Co-occurrence of Malignant Melanoma and Squamous Cell Carcinoma on Burn Scars: A Case Report

Tumors arising from burn scars are not rare but sometimes cause the rare co-existence of different tumors. However, detailed information on this topic remains largely unknown. We present a case of the co-occurrence of malignant melanoma and squamous cell carcinoma in a patient with a history of burn scars. A 73-year-old man presented with an erythematous plaque on his left lower leg that gradually turned into a tumor with ulceration. He also presented with scaly tumors at other sites within the same burn scar lesion. He had a history of burns on the left leg at the age of 20 years. After surgical resection of the tumors, histological analysis revealed that the posterior aspect of the largest tumor was malignant melanoma, and the remaining two tumors were squamous cell carcinomas, indicating the co-existence of different types of malignant skin cancers. Based on a literature review of previously published case reports, this is the first report to highlight the importance of complete skin grafts in reducing this risk.

Health guidance for prevention of lifestyle-related diseases using health-related mobile applications

Issue

Lifestyle modifications are essential for the prevention of lifestyle-related diseases such as hypertension, hyperlipidaemia, and type 2 diabetes. Healthcare providers in Japan are required to use information and communications technologies (ICT), such as health-related mobile applications (mHealth apps), in health guidance.

Description of the Problem

To understand the results of and issues in health guidance, two searches were conducted to identify the domains of health guidance provided using ICT. We searched the PubMed and Japan Medical Abstracts Society databases to identify articles published from 2000-2018. The first search identified frameworks of health guidance provided using ICT. The second search identified primary studies about using mHealth apps published between 2000 and 2018. The sample comprised 22 unique programs from 38 primary studies. The following research questions were explored: 1) What is the purpose of using the mHealth app?

2) Is there a significant difference in the effect of using the mHealth app instead of face-to-face communication?

Results

The mHealth app was used to enhance convenience and to improve or modify lifestyle. The latter included self-monitoring, typing health information, providing knowledge, sharing information, providing encouragement and praise, and correction of action plans. Some positive effects were observed, including compensating for insufficient information, enhancing self-management, and improving degrees of satisfaction of users. Only two programs did not report a significant difference in the effect of using the mHealth app as compared to face-to-face communication.

Lessons

This review showed that the frequency of typing information about diet and exercise appeared to be related to the prevention of primary lifestyle-related diseases and the improvement of self-management behaviour.

Key messages

Use of the mHealth app for providing health guidance might enhance continuous support for self-monitoring and self-management behaviour. Use the mHealth app for providing encouragement and praise might promote a smooth conversation, which in turn would facilitate appropriate self-management behaviour.

Real-time audio detection and regeneration of moving sound source based on optical flow algorithm of laser speckle images

Sound detection with optical means is an appealing research topic. In this manuscript, we proposed a laser microphone system allowing simultaneous detection and regeneration of the audio signal by observing the movement of secondary speckle patterns. In the proposed system, optical flow method, along with some denoising algorithms are employed to obtain the motion information of the speckle sequence with high speed. Owing to this, audio signal can be regenerated in real time with simple optical setup even the sound source is moving. Experiments have been conducted and the results show that the proposed system can restore high quality audio signal in real time under various conditions.

Maresin-1 suppresses imiquimod-induced skin inflammation by regulating IL-23 receptor expression

The anti-inflammatory effect of omega 3 polyunsaturated fatty acids has been confirmed in various inflammatory disease models. Maresin-1 (MaR1) is a lipid mediator derived from the omega-3 fatty acid docosahexaenoic acid (DHA) that has displayed strong anti-inflammatory effects in various inflammatory disease models. However, the effect of topical MaR1 on cutaneous inflammation remains unclear. Therefore, we initially examined the anti-inflammatory effects of topical Maresin-1 using an imiquimod (IMQ)-induced psoriasis-like mouse model of inflammation. Topical MaR1 reduced the ear swelling response as seen in histological findings. RT-PCR and flow cytometry analyses revealed MaR1 had no inhibitory effect on IL-23, but MaR1 suppressed IL-17A production by γδTCR^mid+ and CD4⁺ cells in the skin. These inhibitory effects were also observed in a subcutaneous IL-23-injected psoriasis model. MaR1 downmodulated IL-23 receptor (IL-23R) expression by suppressing retinoic acid-related orphan receptor γt (RORγt) expression and internalization in a clathrin-dependent manner in γδTCR^mid+ and CD4⁺ cells. These results lead to assumptions that topical MaR1 may be a new therapeutic agent for psoriasis and other IL-17-mediated cutaneous inflammatory diseases.

Bullous Pemphigoid Associated with the Dipeptidyl Peptidase-4 Inhibitor Sitagliptin in a Patient with Liver Cirrhosis Complicated with Rapidly Progressive Hepatocellular Carcinoma

A 78-year-old man presented with cutaneous blisters of the limbs and abdominal distension. He had been treated for various diseases, including liver cirrhosis. He had begun receiving sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, for diabetes mellitus three years before the hospitalization. A skin biopsy demonstrated bullous pemphigoid. Ultrasonography (US) revealed multiple liver tumors, although he had been receiving regular US studies. We stopped sitagliptin and started insulin and corticosteroids. However, his renal dysfunction progressed, and he died 14 days after the hospitalization. We should therefore be careful of various complications, including bullous pemphigoid and progression of tumors, when using DPP-4 inhibitors.

Calciphylaxis following acute renal injury: a case and literature review

Background

Calciphylaxis following acute renal failure is rare.

Findings

We report A 57-year-old male with an acute renal failure associated with necrotizing fasciitis. We also review the cases of calciphylaxis due to acute renal disorder further.

Conclusions

It should be kept in mind that calciphylaxis is observed in patient with not only chronic renal disease but also acute renal failure.

Anaphylactoid purpura triggered by cellulitis as a favorable prognosis: case report and literature review

Background

An anaphylactoid purpura affects small capillaries in the skin and other organs. Although two cases of anaphylactoid purpura exacerbated by cellulitis have been reported in Japanese literatures, its prognosis remains still unclear. Because cellulitis exacerbates various cutaneous inflammations, it has been speculated that cellulitis might also exacerbate cutaneous inflammation, such as vasculitis.

Findings

In this article, we report that 78-year-old woman exhibited anaphylactoid purpura, following cellulitis. We also reviewed the literature concerning about this subject.

Conclusions

This type of anaphylactoid purpura is thought to have a favorable prognosis dependent on the treatment for cellulitis.

Nivolumab in the treatment of malignant melanoma: review of the literature

Nivolumab was developed as a monoclonal antibody against programmed death receptor-1, an immune checkpoint inhibitor which negatively regulates T-cell proliferation and activation. Intravenous administration of nivolumab was approved for the treatment of unresectable malignant melanoma in 2014 in Japan. When advanced melanoma patients were treated with nivolumab, median overall survival became longer. Overall survival rate was significantly better in nivolumab-treated melanoma patients than dacarbazine-treated melanoma patients. Nivolumab had an acceptable long-term tolerability profile, with 22% of patients experiencing grade 3 or 4 adverse events related to the drug. Therefore, nivolumab can become an alternative therapy for advanced malignant melanoma.

What determines human body odour?

Human body odour and earwax type are genetically dependent on a single-nucleotide polymorphism (SNP) located in the ABCC11 gene. So far, it still remains to be clear how SNP in the ABCC11 gene is associated with human malodour. In a recent issue of Experimental Dermatology, Baumann et al. propose one of the underlying molecular pathways. Although one of the amino acid conjugated of the odorants, Cys-Gly-3-methyl-3-sulfanylhexanol (3M3SH), was not taken up by the transporter ABCC11, glutathione conjugate of 3MSH (SG-3MSH) was transported by ABCC11. Moreover, SG-3MSH was processed to 3M3SH by γ-glutamyl-transferase 1 (GGT1), which was abundantly expressed in apocrine sweat glands. These findings may pave a way for the pharmacogenetics of human body odour and the development of innovative deodorant products.

Spinal cord compression presumably due to metastasized cutaneous squamous cell carcinoma to the thoracic spine

Cutaneous squamous cell carcinoma (SCC) frequently metastasizes to lymph nodes, but metastasis to the spine is rare. We report a case of cutaneous SCC with metastasis to a particularly rare region, the thoracic spine, which evolved into a spinal cord compression. In November 2005, a 73-year-old man underwent a resection of a primary tumor and standard inguinal lymphadenectomy for a cutaneous SCC of the right fourth toe, defined as T2N1M1 stage. Over the next 3 years, he was given peplomycin, CAV (cisplatin, adriamycin, and vindesine) therapy and radiotherapy for multiple lymph node metastases. In September 2008, he complained of back pain and urinary retention. Magnetic resonance imaging of the thoracic spine showed the presence of masses in the vertebral body, which compressed the spinal cord. Blood examination revealed an elevated level of serum SCC antigen. After irradiation and chemotherapy, the patient's complaint was relieved and the level of serum SCC antigen concomitantly declined. Spinal metastasis is one of the items to be kept in mind during the follow-up of patients with cutaneous SCC.

Assembly and disassembly of the peripheral architecture of the plant cell nucleus during mitosis

The architecture of the nuclei of higher plants includes a structure similar to the nuclear lamina of vertebrates. Changes in this structure were monitored during mitosis in carrot (Daucus carota L.) and celery (Apium graveolens L.) cells by immunofluorescence microscopy using an antibody that recognized the nuclear-matrix protein NMCP1. This protein has been shown to be localized exclusively at the periphery of the nucleus (K. Masuda et al. 1997, Exp Cell Res 232: 173-187). Immunofluorescence was recognized throughout cells in mitotic metaphase, although it was distributed predominantly in the mitotic spindle zone. At late anaphase or telophase, the immunofluorescence was localized around each set of daughter chromosomes. Immunofluorescence in newly formed daughter nuclei was restricted to the periphery of nuclei. This behavior was very similar to that of the nuclear lamina of vertebrates, suggesting that the structure located between the nuclear envelope and the chromosomes in plants disassembles and assembles in parallel with the disintegration and re-formation of the nuclear envelope.

Local continuity of myocardial blood flow studied by monochromatic synchrotron radiation-excited x-ray fluorescence spectrometry

We have developed a monochromatic synchrotron radiation-excited system for two-dimensional mapping of x-ray fluorescence evoked from heavy element-loaded microspheres, which can evaluate myocardial blood flow in small contiguous regions with a small methodological error: 10.8 +/- 2.4% of the average of difference of the dual flow for 7- to 10-mg myocardial tissue (4 dogs). The fractal D value obtained from the slope of the log relative dispersion-log mass plot was 1.21 +/- 0.08 for a voxel size of 7 to 1260 mg (5 dogs) and that for a voxel size of 2.5 to 40 mg (1.12 +/- 0.06) was smaller than that for a voxel size of 40 to 1280 mg (1.25 +/- 0.14, P < .05, ANOVA, 4 dogs). The distance-correlation coefficient relation for paired myocardial regions was attenuated (correlation analysis), and the correlation coefficients between the original grouping and the two aggregates of the adjacent regions were dissociated (extended correlation analysis) under reduction of coronary perfusion pressure (6 dogs). Suppression of myocardial contraction with lidocaine (3 dogs) and vasodilation with adenosine partly improved the distance-correlation coefficient relation under reduced coronary perfusion pressure. Thus, an x-ray fluorescence system designed for precise flow measurement shows that the fractal nature of local flow distribution can be extended into regions smaller than previously reported, that in these regions the flow becomes more homogeneous, and that the self similarity and continuity of local flow are attenuated by the reduction of coronary perfusion pressure and improved by contractile suppression and coronary vasodilation.

Electrical analogy of diastolic pressure difference between left atrium and ventricle

We proposed a mathematical model to describe the early filling process of the left ventricle and applied the model to in vivo experiments. The solution of a second-order differential equation indicated that the pressure difference between the left atrium and ventricle during ventricular filling (PD) could be explained by a transient response, i.e. decremental oscillation, in an LCR circuit. Thereafter, we analysed the sequence of PD during vagal stimulation with two catheter-tip manometers in 12 anaesthetised dogs and evaluated changes in the parameters of the system under various haemodynamic conditions. The values of omega n and zeta were quite stable among beats within an episode of vagal stimulation, between episodes and even among dogs, despite the changes in haemodynamic variables. Pericardiotomy and partial discommunication of the mitral valve with the left ventricular free wall by cutting the mitral chordal tendons decreased omega n and increased zeta, mainly because of the increase in CLV. Occlusion of the coronary vascular beds with large numbers of microspheres increased omega n and decreased zeta, mainly because of the decrease in CLV. Mitral obstruction with an inflated balloon (increase in R) abolished the oscillatory changes and produced an exponential decay sequence of PD. In conclusion, both the logical and experimental approaches indicated that the sequence of PD could be considered as decremental oscillation in the LCR circuit and the parameters omega n and zeta could be good indices of the diastolic property of the left ventricle.