Total splenic infarct due to Aspergillus and AIDS

Invasive aspergillosis is a rare but important cause of morbidity and mortality in patients with AIDS. In the majority of patients, invasive aspergillosis involves the lungs. Extrapulmonary involvement with total splenic infarction has not been previously described. We illustrate a patient who developed total splenic infarction and septic emboli to the brain from Aspergillus.     

Total splenic infarct due to Aspergillus and AIDS.

Invasive aspergillosis is a rare but important cause of morbidity and mortality in patients with AIDS. In the majority of patients, invasive aspergillosis involves the lungs. Extrapulmonary involvement with total splenic infarction has not been previously described. We illustrate a patient who developed total splenic infarction and septic emboli to the brain from Aspergillus.     

耐辐射奇球菌PprI蛋白质在毕赤酵母菌中的高效表达及纯化

目的 利用真核毕赤酵母高效表达原核的耐辐射奇球菌pprI基因,建立高效表达及纯化PprI蛋白质的技术路线。方法 根据毕赤酵母密码子的偏爱性,改造耐辐射奇球菌pprI基因的编码序列,利用PCR技术全合成改造过的pprI基因,并在其N末端添加一个6×His标签。PCR产物经纯化后克隆到毕赤酵母表达载体pHBM-905A中,利用Cop I和Not I双酶切并回收线性化的目的片段后,转化毕赤酵母GS115菌株。将获得的毕赤酵母转化子诱导表达,SDS-PAGE、Western blot和质谱检测培养上清液,用Ni-NTA柱纯化目的蛋白,BCA法测定蛋白浓度。结果 新合成的耐辐射奇球菌pprI基因编码序列正确,毕赤酵母转化菌株的培养上清液经SDS-PAGE和Western blot均可检测到相对分子质量为43000的目的蛋白条带,经质谱检测证实该目的蛋白为耐辐射奇球菌PprI蛋白。选用Ni-NTA柱获得了大量纯化的PprI蛋白,应用浓度为250 mmol/L的咪唑淋洗时,PprI蛋白洗脱率最高。BCA法测得纯化蛋白浓度为0.35 mg/ml。结论 建立了一种新的适于毕赤酵母表达的耐辐射奇球菌pprI基因,成功构建了分泌表达PprI蛋白质的重组毕赤酵母工程菌株,建立了高效表达目的蛋白的技术路线,并获得了高效表达和纯化的PprI蛋白。     

Ruptured splenic abscess: a cause of pneumoperitoneum in a patient with AIDS

We encountered a case of pneumoperitoneum caused by a gas-forming splenic abscess in a patient with acquired immunodeficiency syndrome (AIDS). Plain abdominal films and computed tomography demonstrated a large amount of free air. Pneumoperitoneum was eventually shown to represent gas liberated from fermentation by gas-forming organisms within the splenic abscess. Gas-containing necrotic tissue from the ruptured spleen mimicked the spillage of feces from colon perforation. The authors emphasize that a ruptured abscess should be included in the differential diagnosis of acute abdomen in an immunocompromised patient.     

Unexpected death due to spontaneous splenic rupture: A rare case in splenic angiosarcoma

Splenic angiosarcoma (SA) is a rare disease that can cause spontaneous splenic rupture leading to unexpected death. The rare incidence and non-specific clinical presentations made the early correct diagnosis of SA impossible in clinical practice. Even with medical intervention, 80% of patients died within 6 months after diagnosis. Here, we report a man who had complained of abdominal distension for 2 weeks and succumbed to the disease nine hours after admission. Diagnosis of hepatic and splenic angiosarcomas was based on post-mortem histopathological examination and immunohistochemistry, and the cause of death was hemorrhagic shock caused by spontaneous splenic rupture secondary to SA. This present case was the first forensic autopsy of spontaneous splenic rupture secondary to SA, which can highlight the diagnosis of rare diseases in forensic practice, and forensic pathologists should bear in mind these rare diseases even in routine practice.     

Fatal Aspergillus pancarditis after incompatible blood transfusion intended to be an autologous blood transfusion

Aspergillus pancarditis is a rare infection, and it has rarely been reported after blood transfusion. In this report, we describe a fatal case of Aspergillus pancarditis in a patient who received antibiotics and corticoids after an incompatible blood transfusion intended to be an autologous blood transfusion. A 64-year-old man suffering from herniation of intervertebral disk between C4 and C5 received an anterior cervical spinal fusion. After the operation, he received incompatible blood transfusion and fell into disseminated intravascular coagulation (DIC) and preshock state. Anticoagulants and corticoids were given and he recovered from DIC and the preshock state. However, he remained quadriplegic because of enlargement of cervical epidural hematoma that was initially brought out by the operation. He developed bacterial bronchopneumonia 2 weeks after the transfusion and received antibiotic therapy. The pneumonia was cured a week later. Five weeks after the transfusion, he developed Aspergillus pneumonia and received antimycotic therapy. However, his condition grew worse and died 2 months after the transfusion. Autopsy revealed Aspergillus pancarditis. In this case, the relationship between the erroneous transfusion and the patient's death was obvious and it was considered that the erroneous transfusion should be blamed for the patient's death.     

秀丽隐杆线虫作为电离辐射模型的研究进展

随着放射治疗在肿瘤治疗中的地位日益显著,如何减轻放疗的副作用也逐渐成为研究的热点。秀丽隐杆线虫（Caenorhabditis elegans）因其独特的优势成为一个良好的研究电离辐射的模型。近年来,国内外利用线虫模型对电离辐射特性的研究日益增多。本文简要综述了电离辐射对线虫的影响以及相关机制。     

不同寄主上的桑寄生药材毒性的比较研究

目的： 比较研究不同寄主来源的桑寄生（Taxillus sutchuenensis）药材的毒性。方法： 对6种不同寄主上的桑寄生药材进行急性毒性实验,测定半数致死量（LD₅₀）或最大耐受量（MTD）。并根据寄主来源不同,将98只昆明种小鼠随机分为对照组、沙梨组、李树组、白杨组、柞木组、夹竹桃组和漆树组,除对照组,其余各组小鼠每日ig 7.5 g·kg^-1水提物1次,共4周。测定血清中天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）及肌酐（Cr）、尿素氮（BUN）含量,并观察肝、肾组织病理改变。结果： 夹竹桃上的桑寄生、漆树上的桑寄生毒性明显,LD₅₀及95%可信限分别为109.276 （96.837~122.645） g·kg^-1和77.286（66.891~89.296）g·kg^-1;其余4种寄主上的桑寄生药材未出现死亡。与对照组比较,夹竹桃上的桑寄生能引起Cr指标的升高,并对小鼠肾组织影响较明显;而其他各寄主上的桑寄生组肝、肾功能检测指标差异不明显,对小鼠肝、肾组织损伤也较轻。结论： 寄主为夹竹桃、漆树有毒木类的桑寄生药材有明显的毒性。     

Radiological findings in nine AIDS patients with Rhodococcus equi pneumonia

Rhodococcus equi (R. equi) infections have been incidentally reported as a cause of pulmonary infection in severely immunocompromised hosts, including AIDS patients. Our purpose is to describe the radiological findings in nine AIDS patients with R. equi pneumonia assessed by bronchoalveolar lavage (BAL), biopsies, cultures of sputum, and hemocultures. All patients were examined by chest radiographs and contrast-medium-enhanced chest CT. Dense pulmonary consolidations with or without cavitations accounted for the most striking radiological patterns. Chest CT also revealed six mediastinal involvements, strongly mimicking a lymphoma. Two of them had multiple bilateral pulmonary nodular opacities. Pleural effusion was not identified. Although intensive therapies were administered, seven among nine patients died within few months. In an AIDS patient living in a rural area or exposed to horses and presenting these radiological patterns, the possibility of R. equi pneumonia should be considered in the differential diagnosis along with other infectious diseases or lymphomas.Correspondence to: P. Schnyder     

Determination of k0-values for the reactions Zr (n, γ) Zr and Zr (n, γ) Zr–Nb by irradiation in highly thermalized neutron flux

Determination of k₀-factors for zirconium isotopes was performed by co-irradiation of Zr and Au–Al. Due to the highly thermalized irradiation position at FRM-II, interferences from epithermal neutrons were found largely decreased for ⁹⁶Zr (n, γ) ⁹⁷Zr–^97mNb, the reaction with the highest Q₀-value in all (n, γ) reactions. Results showed that, the ⁹⁵Zr k₀-values from this work were the same as the recommended ones. For ⁹⁷Zr–^97mNb 743.4 keV gamma-line, the new k₀-value was 2.8% higher compared to the recommended value, which is not a significant difference. These results are helpful in clarifying the suspicion about the Zr k₀-factors.     

电子顺磁共振在体测量指甲剂量方法的可行性研究

目的 针对核应急医学救援剂量评估的需求,为解决指甲电子顺磁共振（EPR）剂量评估方法中机械诱发信号难以分离的问题,探讨指甲EPR在体测量的可行性。方法 利用自研的指甲在体EPR测量装置,对未剪碎指甲进行整体测量,在无机械诱发信号干扰的条件下研究指甲的本底信号及辐射诱发信号特性,探索通过水处理恢复本底信号的方法;开展指甲实际在体EPR测量实验,评价在体测量条件对EPR波谱的影响。结果 未剪碎指甲的本底信号分布服从正态分布,不同性别志愿者的指甲本底信号差异无统计学意义（P>0.05）;在2~10 Gy范围内建立了剂量响应关系,指甲辐射诱发信号半衰期约为5 d;建立了变温结合水处理的本底信号恢复方法,处理后指甲EPR信号与本底信号差异无统计学意义（P>0.05）;获得了实际在体测量条件下的指甲EPR波谱。结论 利用本方法可以获得不含有机械诱发信号的EPR波谱,初步验证了指甲在体EPR测量用于剂量评估的可行性。     

Comparison of T1 and T2 weighted images of the lumbar spine

In order to develop an optimal routine magnetic resonance (MR) spine scanning protocol, we have compared the relative efficacy of performing T1- and T2-weighted images in patients with various disorders of the lumbar region. Forty cases were randomly selected from studies performed from 1984 to 1987 and the TI- and T2-weighted images of each case were separated and interpreted blindly and independently by two neuroradiologists.Our results indicate no significant difference between T1- and T2-weighted images in the depiction of disc protrusion. The T2-weighted images were superior in depicting disc dessication, but the clinical significance of identifying a dessication disc remains uncertain. No significant difference in the depiction of osteophytes was seen between T1- and T2-weighted images. Cases of tethered cord, metastatic disease, and arachnoiditis were better delineated with T1-weighted images. The increase in signal of cerebrospinal fluid (CSF) with T2-weighting often obscured lesions within the spinal canal. In a signal case of postoperative diskitis, the T2-weighted images disclosed disc space abnormalities and epidural fluid collections not appreciated on T1 -weighted images. The T1-weighted images, however, did show thecal sac and adjacent epidural extension more clearly. In cases of metastatic disease, increase in the signal of metastases with T2 weighting often rendered them isointense to surrounding medullary bone.Given the lack of superiority of T2-weighted images over T1-weighted images in evaluating intervertebral disc protrusions and the superiority of T1-weighted images in depicting nearly all other abnormalities observed in this series, we no longer acquire T2-weighted images of the lumbar spine on a routine basis. In selected cases, such as evaluation of infected diskitis, T2-weighted imaging may have additional value.     

Standardization of F using the 4π(β+γ) integral counting technique

Α 4π(β+γ) integral counting technique using a 4πβ−4πγ detector configuration was adopted for the standardization of ¹⁸F. In this technique, the β-detector is composed of two thin plastic scintillators sandwiching the source, coupled with a slender photomultiplier tube. The β-detector part with the source was inserted into a large well-type NaI(Tl) scintillation detector for γ-ray detection, making a 4πβ−4πγ coincidence counting system. In this work, positron particles were detected with high efficiency in the β-channel and annihilation quanta were also detected with high efficiency in the 4πγ channel. The very small inefficiency of the 4π(β+γ) integral counter for the β-plus branch has been confirmed by EGS5 Monte Carlo simulation. The result using this technique agreed within the uncertainties with the result obtained by the conventional 4πβ−γ coincidence counting with the efficiency extrapolation technique using the same detector configuration and a conventional 4πβ−γ coincidence counter.     

Splenic artery embolization for spontaneous splenic rupture due to Babesiosis: a case report

Babesiosis incidence in the United States has been increasing with an 11% rise between 2018 and 2019 based on the latest CDC annual summary, reaching its highest ever reported incidence. This primarily tick-borne disease is particularly prevalent in New England. Despite predominantly nonspecific and at times subtle symptoms, life-threatening complications do occur. One such complication is splenic rupture which has been suggested to be more common in younger and otherwise healthy individuals. This is a report on a successful splenic artery embolization in a 65-year-old male from upstate New York who, unlike most prior studies, showed splenic rupture after he was discharged with negative parasitemia and general improvement following several days of targeted antibiotic therapy. Increased incidence and various presentations of Babesiosis call for an attempt to promote clinical awareness for radiologists among other specialties.     

Cerebritis due to Listeria monocytogeneses: CT and MR findings

Infections by Listeria monocytogenes are uncommon, with cerebritis being even rarer. We present three cases of cerebritis which occurred during an outbreak of listeriosis. The CT and MR findings at diagnosis and during follow-up are described. Predominant deep white matter lesions with nodular and ring enhancement were seen. The MR yielded a higher resolution of the lesions than CT. Correspondence to: Y. Aladro     

神经酰胺在辐射诱导的秀丽隐杆线虫生殖细胞旁效应中的机制研究

目的 利用秀丽隐杆线虫为研究对象,以单粒子束为辐射源,从活体水平探究神经酰胺在辐射旁效应中的作用。方法 以野生型N2和突变体L4期线虫的后食道球为辐射部位,分别给予2 000个质子的辐照剂量,检测和分析成虫的生殖腺凋亡细胞以及基因表达水平。结果 定点辐射N2的后食道球可显著诱导线虫旁区生殖腺细胞凋亡的增加（t=9.007,P<0.05）,但在神经酰胺合酶基因突变体中未表现出这一现象（P>0.05）。实时定量PCR结果显示,辐射诱导N2和神经酰胺合酶基因突变体lagr-1（gk327）;hyl-1（ok976）线虫中凋亡核心通路基因egl-1和ced-13表达量的上升,但两品系线虫间的差异无统计学意义（P>0.05）;辐射可诱导N2和DNA损伤检验点突变体hus-1（op241）中hyl-1和lagr-1表达量的上升,且两品系间的差异无统计学意义（P>0.05）。非受体络氨酸激酶abl-1突变可显著增加辐射诱导的旁区细胞凋亡（t=13.241,P<0.05）,而当神经酰胺合酶基因与abl-1同时突变时,凋亡增加的现象被抑制（t=13.462,P<0.05）。结论 神经酰胺参与线虫体内辐射引起的旁区凋亡过程,且可能与凋亡核心通路中的促凋亡蛋白egl-1和ced-13以及DNA损伤响应通路中的HUS-1协同发挥作用。抑凋亡基因abl-1与神经酰胺合酶在凋亡过程中表现出拮抗关系。     

Influence of non-irradiated and ultraviolet-A-irradiated N,N-dialanyl protoporphyrin and diarginine diprotoporphyrinate on the neutrophil respiratory burst in vitro

N,N-Dialanyl protoporphyrin (PP(Ala)₂) and diarginine diprotoporphyrinate (PP(Arg)₂) are porphyrin photosensitizers that are currently being used in the photodynamic therapy (PDT) of cancer. In the present study, the effects of these agents on the neutrophil respiratory burst in vitro were investigated. In the case of non-stimulated neutrophils, the respiratory burst was significantly increased in the presence of PP(Ala)₂ in concentration 5.0 mg/l, while in the presence of PP(Arg)₂ in the same concentration it did not change. By contrast, both photosensitizers decreased a respiratory burst by neutrophils stimulated with opsonized zymosan. Pre-irradiation of solutions of PP(Ala)₂ and PP(Arg)₂ with ultraviolet A did not alter the observed responses. The prooxidative effect of PP(Ala)₂ is probably due to the stimulation of protein kinase C, which plays a key role in the respiratory burst of non-stimulated cells, whereas the antioxidant effect of both photosensitizers may be explained by their inhibitory effect on EGFR tyrosine kinase, which plays an important role in the respiratory burst of cells stimulated by opsonized zymosan. The lack of effect of the two dyes after UV-A pre-irradiation may be due to rapid self-quenching of UV-A-excited dye molecules to the ground state. The results of this study provide a starting point for experiments in animal models aimed at determining the clinical importance of the observed effects in cancer diagnosis and therapy.     

Measurement of Am L X-ray emission probabilities

Measurements of ²⁴¹Am L X-ray emission probabilities were conducted using both HPGe and Si(Li) detectors. The efficiency calibrations of these detectors were performed by means of a tunable, monochromatic photon beam and the determination of the thickness of absorbing materials inside the detector. These efficiency calibrations were obtained without any reference to radionuclide decay data, and with 0.8% relative standard uncertainty. The complex L X-ray region was processed using Voigt functions and by taking account of the detector response function established with the monochromatic beam. Twenty-two components of the L X-ray group were identified and quantified. The present results are compared with previously published data.     

Difuse bilateral Gallium pulmonary uptake in a patient with Hodgkin's lymphoma and Pneumocystis carini infection

We report the case of a 12-year-old boy with chemoresistant stage IV Hodgkin's lymphoma. A ⁶⁷Gallium scan was performed when his fever did not diminish following intensification of therapy. Apart from a known bone lesion, it showed diffuse bilateral lung uptake which could well be interpreted as an extension of his disease. But further investigations brought evidence of a Pneumocystis carinii infection. Because of the underlying disease, it was an important pitfall with clinical implications.     

Endocavitary in vivo Dosimetry for IMRT Treatments of Gynecologic Tumors

The accuracy and reproducibility of endometrial carcinoma treatment with intensity-modulated radiotherapy (IMRT) was assessed by means of in vivo dosimetry. Six patients who had previously undergone radical hysterectomy for endometrial carcinoma were treated with IMRT using a vaginal applicator with radio-opaque fiducial markers. An ion-chamber inserted into the applicator supplied an endocavitary in vivo dosimetry for quality assurance purposes. The ratio R = D/D_TPS between the in vivo measured dose D and the predicted dose by the treatment planning system D_TPS was determined for every fraction of the treatment. Results showed that 90% and 100% of the ratios resulted equal to 1 within 5% and 10%, respectively. The mean value of the ratios distribution for the 6 patients was R = 0.995 and the SD = 0.034. The ratio R* between the measured and predicted total doses for each patient was near to 1, within 2%. The dosimetric results suggest that the use of a vaginal applicator in an image-guided approach could make the interfractions target position stable and reproducible, allowing a safe use of the IMRT technique in the treatment of postoperative vaginal vault. In vivo dosimetry may supply useful information about the discrimination of random vs. systematic errors. The workload is minimum and this in vivo dosimetry can be applied also in the clinical routine.