Chinese University of Hong Kong, Shenzhen (Longgang District People’s Hospital), Shenzhen, China
Renal clear cell carcinoma (RCC), the predominant subtype of kidney cancer, is characterized by paraneoplastic syndromes, of which membranous nephropathy (MN) represents the most common paraneoplastic glomerulonephritis. While phospholipase A2 receptor (PLA2R) antibodies indicate primary MN, the concurrent presence of light-chain amyloidosis may further complicate the clinical manifestations in malignancy-associated cases. A rare case of RCC concurrent with phospholipase A2 receptor PLA2R-positive MN and light chain amyloidosis is reported in this paper. An elderly male patient presented with nephrotic syndrome and a right renal mass. The patient underwent a nephrectomy after admission. Pathological examination confirmed the diagnosis of right kidney renal clear cell carcinoma. Renal biopsy revealed PLA2R-positive MN and AL amyloidosis. Interestingly, in this case, glomerular light chain staining showed no monoclonal restriction, but λ light chain deposition was found in the vessels. However, the nephrotic syndrome showed no improvement after tumor resection. The patient achieved remission following sequential treatment with bortezomib, dexamethasone, daratumumab, and rituximab. This case illustrates the complex interplay among RCC, PLA2R-positive MN, and AL amyloidosis, complicating patient management. Future research should focus on the immunological mechanisms of PLA2R antibody production in malignancy and the pathophysiological links among these conditions. Clinicians should remain vigilant for secondary causes of nephrotic syndrome in renal malignancy patients and adopt comprehensive, multidisciplinary approaches to improve outcomes. Correspondence to:
Hui Zhao, MD, 204 Donggang West Road, Chengguan District, Lanzhou 730000, Gansu, China
Email: [email protected]

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