ABSTRACT
@#Eggerthelle lenta (E. lenta) is a gram-positive non-spore-bearing anaerobic bacilli that was first isolated from human feces by Arnold Eggerth in 1935.[1] It is classified as an anaerobic eubacterium that cannot decompose glucose and tryptophan[2] but can synthesize different kinds of steroid metabolism enzymes.[3] On the basis of the high content of guanine + cytosine detected by 16S ribosomal RNA gene sequencing, its original name Eubacterium lentum was changed to E. lenta and concurrently transferred to its own distinct genus Eggerthella.[4]E. lenta often exists in the gastrointestinal tract.[5] Previous reports on E. lenta-induced sepsis were rare. Herein, we present a case of E. lenta-induced sepsis with abdominal pain as the main symptom.
ABSTRACT
@#Metastatic brain lymphomas, which belong to secondary central nervous system lymphomas, usually originate from primary tumors of the bone marrow, testis, or orbit. Gastrointestinal lymphomas commonly metastasize to the lung or heart. We report here a case of brain hemorrhage due to metastasis from primary gastrointestinal diffuse large B-cell lymphoma (DLBCL). A 30-year-old male presented with headache. He was diagnosed to have gastrointestinal lymphoma 6 months earlier, and treated with gastrointestinal surgery. Pathological diagnosis was DLBCL. A PET-CT scan immediately after gastrointestinal surgery demonstrated no brain metastasis. On admission to the ward, imaging of the brain showed right temporoparietal hematoma. In the ward, the patient deteriorated with impaired consciousness. Repeat brain imaging showed enlargement of the hematoma. He underwent right temporoparietal craniotomy for the removal of a hematoma, and tumor nodules adherent to the cortex was found. Pathology confirmed a metastatic DLBCL in the brain. Literature review showed that this was the first reported case of brain hemorrhage from metastatic lymphoma. Metastatic central nervous system lymphoma should be considered as a differential diagnosis in patients with a history of gastrointestinal lymphoma presenting with neurological symptoms.
ABSTRACT
Piloerection is an involuntary erection of body hairs that usually has physiological correlates such as cold or a strong emotional experience. Piloerection may also be a rare manifestation of seizure.Here, we report a case of 54-year-old man who experienced pilomotor seizures from temporal lobe epilepsy. The patient presented with sudden piloerection and no loss of consciousness many times a day. Magnetic resonance imagingof the brain showed threelesions in the right hemisphere, with the largest lesion in the right temporal lobe. A video-EEG showed an ictal discharge in the delta range with right temporal onset. Digital subtraction angiography excluded arteriovenous malformation. The lesion in the right temporal lobe was resected. Immunohistochemistry confirmed a cerebral cavernous malformation. There was no further seizure. A review of the published literature revealed that ictal piloerection as a lone manifestation is rare. Most cases of pilomotor seizure originate in the temporal lobe. Close to four fifth of the cases has a structural lesion. EEG was able to confirm the diagnosis of ictal piloerection in the majority of cases.
ABSTRACT
<p><b>OBJECTIVE</b>A new technique of transthoracic lung ultrasonography (TLS) has emerged and demonstrated promising results in acute heart failure diagnosis at an early stage. However, the diagnostic value of ultrasound lung comets (ULCs) for acute heart failure (AHF) performed in busy emergency department (ED) is uncertain. The present meta-analysis aimed to assess the diagnostic efficiency of ULCs in AHF.</p><p><b>METHODS</b>We conducted a search on online journal databases to collect the data on TLS performed for diagnosing AHF published up to the end of July 2017. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and summary receiver operating characteristic (SROC) curve were calculated. The post-test probability of AHF was calculated by using Bayes analysis.</p><p><b>RESULTS</b>We enrolled a total of 15 studies involving 3,309 patients. The value of sensitivity, specificity, PLR, NLR, DOR, area under the SROC curve, and Q* index was 85%, 91%, 8.94, 0.14, 67.24, 0.9587, and 0.9026, respectively. We detected significant heterogeneity among included studies, and therefore, all these results were analyzed under the random-effect model. We also explored possible sources of heterogeneity among the studies by using meta-regression analysis. Results suggest that the time interval between patient's admission to bedside TLS examination was closely related to TLS accuracy.</p><p><b>CONCLUSION</b>This meta-analysis demonstrated that detecting ULCs is a convenient bedside tool and has high accuracy for early AHF diagnosis in ED. TLS could be recommended to be applied for early diagnosis of AHF in ED.</p>
ABSTRACT
Microvascular decompression is an effective treatment for hemifacial spasm. Hemorrhage is oneof the complications of microvascular decompression. However, delayed hemorrhage is very rare.Here, we report a case of ipsilateral cerebellar hemorrhage at day seven following microvasculardecompression. A 45-year-old woman presented with left HFS for the previous two years. Diagnostictesting demonstrated the presence of neurosyphilis. Brain magnetic resonance image was unremarkableon presentation. She received microvascular decompression and her hemifacial spasm completelyresolved after surgery. At day seven post-operatively, the patient presented with a sudden onsetheadache. Emergency computed tomography scan showed a cerebellar hemorrhage. A suboccipitalcraniotomy was performed and a cerebellar hematoma was evacuated. The delayed hemorrhage wasattributed to possible microaneurysm from syphilis.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the expression of SNCG in colorectal cancer with liver metastasis and its clinical significance.</p><p><b>METHODS</b>Surgical specimens were collected from 217 colorectal cancer patients with complete clinical and follow up data between January 1999 and December 2003. There were 113 cases with liver metastasis and 104 without liver metastasis. SNCG expression was identified by immunohistochemistry. Association of SNCG expression with clinicopathologic factors and prognosis of colorectal cancer was accessed.</p><p><b>RESULTS</b>The positive rate of SNCG in colorectal cancer with and without liver metastasis was 68.1% and 27.9%, respectively, and the difference was statistically significant(P<0.05). Logistic regression analysis showed that SNCG expression was an independent factor associated with the presence of liver metastasis(OR=8.29, 95%CI: 3.37-20.37, P<0.01). In synchronous colorectal liver metastasis, the median survival time of SNCG-negative and SNCG-positive was 12.6 months and 8.2 months, respectively(Log Rank, P<0.05). Multivariate Cox analysis showed that SNCG expression was an independent prognostic factor for colorectal cancer with synchronous liver metastasis(RR=1.97, 95%CI:1.10-3.53, P<0.05).</p><p><b>CONCLUSIONS</b>High expression of SNCG is present in the tumor tissue in patients with liver metastasis from colorectal cancer. SNCG may be used as a predictive biomarker for colorectal liver metastases and is an important prognostic factor in patients with liver metastasis from colorectal cancer.</p>
Subject(s)
Female , Humans , Male , Middle Aged , Colorectal Neoplasms , Metabolism , Pathology , Follow-Up Studies , Liver Neoplasms , Neoplasm Proteins , Metabolism , Prognosis , Retrospective Studies , gamma-Synuclein , MetabolismABSTRACT
<p><b>BACKGROUND</b>Nicotine, a major component of tobacco, is the main cause of smoking addiction. It was found that asthmatic patients who smoke were insensitive to glucocorticoid treatment. In this paper, we investigated whether nicotine could inhibit histone deacetylase 6 activity (HDAC6) and chaperone-dependent activation of the glucocorticoid receptor (GR) in A549 cells. Furthermore, the expression level of heat shock protein 90 (HSP90) was determined.</p><p><b>METHODS</b>Quantitative real-time polymerase chain reaction was used to detect the levels of RNA transcription, and Western blotting was applied to analyze the levels of protein expression of HDAC6, GR, and HSP90 in A549 cells. Moreover, the effects of dexamethasone and trichostatin A were observed in A549 cells.</p><p><b>RESULTS</b>A549 cell proliferation was inhibited in the presence of nicotine, and the level of RNA and protein expression of HDAC6 and GR were down-regulated.</p><p><b>CONCLUSIONS</b>Nicotine could inhibit HDAC6 activity and chaperone-dependent activation of GR. This might be the main reason why asthmatic patients who smoke show insensitivity to the glucocorticoid treatment.</p>