Spontaneous Remission of Minimal Change Disease in a Colon Cancer Patient: A Case Report.

Introduction: Minimal change disease (MCD) is most often primary but may occur secondary to other systemic diseases such as malignancy. In secondary MCD, spontaneous remission of nephrotic syndrome after the treatment of related diseases without steroid therapy is rare. Case Presentation: A 78-year-old man visited the outpatient clinic with foamy urine and generalized edema that had persisted for 2 months. The patient had nephrotic syndrome. Before a kidney biopsy, he underwent several tests to determine the secondary cause of the nephrotic syndrome. The serum CEA was slightly elevated, and colon cancer was detected in the sigmoid colon. MCD was diagnosed from a kidney biopsy. He immediately underwent surgery for colon cancer. Complete remission of the MCD was achieved within 2 weeks after surgery. Conclusion: Here, we report a rare case of a patient with secondary MCD who successfully achieved spontaneous remission after colon cancer surgery.

Successful management of proteinuria in recurrent immunoglobulin A nephropathy after deceased donor kidney transplantation: A case report.

BACKGROUND: Immunoglobulin A nephropathy (IgAN) is the most common type of primary glomerulonephritis, and recurrent IgAN is common after kidney transplantation (KT). Owing to the differences in various biopsy protocols and follow-ups in each study, the recurrence rate varies from 9.7% to 46%. Although the relapse rates are high, there is no definitive treatment for IgAN recurrence. METHODS: We present a case of successful management of proteinuria in recurrent IgAN after deceased donor KT. A 60-year-old man diagnosed with IgAN 20 years prior, who progressed to end-stage renal disease, underwent deceased donor KT 5 years prior and was admitted to our hospital with progressively increasing proteinuria. RESULTS: The pathological examination of the kidney biopsy specimen revealed recurrent IgAN. High-dose steroid treatment was initiated, and the patient was discharged while maintaining steroid treatment. However, outpatient follow-up showed that proteinuria did not decrease while steroids were maintained. Therefore, an angiotensin receptor blocker was administered after explaining its benefits to the patient. After the addition of angiotensin receptor blocker, proteinuria continued to decrease. CONCLUSION: This case report highlights the importance of using renin-angiotensin system inhibitors with supportive care in cases of suspected of recurrent IgAN after KT. It also emphasizes the need to prescribe renin-angiotensin system inhibitors when steroid therapy is unsuccessful in cases of recurrent IgAN after KT.

Improving quality control in the routine practice for histopathological interpretation of gastrointestinal endoscopic biopsies using artificial intelligence.

BACKGROUND: Colorectal and gastric cancer are major causes of cancer-related deaths. In Korea, gastrointestinal (GI) endoscopic biopsy specimens account for a high percentage of histopathologic examinations. Lack of a sufficient pathologist workforce can cause an increase in human errors, threatening patient safety. Therefore, we developed a digital pathology total solution combining artificial intelligence (AI) classifier models and pathology laboratory information system for GI endoscopic biopsy specimens to establish a post-analytic daily fast quality control (QC) system, which was applied in clinical practice for a 3-month trial run by four pathologists. METHODS AND FINDINGS: Our whole slide image (WSI) classification framework comprised patch-generator, patch-level classifier, and WSI-level classifier. The classifiers were both based on DenseNet (Dense Convolutional Network). In laboratory tests, the WSI classifier achieved accuracy rates of 95.8% and 96.0% in classifying histopathological WSIs of colorectal and gastric endoscopic biopsy specimens, respectively, into three classes (Negative for dysplasia, Dysplasia, and Malignant). Classification by pathologic diagnosis and AI prediction were compared and daily reviews were conducted, focusing on discordant cases for early detection of potential human errors by the pathologists, allowing immediate correction, before the pathology report error is conveyed to the patients. During the 3-month AI-assisted daily QC trial run period, approximately 7-10 times the number of slides compared to that in the conventional monthly QC (33 months) were reviewed by pathologists; nearly 100% of GI endoscopy biopsy slides were double-checked by the AI models. Further, approximately 17-30 times the number of potential human errors were detected within an average of 1.2 days. CONCLUSIONS: The AI-assisted daily QC system that we developed and established demonstrated notable improvements in QC, in quantitative, qualitative, and time utility aspects. Ultimately, we developed an independent AI-assisted post-analytic daily fast QC system that was clinically applicable and influential, which could enhance patient safety.

Amphritea spongicola sp. nov., isolated from a marine sponge, and emended description of the genus Amphritea.

A Gram-stain-negative, rod-shaped (1.2-2.1 µm × 0.8-0.9 µm), flagellated and motile marine bacterium, designated MEBiC05461T, was isolated from a marine sponge inhabiting Micronesia. Strain MEBiC05461T was oxidase-negative and catalase-positive. Growth was observed at 8.0-35.6 °C (optimum 30.0 °C), at pH 5.0-9.0 (optimum pH 7.0) and with 1.5-6.0 % (w/v, optimum 2.0-2.5 %) NaCl. 16S rRNA gene sequence analysis revealed that strain MEBiC05461T showed high similarity to members of the genus Amphritea (96.4-96.6 %). The predominant cellular fatty acids were C16:0 (23.9 %), summed feature 3 (C16:1ω7c and/or C16:1ω6c; 39.7 %) and summed feature 8 (C18:1ω7c and/or C18:1ω6c; 22.0 %). The DNA G+C content was 48.5 mol%. The major respiratory quinone was Q-8.Phosphatidylethanolamine, phosphatidylglycerol, one unidentified glycolipid, one unidentified aminolipid, one unidentified glycophospholipid and two unidentified lipids were detected as the major polar lipids. On the basis of the data from this polyphasic taxonomic study, strain MEBiC05461T should be classified as a representative of a novel species in the genus Amphritea, and the name proposed is Amphritea spongicola sp. nov. The type strain is MEBiC05461T ( = KCCM 42943T = JCM 16668T). Emendations of the genus Amphritea and species Amphritea atlanticaGärtner et al. 2008 and Amphritea balenaeMiyazaki et al. 2008 are were also given.

Carboxylicivirga gen. nov. in the family Marinilabiliaceae with two novel species, Carboxylicivirga mesophila sp. nov. and Carboxylicivirga taeanensis sp. nov., and reclassification of Cytophaga fermentans as Saccharicrinis fermentans gen. nov., comb. nov.

Two facultatively anaerobic mesophilic bacteria, strains MEBiC 07026(T) and MEBiC 08903(T), were isolated from two different tidal flat sediments and both strains showed approximately 92.2 % 16S rRNA gene sequence similarity with [Cytophaga] fermentans DSM 9555(T). 16S rRNA gene sequence similarity between the two new isolates was 97.5 % but levels of DNA-DNA relatedness between the two were 31.3-31.8 %. Phylogenetic analysis revealed that the two isolates and [Cytophaga] fermentans DSM 9555(T) were affiliated with the family Marinilabiliaceae in the class Bacteroidia. The dominant fatty acids of strains MEBiC 07026(T), MEBiC 08903(T) and [Cytophaga] fermentans DSM 9555(T) were branched-type or hydroxylated C15 : 0, but [Cytophaga] fermentans DSM 9555(T) contained a higher proportion of anteiso-branched fatty acids. The two new isolates contained a markedly higher proportion of monounsaturated fatty acids than other members of the family Marinilabiliaceae. The major respiratory quinone of the strains was MK-7. Strains MEBiC07026(T) and MEBiC08903(T) utilized a wide range of carboxylic acids whereas [Cytophaga] fermentans DSM 9555(T) utilized carbohydrates rather than carboxylic acids. The DNA G+C content of the novel strains was about 44 mol% but that of [Cytophaga] fermentans DSM 9555(T) revealed from the genome sequence was 37.6 mol%. Based on evidence from this polyphasic taxonomic study, a novel genus, Carboxylicivirga gen. nov., is proposed in the family Marinilabiliaceae with two novel species, Carboxylicivirga mesophila sp. nov. with type strain MEBiC 07026(T) ( = KCCM 42978(T) = JCM 18290(T)) and Carboxylicivirga taeanensis sp. nov. with type strain MEBiC 08903(T) ( = KCCM 43024(T) = JCM 19490(T)). Additionally, [Cytophaga] fermentans DSM 9555(T) ( = ATCC 19072(T)) is reclassified as Saccharicrinis fermentans gen. nov., comb. nov.