Atypical CT findings of pulmonary sarcoidosis: A case report

RATIONALE

Pulmonary involvement occurs in about 90% of patients with sarcoidosis. However, delayed diagnosis sometimes occurs due to atypical thoracic imaging findings.

PATIENT CONCERNS

A 52-year-old woman presented with recurrent uveitis and fever of unknown origin. She had been admitted to the hospital due to fever, but its cause was not determined.

DIAGNOSES

Chest computed tomography (CT) revealed a solitary pulmonary nodule and an enlarged right axillary lymph node. The nodule had showed an interval growth from 0.7 cm to 1.1 cm over 18 months, when compared to the previous chest CT. Mosaic attenuation was also observed.

INTERVENTIONS

The patient underwent thoracoscopic wedge resection of the nodule and excisional biopsy of the enlarged lymph node to exclude malignancy and non-caseating granulomas consistent with sarcoidosis was confirmed.

OUTCOMES

Medical treatment with prednisolone and azathioprine was administered. Fever and uveitis no longer recurred after 6 months of medication. We demonstrated that sarcoidosis shows only atypical pulmonary imaging findings, with an enlarged solitary nodule, an axillary lymphadenopathy, and mosaic attenuation, mimicking a malignancy.

LESSONS

Awareness on atypical CT manifestations that are correlated with pathologic findings may be helpful for early diagnosis of sarcoidosis.

Enhanced sensitivity and responses to viologens from a whole-cell bacterial bioreporter treated with branched polyethyleneimines

AIMS

Evaluate the use of polyethyleneimines (PEIs) as membrane permeabilizers to improve the responses and sensitivity of a bacterial bioreporter strain to viologens.

METHODS AND RESULTS

The responses from E. coli str. EBS, i.e., E. coli BW25113 carrying plasmid pSDS, when exposed to five different viologens were characterized, as were the toxicities of seven different PEIS, including two linear and five branched species. Based on these results, benzyl viologen led to the greatest responses, and 0·8-kDa branched PEI (BPEI) was the least toxic of the PEIs tested and, therefore, both were selected for the subsequent tests. The bioluminescence and relative responses from E. coli str. EBS exposed to various concentrations of 0·8 kDa BPEI identified 400 mg l^-1 as the optimal concentration. Using this concentration, tests were performed with all five of the viologens.

CONCLUSIONS

The responses from E. coli str. EBS to the viologens were improved, with the maximum relative bioluminescence values increasing between 5·6 and 16·5-fold. The minimum detectable levels for four of the viologens were likewise improved 2- to 4-fold.

SIGNIFICANCE AND IMPACT OF STUDY

Improving bacterial membrane permeability in a controlled manner using BPEIs can improve biosensing of toxic compounds, as well as be used in biofuel and bioenergy applications where membrane permeability to a solute is important.

Continuous removal of hydrogen peroxide with immobilised catalase for wastewater reuse

Hydrogen peroxide was continuously removed for wastewater reuse using an immobilised biocatalyst. A commercial catalase, which is an enzyme to decompose hydrogen peroxide to water and oxygen, was entrapped in chitosan beads. Hydrogen peroxide in aqueous solutions of varying pH, temperature and concentration was continuously removed through a reactor containing the catalase-entrapped chitosan beads at high efficiency for 24 h. Additional silicate coating of the chitosan beads resulted in significant improvements in the catalase performance under harsh conditions, which are often found in peroxide-based industrial processes. We expect that immobilisation of catalases can enhance their applicability for continuous degradation of hydrogen peroxide for wastewater reuse.

MOLECULAR AND BIOLOGIC CHARACTERISTICS OF TOXOPLASMA GONDII ISOLATES FROM WILDLIFE IN THE UNITED STATES

Toxoplasma gondii isolates can be grouped into 3 genetic lineages. Type I isolates are considered more virulent in outbred mice and have been isolated predominantly from clinical cases of human toxoplasmosis, whereas types II and III isolates are considered less virulent for mice and are found in humans and food animals. Little is known of genotypes of T. gondii isolates from wild animals. In the present report, genotypes of isolates of T. gondii from wildlife in the United States are described. Sera from wildlife were tested for antibodies to T. gondii with the modified agglutination test, and tissues from animals with titers of 1:25 (seropositive) were bioassayed in mice. Toxoplasma gondii was isolated from the hearts of 21 of 34 seropositive white-tailed deer (Odocoileus virginianus) from Mississippi and from 7 of 29 raccoons (Procyon lotor); 5 of 6 bobcats (Lynx rufus); and the gray fox (Urocyon cinereoargenteus), red fox (Vulpes vulpes), and coyote (Canis latrans) from Georgia. Toxoplasma gondii was also isolated from 7 of 10 seropositive black bears (Ursus americanus) from Pennsylvania by bioassay in cats. All 3 genotypes of T. gondii based on the SAG2 locus were circulating among wildlife.

Computer-aided control of water activity for lipase-catalyzed esterification in solvent-free systems

A computer system for on-line monitoring and control of the water activity (a(w)) in solvent-free media has been developed. The performance of this system was investigated by carrying out the lipase-catalyzed esterification of n-capric acid with n-decyl alcohol. A humidity sensor measured the relative humidity in the reactor headspace, which was then transmitted electrically to a digital computer that was used as a feedback controller. The water activity control was achieved by sparging either humidified air or dried air through the reaction medium at a flow rate determined by the digital feedback controller. The use of humid air and dry air for a(w) control made it possible to induce a larger a(w) gradient and thereby higher water transfer rate. As a result, the water activity quickly reached the desired a(w) values. We tested whether water activity in the reaction medium can be monitored by measuring relative humidity in the headspace. When the water activity in the liquid phase was determined from measurements of water content in the medium and compared to that measured directly with the humidity sensor, the a(w) in the reaction medium did not differ significantly from that in the headspace. This indicates that there is a near-equilibrium between the liquid medium and the exit air stream. Water activity was also successfully maintained close to the set point despite the massive production of water during the esterification process. Thus, the control system developed in this study is particularly useful for systems where large amounts of water are produced and where conventional methods make it difficult to control water activity as a result of a low water transfer rate. The effects that computer control of the water activity had on the reaction rate and yield were also examined. The reaction yield was significantly improved with water activity control. The conversions obtained at 28 h without and those with water activity control were 70% and 96%, respectively. In addition, from the fact that the final yields increased with decreasing a(w), computer-aided water activity control was performed with a set-point change. By controlling a(w) at 0.55 during initial reaction phase, followed by a step change of a(w) from 0.55 to 0 after 11 h of reaction, it was possible to enhance the final conversion to 100%.

Truncation of the TGF-beta type II receptor gene results in insensitivity to TGF-beta in human gastric cancer cells

The transforming growth factor-beta (TGF-beta receptor system has been implicated in the development of resistance to the growth-inhibitory effects of TGF-beta. It has been reported that resistance to TGF-beta correlates with inactivation of the TGF-beta type II receptor (RII). In the present report, we examine the genetic changes in the TGF-beta RII gene of human gastric cancer cell lines, SNU-5 and SNU-668, which we had previously reported to express truncated TGF-beta RII transcripts. By independent PCR and Southern hybridization analysis of genomic DNA, we found that the genomic sequence of TGF-beta RII is truncated after exon 2 in SNU-5 and after exon 3 in SNU-668. This was confirmed by sequencing the TGF-beta RII cDNA cloned from a SNU-5 cDNA library. Predicted TGF-beta RII protein of SNU-5 cells based on sequencing data contains only a part of extracellular domain of TGF-beta RII. We demonstrate that cotransfection of 3TP-Lux and wild type TGF-beta RII restores the TGF-beta responsiveness in SNU-5 cells, suggesting that genetic changes in the TGF-beta RII gene of SNU-5 cells are responsible for the loss of sensitivity to TGF-beta. This is the first report demonstrating that truncation of the TGF-beta RII gene is an alternative mechanism to inactivate the TGF-beta signal transduction pathways.

Genetic integrity of transforming growth factor beta (TGF-beta) receptors in cervical carcinoma cell lines: loss of growth sensitivity but conserved transcriptional response to TGF-beta

Transforming growth factor beta (TGF-beta) exerts an inhibitory effect on the growth of most epithelial cell types, and the loss of responsiveness to this growth inhibition has been implicated in the development of a variety of human cancers. The genetic alteration of TGF-beta receptors is known to play a critical role in this escape from growth regulation. We asked whether there is a correlation between TGF-beta sensitivity and the genetic status of TGF-beta type I and type II receptors (RI and RII, respectively) in human cervical carcinoma cell lines. Among 8 cell lines examined, 3 (ME-180, C-33A and HeLaS3) showed resistance to TGF-beta and 3 (SiHa, CaSki and HeLa229) showed minimal response to the growth inhibitory effect of TGF-beta; the other cell lines (HeLa and HT-3) were sensitive. Northern blot analysis revealed that the RII mRNA was not expressed in 2 TGF-beta-resistant cell lines (ME-180 and C-33A) but was expressed in the other cell lines. Southern blot analysis of RI and RII revealed a homozygous deletion of the entire TGF-beta RII gene in the cell line ME-180. We then asked whether the other TGF-beta-resistant or refractory cell lines had microsatellite instability and/or poly-adenine tract mutations of RII. We also checked for point mutations in the individual exons of the entire RII using polymerase chain reaction-single-strand conformational polymorphism (PCR-SSCP). Although C-33A exhibited poly-adenine microsatellite instability, its RII gene showed no signs of mutation. The molecular integrity of the TGF-beta, receptors in all cell lines, except ME-180 and C-33A, could be confirmed by examining the distinct transcriptional induction of plasminogen activator inhibitor-1 (PAI-1), p21(WAF1/CIP1) and, in some cases, the accompanying downregulation of c-myc in response to TGF-beta. Our observations, taken together, indicate that inactivation of the RII contributes to the resistance to TGF-beta of some cervical carcinoma cell lines. Loss of or attenuated sensitivity to TGF-beta growth inhibition in other cells may be attributed to the disruption of distal components in the TGF-beta signal pathway, but not to the receptor system.