Malignant psoas syndrome associated with gynecological malignancy: Three case reports and a review of the literature

Malignant psoas syndrome (MPS) is a rare and unique cancer-associated syndrome caused by the malignant involvement of the psoas major muscle, and is characterized by ipsilateral lumbosacral plexopathy and painful hip flexion. The pain in MPS is often distressing and intractable, and there is no established effective treatment approach. Herein, the present study reports on three cases of MPS associated with gynecological malignancies, wherein symptom improvement was observed following chemotherapy or radiotherapy. Among 39 cases documented in the literature, female genital tract malignancies were the most frequent causes of MPS; however, the condition may be under-diagnosed, owing to the lack of general recognition. Considering the development of recent high-precision radiation therapy, palliative radiotherapy may serve an important role in the management of MPS. For physicians treating gynecological cancers, early detection of MPS is clinically important as this may allow patients to receive possible therapies and improve their quality of life in end-stage cancer. Further prospective studies should be performed to evaluate effective therapeutic approaches for MPS.

Humoral hypercalcemia caused by uterine corpus carcinosarcoma consisting of squamous cell carcinoma in its epithelial component

Humoral hypercalcemia of malignancy (HHM) is a paraneoplastic syndrome primarily caused by a tumor-producing parathyroid hormone-related protein (PTH-rP). We describe the first reported case of a uterine carcinosarcoma causing HHM. A 70-year-old patient was transferred to our hospital for a uterine tumor accompanied by impaired consciousness. The laboratory tests indicated anemia, malnutrition, elevated serum calcium and elevated PTH-rP. Emergency surgery, including abdominal hysterectomy and bilateral salpingo-oophorectomy, was performed due to uncontrollable uterine bleeding. The pathological diagnosis was carcinosarcoma consisting of pure squamous cell carcinoma in its epithelial component. Postoperatively, chemotherapy with paclitaxel and carboplatin was performed. The patient had recurrent tumors at the para-aortic lymph nodes 11 months after the initial surgery and underwent a pelvic and para-aortic lymphadenectomy, which removed all of the recurrent tumors.

Comparison of sensitivity of lung nodule detection between radiologists and technologists on low-dose CT lung cancer screening images

OBJECTIVES

The objective of this study was to compare the sensitivity of detection of lung nodules on low-dose screening CT images between radiologists and technologists.

METHODS

11 radiologists and 10 technologists read the low-dose screening CT images of 78 subjects. On images with a slice thickness of 5 mm, there were 60 lung nodules that were ≥5 mm in diameter: 26 nodules with pure ground-glass opacity (GGO), 7 nodules with mixed ground-glass opacity (GGO with a solid component) and 27 solid nodules. On images with a slice thickness of 2 mm, 69 lung nodules were ≥5 mm in diameter: 35 pure GGOs, 7 mixed GGOs and 27 solid nodules. The 21 observers read screening CT images of 5-mm slice thickness at first; then, 6 months later, they read screening CT images of 2-mm slice thickness from the 78 subjects.

RESULTS

The differences in the mean sensitivities of detection of the pure GGOs, mixed GGOs and solid nodules between radiologists and technologists were not statistically significant, except for the case of solid nodules; the p-values of the differences for pure GGOs, mixed GGOs and solid nodules on the CT images with 5-mm slice thickness were 0.095, 0.461 and 0.005, respectively, and the corresponding p-values on CT images of 2-mm slice thickness were 0.971, 0.722 and 0.0037, respectively.

CONCLUSION

Well-trained technologists may contribute to the detection of pure and mixed GGOs ≥5 mm in diameter on low-dose screening CT images.

Molecular phylogenetic analyses reveal a close evolutionary relationship between Podosphaera (Erysiphales: Erysiphaceae) and its rosaceous hosts

Podosphaera is a genus of the powdery mildew fungi belonging to the tribe Cystotheceae of the Erysiphaceae. Among the host plants of Podosphaera, 86 % of hosts of the section Podosphaera and 57 % hosts of the subsection Sphaerotheca belong to the Rosaceae. In order to reconstruct the phylogeny of Podosphaera and to determine evolutionary relationships between Podosphaera and its host plants, we used 152 ITS sequences and 69 28S rDNA sequences of Podosphaera for phylogenetic analyses. As a result, Podosphaera was divided into two large clades: clade 1, consisting of the section Podosphaera on Prunus (P. tridactyla s.l.) and subsection Magnicellulatae; and clade 2, composed of the remaining member of section Podosphaera and subsection Sphaerotheca. Because section Podosphaera takes a basal position in both clades, section Podosphaera may be ancestral in the genus Podosphaera, and the subsections Sphaerotheca and Magnicellulatae may have evolved from section Podosphaera independently. Podosphaera isolates from the respective subfamilies of Rosaceae each formed different groups in the trees, suggesting a close evolutionary relationship between Podosphaera spp. and their rosaceous hosts. However, tree topology comparison and molecular clock calibration did not support the possibility of co-speciation between Podosphaera and Rosaceae. Molecular phylogeny did not support species delimitation of P. aphanis, P. clandestina, P. ferruginea, P. spiraeae and P. tridactyla in their current circumscriptions, which suggests the need for revision of these species.

Molecular phylogeny and taxonomy of Eurasian Neoerysiphe species infecting Asteraceae and Geranium

Because Eurasian samples of Neoerysiphe collected on the Asteraceae were not identical in morphology, the molecular and morphological differences among these specimens were compared with those of the American N. cumminsiana. Neoerysiphe on Asteraceae was found to consist of at least four different species. Three of them are described as new species, viz. N. hiratae, N. joerstadii, and N. nevoi. Neoerysiphe hiratae is a Japanese species parasitizing hosts belonging to the genera Cacalia and Ligularia (tribe Senecioneae). Neoerysiphe joerstadii was found in Israel on Phagnalon rupestre (tribe Gnaphalieae). Neoerysiphe nevoi was recorded in Israel and Ukraine on a number of hosts in different genera but all belonging to tribe Cichorieae. Thus, Eurasian Neoerysiphe species infecting the Asteraceae are strongly specialised to particular tribes of this family. Phylogenetic analyses indicated that the three new species were not closely allied. Neoerysiphe hiratae is related to the American N. cumminsiana and species belonging to Oidium subg. Striatoidium. Neoerysiphe nevoi is sister to N. geranii, and N. joerstadii is allied to N. galii. In addition, Ukrainian Neoerysiphe samples on Geranium were phylogenetically and morphologically identical to Japanese samples of N. geranii, and this fungus seems to be an invasive species in Ukraine.

Rapid and accurate identification of microorganisms contaminating cosmetic products based on DNA sequence homology

The aim of this study was to develop rapid and accurate procedures to identify microorganisms contaminating cosmetic products, based on the identity of the nucleotide sequences of the internal transcribed spacer (ITS) region of the ribosomal RNA coding DNA (rDNA). Five types of microorganisms were isolated from the inner portion of lotion bottle caps, skin care lotions, and cleansing gels. The rDNA ITS region of microorganisms was amplified through the use of colony-direct PCR or ordinal PCR using DNA extracts as templates. The nucleotide sequences of the amplified DNA were determined and subjected to homology search of a publicly available DNA database. Thereby, we obtained DNA sequences possessing high similarity with the query sequences from the databases of all the five organisms analyzed. The traditional identification procedure requires expert skills, and a time period of approximately 1 month to identify the microorganisms. On the contrary, 3-7 days were sufficient to complete all the procedures employed in the current method, including isolation and cultivation of organisms, DNA sequencing, and the database homology search. Moreover, it was possible to develop the skills necessary to perform the molecular techniques required for the identification procedures within 1 week. Consequently, the current method is useful for rapid and accurate identification of microorganisms, contaminating cosmetics.

Neuroprotective effect of chronic lithium treatment against hypoxia in specific brain regions with upregulation of cAMP response element binding protein and brain-derived neurotrophic factor but not nerve growth factor: comparison with acute lithium treatment

OBJECTIVES

We evaluated the neuroprotective effect of chronically or acutely administered lithium against hypoxia in several brain regions. Furthermore, we investigated the contribution of brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and cAMP response element binding protein (CREB) to the neuroprotective effect of lithium.

METHODS

Brain slices were prepared from rats that had been treated chronically or acutely with lithium. The cerebral glucose metabolic rate (CMRglc) before and after hypoxia loading to brain slices was measured using the dynamic positron autoradiography technique with [(18)F]2-fluoro-2-deoxy-D-glucose. The changes of expression of proteins were investigated using Western blot analysis.

RESULTS

Before hypoxia loading, the CMRglc did not differ between the lithium-treated and untreated groups. After hypoxia loading, the CMRglc of the untreated group was significantly lower than that before hypoxia loading. However, the CMRglc of the chronic lithium treatment group recovered in the frontal cortex, caudate putamen, hippocampus and cerebellum, but not in the thalamus. In contrast, the CMRglc of the acute lithium treatment group did not recover in any analyzed brain regions. After chronic lithium treatment, the levels of expression of BDNF and phospho-CREB were higher than those of untreated rats in the frontal cortex, but not in the thalamus. However, the expression of NGF did not change in the frontal cortex and thalamus.

CONCLUSIONS

These results demonstrated that lithium was neuroprotective against hypoxia only after chronic treatment and only in specific brain regions, and that CREB and BDNF might contribute to this effect.

Region-specific induction of hypoxic tolerance by expression of stress proteins and antioxidant enzymes

We examined the induction of hypoxic tolerance after hypoxic preconditioning in the frontal cortex, caudate putamen and thalamus using the dynamic positron autoradiography technique and [18F]2-fluoro-2-deoxy-D-glucose with rat brain slices. Hypoxic tolerance induction was confirmed in the frontal cortex, but not in the caudate putamen and thalamus. Next, we compared the gene expression in the frontal cortex and caudate putamen using the ATLAS Rat Stress Array, and found that the expression of 150-kDa oxygen-regulated protein and mitochondrial heat shock protein 70 as stress proteins, and copper-zinc-containing superoxide dismutase and manganese-containing superoxide dismutase as antioxidant enzymes was elevated only in the frontal cortex. These results suggest that the induction of hypoxic tolerance after hypoxic preconditioning is region-specific, and stress proteins and antioxidant enzymes participate in this phenomenon.

Microbial community change of sulfate reduction and sulfur oxidation bacteria in the activated sludge cultivated with acetate and peptone

The growth of sulfate reducing bacteria (SRB) and filamentous sulfur bacteria was monitored on a laboratory scale in activated sludge reactors using acetate and peptone as the artificial wastewater. When the artificial wastewater contained acetate and peptone, filamentous bacteria increased in the sludge and the SVI values increased. There was a good correlation between sulfate reducing activity and sulfur oxidation activity in the produced sludge. The microbial community change of filamentous sulfur bacteria and sulfate reducing bacteria was analyzed using the fluorescent in situ hybridization (FISH) method. The tendency for the growth of filamentous sulfur bacteria Thiothrix eikelboomii following the growth of SRB was observed. The percentage of SRB385- hybridized cells and DNMA657-hybridized cells found in the total cell area increased from 2-3% to 7-10% when the filamentous bulking occurred.

Intraluminal duodenal diverticulum: MR findings

We report a case of intraluminal duodenal diverticulum with special reference to its magnetic resonance imaging findings. An intraluminal duodenal fluid collection surrounded by a hypointense rim on T2-weighted or magnetic resonance cholangiopancreatographic images, the shape of which is changed by peristalsis, is considered to be almost diagnostic for intraluminal duodenal diverticulum.

Solid serous cystadenoma of the pancreas: MR imaging with pathologic correlation

We report a case of solid type serous cystadenoma of the pancreas. Computed tomographic and magnetic resonance (MR) images showed a hypervascular solid tumor that was difficult to differentiate from endocrine tumor of the pancreas. However, the tumor showed marked hyperintensity similar to that of hepatic cyst on MR cholangiopancreatography, indicating not a solid but rather a cystic nature. MR cholangiopancreatography (heavily T2-weighted image) is quite useful for clearly differentiating solid from cystic tumors.

Treatment strategy for Boerhaave's syndrome

Esophageal rupture is a potentially mortal condition. Rapid and correct diagnosis, and urgent surgical treatment with esophagectomy is indicated, but conservative and other surgical treatments have also been reported recently. The treatment strategies for esophageal rupture are discussed here, based on our experiences with four cases during the last 10 years. They were admitted urgently and each was treated by a different method. Three of them underwent emergency operations, one undergoing primary closure of the ruptured esophagus, another received a T-tube insertion from the ruptured site with omental flap, and the third an esophagogastrectomy. The fourth case was treated conservatively. All patients survived and were discharged 36-144 days post treatment. One of them was readmitted for debridement of necrotic rib. In conclusion, the prompt and accurate diagnosis of esophageal rupture is crucial for a subsequent successful treatment. Conservative treatment or operation including esophagectomy will be determined by the severity of the condition.

Introduction of a benzoyl group onto 6-chloropurine riboside in aqueous solution and its application to the synthesis of nucleoside derivatives

A benzoyl group was introduced onto the 3'-hydroxyl group of 6-chloropurine riboside by treatment with benzoic anhydride in the presence of a base in aqueous solution. The product (3b) was converted to 9-(2,3-Di-deoxy-2-fluoro-beta-D-threo-pentofuranosyl)adenine (1, FddA) in 6 steps, including radical deoxygenation.