Orbital marginal zone lymphomas: an immunohistochemical, polymerase chain reaction, and fluorescence in situ hybridization study

Many studies have been performed on chromosomal aberrations of extranodal marginal zone lymphomas. However, only a few have been published so far on ocular adnexal marginal zone lymphomas. We studied 18 cases of orbital lymphoid cell infiltrates. Using fluorescence in situ hybridization (FISH), we studied some of the most common chromosomal aberrations found in extranodal marginal zone lymphomas as: trisomies 3, and rearrangements of the 18q21 MALTI gene to detect the translocations t(11;18)(q21;q21) and t(14;18)(q32;q21)MALT1. Our goals were as follows: (1) study those aberrations in our material and compare them with the literature, (2) check their prognostic significance, and (3) check whether studying those aberrations with FISH can be used as a diagnostic tool to differentiate reactive from neoplastic infiltrates, in addition to immunohistochemistry and polymerase chain reaction. We found a high frequency of trisomies 3 (68%) and 18 (56.6%), the highest published so far in orbital lymphomas. On the other hand, no rearrangement was seen in any of our cases. The histologic picture and the clinical course were the same when there was one or more aberrations. As for the diagnostic significance, the presence of a prior, concurrent, or subsequent lymphoma in almost all the positive for aberrations cases suggests that either the orbital infiltrates in these cases are lymphomas, or they have, at least, a malignant potential or a genetic instability. Therefore, the demonstration of these numerical aberrations by FISH may be an additional sensitive, reliable, and relatively simple tool to differentiate reactive from neoplastic orbital lymphoid cell infiltrates when the immunohistochemistry and polymerase chain reaction, performed in a busy and routine-based histopathology laboratory, are unsatisfactory.     

Hypotonic duodenography — Too often performed but of too little value?

Hypotonic duodenography was compared with conventional barium examination in 68 patients (70 examinations) with clinically suggested or verified disease of the pancreas or duodenum. In 13 cases (18.5%) conventional examination demonstrated the duodenal anatomy better than hypotonic duodenography. In nine cases (13%) hypotonic duodenography was superior and in 48 cases (68.5%) both techniques were diagnostically equal.It is concluded that, in only a few cases, does hypotonic duodenography add any diagnostic information to that which can be obtained with properly performed conventional examination of the duodenum.     

Intrapleural administration of a large amount of diluted fibrin glue for intractable pneumothorax

OBJECTIVE: Pleurodesis using chemical agents has been applied to high-risk patients with pneumothorax. This treatment, however, is sometimes unsuccessful in patients with intractable pneumothorax or intrapleural dead space. We developed a technique for the intrapleural administration of diluted fibrin glue as a treatment for such patients. METHODS: Fibrin glue was diluted fourfold with saline solution and/or contrast medium. Pleurodesis with a large amount of the diluted fibrin glue was performed in 40 high-risk patients with intractable pneumothorax and in 13 postthoracotomy patients with persistent air leakage associated with an intrapleural dead space. RESULTS: The air leaks were stopped by administration of the glue in all patients of both groups. During the follow-up period, a recurrence rate of 12.5% was observed in the former group. These recurrent pneumothoraces also were successfully treated by glue administration with no further recurrence. In the 13 postthoracotomy patients, there was no recurrence after the initial treatment. Pyrexia (12.5%) and chest discomfort (4.1%) were observed as side effects, but there were no findings of severe chest pain or thoracic empyema. CONCLUSIONS: These results suggest that intrapleural administration of a large amount of diluted fibrin glue is a useful treatment for intractable pneumothoraces in high-risk or postthoracotomy patients who have an intrapleural dead space.     

Functional indexes of reactive cognitive control: ERPs in cued go/no‐go tasks

We aimed to determine the functional meaning of latent (hidden) components decomposed from ERPs, in the context of a go/no‐go paradigm. To accomplish this, we used a new group blind source separation method, based on joint diagonalization of covariance matrices of ERPs. Four variants of a frequently used go/no‐go paradigm were designed, in which operations of reactive cognitive control, such as conflict detection and action inhibition, were independently manipulated. The results showed that a latent component, generated in the anterior cingulate cortex, induced N2/P3 fluctuation only in conditions in which the prepotent model was violated, and thus can be associated with conflict detection operations. In contrast, the two latent components generated in the vicinity of the central sulcus induced P3‐like fluctuations in conditions in which the prepared action was suppressed, and thus can be associated with action inhibition operations. The advantages and limitations of the new blind source separation method in relation to ERP research are also discussed.     

Efficacy of the polo-like kinase inhibitor rigosertib,alone or in combination with Abelson tyrosine kinase inhibitors,against break point cluster region-c-Abelson-positive leukemia cells

The potency of Abelson (ABL) tyrosine kinase inhibitors (TKIs) against chronic myeloid leukemia (CML) has been demonstrated. However, ABL TKI resistance can develop. In this study, we investigated the efficacy of a combination therapy including rigosertib (ON 01910.Na), a polo-like kinase (PLK) and phosphoinositide 3-kinase (PI3K) inhibitor, and ABL TKIs. A 72-h rigosertib treatment was found to inhibit cell growth, induce apoptosis, reduce phosphorylation of the breakpoint cluster region-c (BCR)-ABL and its substrate Crk-L, and increase the activities of caspase 3 and poly (ADP-ribose) polymerase (PARP). This combination therapy also exerted a synergistic inhibitory effect on Philadelphia chromosome (Ph)-positive cell proliferation and reduced the phosphorylation of BCR-ABL and Crk-L while increasing that of cleaved PARP and the H2A.X histone. Rigosertib also potently inhibited the growth of ABL TKI-resistant cells, and cotreatment with ABL TKIs and rigosertib induced higher cytotoxicity. These results indicate that rigosertib treatment may be a powerful strategy against ABL TKI-resistant cells and could enhance the cytotoxic effects of ABL TKIs.     

Gelation and luminescence of lanthanide hydrogels formed with deuterium oxide

Gel formations and efficient lanthanide luminescence appeared in deuterium oxide (D₂O) medium instead of light water (H₂O), and their solvation possibilities by using luminescence lifetimes were discussed. The lanthanide ions in the hydrogel of 1 obtained by H₂O (abbreviated as H₂O-Ln1; Ln = Eu, Tb, and Gd) in our previous report act as the coupling part between neighbor molecules for the bundle structure. Here, D₂O also acts as a medium to form the lanthanide-hydrogel of 1, and increases intensities of luminescence for Tb, because a soft crystalline state reducing resonance thermal relaxation is realized. The gel-formation and luminescence band positions of Ln1 in D₂O corresponded to those in H₂O. From the observation of luminescence lifetimes in H₂O and D₂O, the number of coordinating water molecules on Eu and Tb were estimated to be around 3 or 4 for both. The luminescence intensity of Eu1 did not increase even in D₂O, due to a blue shift of the excited triplet state of 1, as compared to that in H₂O.

Luminescent lanthanide hydrogels using the low-molecular weight gelator 1 in D₂O were developed and evaluated quantitatively.     

New records of mosquitoes from northwestern Argentina

Eleven mosquito species, namely Aedes hastatus, Ae. fulvus, Coquillettidia albicosta, Cq. juxtamansonia, Culex aliciae, Cx. delpontei, Cx. oedipus, Cx. pedroi, Mansonia flaveola, Uranotaenia leucoptera, and Wyeomyia oblita, are recorded for the first time from northwestern Argentina. In addition, 3 species, Cx. brethesi, Limatus durhami, and Ur. nataliae, are reported for the first time from Salta Province. These records extend the geographical distribution of these 3 species to Salta Province. This study also extends the geographical distributions of Cq. nigricans, Cx. chidesteri, and Ma. humeralis to Jujuy Province and of Ae. meprai, Ae. milleri, Ae. oligopistus, Cx. brethesi, Cx. fernandezi, and Cx. tatoi to Tucumán Province.     

Unusual cause of palpable mass in upper abdomen--giant gastric trichobezoar: report of a case

A trichobezoar is a ball of swallowed hair that accumulates in the stomach and fails to pass through the intestines. Usually a trichobezoar presents in early satiety and malnutrition. Obstructive symptoms and manifestations of gastric outlet obstruction may occur. While small gastric trichobezoars may be removed via gastroscopy, large trichobezoars require surgical removal by gastrotomy through abdominal incision. We present a case of a successful mini-laparotomy removal of a giant gastric trichobezoar in a 15-year-old girl with a history of trichophagia for a long time and marginal psychological disturbances.     

Emergent thoracic endovascular aortic repair in a patient with hemoptysis due to bronchial fistula: a case for airway management

Bronchial fistula due to bronchial compression is a rare complication following both open surgical and endovascular repair of thoracic aortic aneurysms. We report on the airway management for a case of emergent thoracic endovascular aortic repair (TEVAR) in a patient with left bronchial obstruction due to hemoptysis. A 68-year-old man had undergone total arch replacement 8 years before, and was preoperatively diagnosed with aortobronchial fistula in the left lung. To prevent obstruction of the right lung by rebleeding in the left bronchus, we planned to exchange the single lumen endotracheal tube placed following hemoptysis to a double lumen tube prior to the operation. With assisted spontaneous breathing, bronchoscopy performed before replacing of the endotracheal tube showed obstruction of the left bronchus with many clots. With bronchoscopic assistance, clots were removed from the left bronchus and oxygenation improved significantly. We found a blue nylon suture penetrating the bronchial wall, most likely from a previous operation. However, bronchoscopy did not disclose aortobronchial fistula. Following TEVAR, the patient was diagnosed with bronchopleural fistula induced by bronchial compression due to blood vessel prosthesis and surrounding felt strips. Cooperation from surgeons and careful airway management were required to prevent life-threatening oxygenation insufficiency.     

A Reliability of the Prototype Trunk Training System for Sitting Balance

[Purpose] Cerebral palsy is a disorder that affects balance in the sitting position. Cerebral palsy patients need trunk muscle strengthening and balance training. In order to improve trunk control sensory-motor control training is carried out on an unstable surface. We have developed a Trunk Training System (TTS) that can provide visual feedback using a tilt sensor for balance training in the sitting position. Before using the TTS for training children with cerebral palsy experiments were conducted with healthy adult subjects and the TTS to gather basic data for its improvement. [Subjects] The subjects were 11 healthy men (n=3) and women (n=8). [Methods] Subjects trained at two levels (5°, 10°), in four different directions (anterior, posterior, left, right), three times each. TTS outcome indices (stability index, performance time) were measured. [Results] The stability index and performance time showed high correlation (−0.6<r<1). The measurements of the different task levels and directions showed high reliability (0.9<α). [Conclusion] The TTS may be used to evaluate the range of motion and execution capabilities of sitting balance. Additional experiments will be needed to investigate the validity of the TTS measurements.Key words: Trunk training system, Reliability, Cerebral palsy