d-Tartrate utilization correlates with phylogenetic subclade in Pseudomonas cichorii.

Pseudomonas cichorii is divided into two subclades based on the 16S ribosomal RNA gene sequence and core genome multilocus sequence typing. It was shown that subclade 2 strains utilize d-tartrate as a sole carbon source, whereas subclade 1 strains do not. Draft genome sequencing was performed with P. cichorii strains to identify d-tartrate utilization genes. By genome comparative and homology search studies, an ∼7.1-kb region was identified to be involved in d-tartrate utilization. The region is subclade 2 specific, and contains tarD and dctA genes, which encode a putative enzyme and transporter of d-tartrate, respectively. When the region was introduced into subclade 1 strains, the transformants were able to utilize d-tartrate. Partial fragments of tarD and dctA were amplified from all subclade 2 strains tested in this study by PCR using gene-specific primers, but not from subclade 1 strains. This is the first report on the genetic analysis of biochemical characteristics corresponding to a specific phylogenetic group in P. cichorii.

Pneumothorax caused by costal exostosis.

Exostosis occurs in the ribs either sporadically or as a manifestation of a genetic disorder known as hereditary multiple exostoses. Costal exostosis may cause chest pain and, on rare occasions, result in hemothorax, pneumothorax, hemopneumothorax, and diaphragmatic or pericardial laceration. We report a case of pneumothorax in a 16-year-old boy with exostosis in the right seventh and eighth ribs. He previously received a diagnosis of multiple exostoses and underwent costal resection. The lung and pleura were injured because of long-term friction between the exostoses and the visceral pleura.To the best of our knowledge, this is only the fourth report of pneumothorax caused by costal exostosis. Moreover, all previously reported cases of pneumothorax or hemopneumothorax caused by costal exostosis, including the present case, involved lower lobe injury.

Surgical outcomes and reevaluation of treatment strategies for thymomas.

Improved histological typing systems for thymic tumors and advances in induction and adjuvant therapy have created the need to reevaluate strategies for the management of thymoma. We retrospectively studied 73 patients with completely resected thymomas unassociated with myasthenia gravis. The World Health Organization (WHO) histologic classification, clinicopathological features and surgical outcomes were analyzed. Overall survival was 66.2% at 10 years, and the median survival time was 169 months. According to the Masaoka staging system, overall survival rates at 10 years were 94.7% in stage I, 76.1% in stage II, 30% in stage III and 0% in stage IV. In the WHO classification, overall survival rates at 10 years were 91.9% in types A and AB, 50.9% in type B2 and not achieved in type B3. The disease-free interval was slightly shorter in patients with B2 and B3 disease than in those with type A, AB and B1 disease. Advanced thymomas were significantly associated with type B2 and B3 (p<0.01). In stage III and IV disease, adjuvant or neoadjuvant therapy was associated with better survival as compared to no adjuvant therapy (p=0.07). On multivariate analysis, Masaoka stage III and IV disease and extended thymectomy indicated significant, negative and independent risk factors for survival (p<0.01). Masaoka stage I and II thymomas or WHO type A and AB thymomas have favorable prognoses and do not require postoperative adjuvant therapy. Patients with stage III and IV thymomas require additional therapy after surgery.

Correlation of 18F-fluorodeoxyglucose uptake on positron emission tomography with Ki-67 index and pathological invasive area in lung adenocarcinomas 30 mm or less in size.

BACKGROUND: (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) is commonly used to distinguish benign from malignant lesion. Recently, maximum standardized uptake value (SUVmax) on FDG-PET has found to have prognostic value. We examined the relationship between SUVmax and proliferative activities as indicated by maximum diameter of tumor opacity on mediastinal-window images (TOM), Ki-67 index, and diameter of the pathological invasive area in lung adenocarcinomas 5mm was determined as 2.15 by ROC analysis, with sensitivity of 88.3% and specificity of 84.6%. CONCLUSIONS: SUVmax correlated significantly with Ki-67 index and diameter of the pathological invasive area. The present results suggest the potential role of FDG-PET in predicting adenocarcinomas with invasive characteristics.

Quantitative p16 and ESR1 methylation in the peripheral blood of patients with non-small cell lung cancer.

Inactivation of the p16 and ESR1 tumor suppressor genes by promoter lesion methylation has been reported in many tumor types, including lung cancer. We examined the blood of 95 non-small cell lung cancer patients (66 cases of adenocarcinoma, 23 of squamous cell carcinoma and 6 of large cell carcinoma) and 30 controls consisting of normal subjects and benign disease patients to determine the methylation ratios of p16 and ESR1 using real-time PCR. For both genes, there was a statistically significant difference in the methylation ratio between non-small cell lung cancer patients and controls (p16; p<0.01, ESR1; p<0.001). In addition, there was a strong correlation between the methylation ratio of each gene and old age (p16; p<0.01, ESR1; p<0.001 and p16 or ESR1; p<0.001), and between p16 or ESR1 methylation rate and smoking history (p<0.01). Moreover in Stage I cases, the methylation positive rate of each gene (p16, ESR1 and p16 or ESR1) was higher than the CEA positive rate (p<0.05, p<0.001, p<0.001). Evaluation of p16 and ESR1 promoter methylation in blood using real-time PCR appears to be very useful for lung cancer diagnosis and there is some possibility that these methylated genes might come to represent useful biomarkers for the early detection of lung cancer. Our study results also suggested that comparative evaluation of the methylation ratio before and after surgery might be a powerful tool to predict the prognosis of lung cancer patients.

Syntheses and characterizations of a new calixarene-porphyrin conjugate as electron transfer system.

A new calixarene-based donor-acceptor system, cone conformer 1, was prepared for the first time. In this compound, the calix[4]arene serves to juxtapose a tri-chloroquinone acceptor near the porphyrin photo-donor plane. As to the conformational control, the cone conformer 1 gave two peaks of phenolic OH groups at 8.40 and 8.43 ppm. This shows that cone conformer 1 is stabilized by intramolecular hydrogen bonds. The fluorescence intensity of 1 was 35% of that for the control compound 2. This means the tri-chloroquinone group in 1 efficiently quenched the fluorescence of ZnP*. The shortest edge-to-edge separation of the chromophores of 1 is ca. 8 A (as judged by CPK models). This provides a new calixarene-based supramolecular system in which through-space donor-to-acceptor electron transfer is observed upon photoexcitation.

13C NMR longitudinal relaxation time studies of a molecular tweezers derived from a calixarene-porphyrin conjugate.

Zn(II)porphyrin-substituted calix[4]arene 1 serves as molecular tweezers for 1,4-diazabicyclo[2.2.2] octane (DABCO) selectively, which led to the formation of Ensemble I. The molecular segments composing the calixarene cavity change upon inclusion of DABCO as Ensemble I were evaluated through (13)C NMR longitudinal relaxation times (T(1)) for the first time. As for Ensemble I, the 1:1 complex should be formed. The T(1) values for Ensemble I are generally smaller than those for 1: in CDCl(2)CDCl(2), DT1 = 5.03 s for C-1, 5.31 s for C-2, 0.13 s for C-3, 0.7 s for C-4, and 0.16 s for C-5. This substantiates that the rings of Ensemble I are firmly freezed because of the two-point coordination by DABCO. In 1, the T1 values for C-3 are always greater than those for C-4, and the difference between C-3 and C-4 is slight. As for Ensemble I, on the other hand, the difference between C-3 and C-4 is large. We can suggest two different motions for phenol units in 1 and Ensemble I: a rotational motion around a C-1 to C-4 axis (A) and a seesaw motion around a C-2 to C-2' axis (B). The data indicate that in Ensemble I motion (A) is predominant over motion (B). This indicates that motion (B) is specifically suppressed because of the two-point coordination interactions in Ensemble I.

Hypereosinophilia in a patient with invasive thymoma with clonal T-lymphocyte expansion expressing CD4, CD8, and CD25 antigens.

We report the case of a patient with hypereosinophilia and invasive thymoma harboring probable clonal proliferation of CD4+, CD8+, and CD25+ T-lymphocytes. A 64-year-old woman had eosinophilia (14.1 x 10(9)/L) and an anterior mediastinal tumor with elevated levels of serum immunoglobulin E (609.8 mg/dL) and interleukin 5 (239 pg/mL). Bone marrow aspirate showed marked infiltration by morphologically normal eosinophils with a normal karyotype but no FIP1L1-PDGFRA fusion gene. Flow cytometric analysis revealed an increasing number of CD3+/CD25+ lymphocytes in the peripheral blood, and the resected thymoma had infiltrated lymphocytes with CD4/CD8/CD25 antigens. Moreover, the thymoma had T-cell receptor rearrangements with a cytogenetically clonal nature, ie, t(2;4)(p22;q26). Although the number of patients with thymoma showing hypereosinophilia is small, this case suggests that a subset of patients with thymoma may have clonal expansion of T-lymphocytes with abnormal phenotypes that affect clinical manifestations, including hypereosinophilia.

Photodynamic therapy (PDT) for lung cancers.

Photodynamic therapy (PDT), a treatment for cancer, uses a photosensitizer and laser irradiation to produce reactive oxygen in cells. In Japan, the United States, and many other countries, PDT is a treatment option for stage 0 (TisN0M0) and stage I (T1N0M0) centrally located early stage lung cancer. PDT can preserve lung function, can be repeated, and can be combined with other therapeutic modalities such as chemotherapy. Recently, mono-l-aspartyl chlorine e6 (NPe6, Laserphyrin), a second-generation photosensitizer with lower photosensitivity than Photofrin (porfimer sodium), was approved by the Japanese government and a phase II clinical study using NPe6 with a new diode laser demonstrated an excellent antitumor effect and low skin photosensitivity. We expect PDT to be widely employed in many fields and the applications of PDT to be extended because of the decreasing cost of laser equipment and lower systemic photosensitivity induced by the photosensitizer. The purpose of this review is to introduce not only recent clinical trials of PDT for centrally located early lung cancer, but also new applications of PDT for cases of peripheral-type, early-stage lung cancers. We also discuss the applications of PDT for advanced lung cancer and combined therapy using PDT and other treatments for lung cancer.

Present strategy of lung cancer screening and surgical management.

Previous lung cancer screening trials in the United States (US) employing chest X ray and sputum cytology did not demonstrate reductions in lung cancer mortality. However, recent case control studies in Japan demonstrated a decrease in lung cancer mortality in the computed tomography (CT) screened group. Lung cancer screening using chest CT detected more cancers at an earlier stage than chest X ray. Before CT screening is widely performed, lung cancer mortality reduction should be proved in a scientific manner. The problem of a much higher false positive rate of this method should be solved. The subtypes of adenocarcinoma; bronchioloalveolar carcinoma (BAC) tends to show specific CT findings called ground glass opacity (GGO) and a favorable prognosis can be expected. BAC is usually invisible by chest X ray and detected only by CT. Recent studies have shown the proportion of GGO is strongly related to biological malignancy of small adenocarcinoma. Based on this fact, thoracic surgeons wish to identify the possibility of limited resection for minimally invasive cancers. Lung cancer researchers are interested in evaluating the nature of small adenocarcinoma as well as the carcinogenic process. A comprehensive understanding of screening-detected cancers including the CT images, pathology and genetic analysis is necessary for optimum management of such nodules.