Cervical esophagotomy for removal of an ingested clam shell: a very uncommon foreign body ingestion

Objective: To report the removal of an ingested clam shell that was firmly impacted in the esophagus

Clinical Presentation and Intervention: A 77-year-old man presented at our hospital with acute dysphagia after eating a seafood risotto. An urgent dedicated examination [noncontrast helical multislice computed tomography scan of the neck and flexible esophagoscopy] detected a clam shell lodged in the upper esophagus. After several unsuccessful endoscopic attempts, a lifesaving cervical esophagotomy was performed and the foreign body was retrieved

Conclusion:This patient who ingested clam shell recovered well following the retrieval of the foreign body by performing a lifesaving cervical

Role of Chromosome Changes in Crocodylus Evolution and Diversity

The karyotypes of most species of crocodilians were studied using conventional and molecular cytogenetics. These provided an important contribution of chromosomal rearrangements for the evolutionary processes of Crocodylia and Sauropsida (birds and reptiles). The karyotypic features of crocodilians contain small diploid chromosome numbers (30~42), with little interspecific variation of the chromosome arm number (fundamental number) among crocodiles (56~60). This suggested that centric fusion and/or fission events occurred in the lineage, leading to crocodilian evolution and diversity. The chromosome numbers of Alligator, Caiman, Melanosuchus, Paleosuchus, Gavialis, Tomistoma, Mecistops, and Osteolaemus were stable within each genus, whereas those of Crocodylus (crocodylians) varied within the taxa. This agreed with molecular phylogeny that suggested a highly recent radiation of Crocodylus species. Karyotype analysis also suggests the direction of molecular phylogenetic placement among Crocodylus species and their migration from the Indo-Pacific to Africa and The New World. Crocodylus species originated from an ancestor in the Indo-Pacific around 9~16 million years ago (MYA) in the mid-Miocene, with a rapid radiation and dispersion into Africa 8~12 MYA. This was followed by a trans-Atlantic dispersion to the New World between 4~8 MYA in the Pliocene. The chromosomes provided a better understanding of crocodilian evolution and diversity, which will be useful for further study of the genome evolution in Crocodylia.

Appropriate Condition of Germ Tube Formation as Presumptive Identification Test for Candida albicans / 대한의진균학회지

BACKGROUND: Candida albicans is the most prevalent species found in human yeast infections. The germ tube test is still frequently used for its rapid presumptive identification. Recently Candida dubliniensis as well as C. albicans has been reported to form germ tubes. OBJECTIVE: The purpose of this study was to evaluate the germ tube test at various conditions for rapid presumptive identification of C. albicans. METHODS: C. albicans ATCC 14053, C. albicans ATCC 18804, C. dubliniensis ATCC MYA 646, and C. dubliniensis KCTC 17427 were tested. Human pooled serum (HPS), HBV, HCV infected patient serum, fetal bovine serum (FBS) and rabbit serum (RS) were used for germ tube test. The germ tube formation was evaluated at different keeping condition of various sera, after mixing with 5 different bacterial suspensions and at various incubation conditions. RESULTS: The germ tube formation of C. albicans was more in the RS or FBS than in the HPS. For the various sera fresh sample was always the best expression of germ-tube forming ability. In the HCV infected patient serum and mixing with Pseudomonas aeruginosa germ tube formation was suppressed. C. dubliniensis did not form germ tube in the HPS, only formed in the FBS or RS. CONCLUSION: For rapid presumptive identification of C. albicans not C. dubliniensis the best selection of serum is the fresh HPS. We recommend the examination with isolated colony free from bacteria after incubation for 2 to 3 hours.

Proliferation of Tricholoma matsutake Mycelial Mats in Pine Forest Using Mass Liquid Inoculum

Two isolates of Tricholoma matsutake T-008 and T-034, preserved in Entomopathogenic Fungal Culture Collection (EFCC) of Korea, were used in the present study. The isolates had 100% Bootstrap homology with Tricholoma matsutake U62964 and T. matsutake AB188557 and AF309538 preserved in Gene Bank of NCBI. Mycelial growth of T. matsutake was highest in TMM and MYA at 25degrees C. The highest dry wt. of mycelium was obtained after 65 days of culture, when 6 mycelial discs were inoculated in 100 ml of broth in 250 ml shaking flask. Mycelial mats were observed in clumped condition at the inoculation sites of pine forest after two weeks of inoculation. After 5 months of inoculation, mycelia mats were observed growing inside soil and walls of a few inoculation sites, while mycelial mats growth up to 5~8 cm were observed in the roots of pine tree after 6 months. The survival rate of the inoculum was about 40% of the total inoculation sites. The survival rate was found below 20% when the mycelium was inoculated in the summer. The reasons for low survival rates of the mycelium were mainly due to dry season and the soil-borne small animals such as earthworm and mole. After one year of inoculation, no external difference was observed between the artificially inoculated mycelia and the naturally existing mycelia of T. matsutake. The present study showed that fruiting bodies of T. matsutake could be produced by artificial inoculation under the appropriate environmental conditions.

Development of Systemic Lupus Erythematosus after Total Resection of a Thymoma for Myasthenia Gravis / 대한내과학회지

Systemic lupus erythematosus and myasthenia gravis are autoimmune disorders in which genetic, environmental and hormonal as well as immunological factors have been implicated. We experienced a case of 24 year-old female patient developed SLE(anemia, leukopenia, facial malar rash, high titers of anti-DNA and anti-nuclear antibody) 3 years following successful therapeutic thymectomy for myas thenia gravis. A review of the world-wide literature revealed 8.3% to 24.3% association between myasthenia gravis and SLE. However there has been no controlled epidemiological study to prove a real association between these two disease. The differential diagnosis of fatigue and fever in patient with SLE should always include the possibility of myasthenia gravis.