Direct and indirect effects of amphidromous shrimps on nutrient mineralization in streams in Japan.

Animals affect element cycling in ecosystems by consumption and excretion. Amphidromous shrimps frequently dominate low-mid altitude streams, where downstream connectivity to oceans is sustained. Although shrimps' direct influence on benthic communities has been studied, little is known about their influences on nutrient cycling. Here, we hypothesized that the dominance of shrimps alters nutrient mineralization by benthic macroinvertebrates in streams due to the difference in the quality and quantity of excretion between shrimps and aquatic insects. We tested this hypothesis through a field manipulative experiment, excretion measurements of animals, and field surveys. In the field manipulative experiment, the presence of shrimps slightly decreased the biomass of aquatic insects but tripled total benthic macroinvertebrate biomass directly through their own biomass. The mass-specific NH4+ excretion rate by shrimps was similar to aquatic insects, and the areal NH4+ excretion by benthic macroinvertebrates was increased by 2.5 times in the presence of shrimps. In contrast, shrimps excreted significantly less soluble reactive phosphorus (SRP) than aquatic insects, and the presence of shrimps did not affect areal SRP excretion by benthic macroinvertebrates. The field survey showed a positive correlation of NO3- concentration with the shrimp density, inferring the excess NH4+ was nitrified. Although the nutrient concentration of stream water is frequently attributed to watershed conditions, the results of this study indicate that downstream connectivity to oceans may also influence nutrient dynamics of the stream through the density of amphidromous shrimps.

Classification of Skin Injury Risk Caused by Extravasation of Electrolyte Solutions or Infusions in a Rat Model.

Cytotoxic agents are classified according to the severity of skin injury after extravasation. However, injuries caused by extravasation of noncytotoxic agents have not been sufficiently investigated, although the risk of extravasation is mentioned in medical safety information published by the Japan Council for Quality Health Care. Therefore, in this study, we focused on noncytotoxic electrolyte solutions and infusions and evaluated skin injuries during leakage using extravasation model rats. Rats were anesthetized and intradermally injected with 100 µL of an electrolyte solution or infusion. Injection lesions were macroscopically and histopathologically evaluated for extravasation injuries. Each electrolyte solution and infusion were classified into three categories (vesicants, irritants, and non-tissue-damaging agents) depending on the degree of skin injury. Similar to saline, 0.3% potassium chloride and 0.6% magnesium sulfate showed almost no injury, and 3% sodium chloride and BFLUID® caused erythema and induration. Erythema, induration, and ulceration were observed with the following: 10% sodium chloride, 2% calcium chloride, 8.5% calcium gluconate, 12.3% magnesium sulfate, MAGSENT®, FESIN®, and Intralipos®. The duration of damage with these agents was markedly prolonged. Electrolyte solutions and infusions can be classified into vesicants (10% sodium chloride, 2% calcium chloride, 8.5% calcium gluconate, 12.3% magnesium sulfate, MAGSENT®, FESIN®, and Intralipos®), irritants (3% sodium chloride and BFLUID®), and non-tissue-damaging agents (0.3% potassium chloride and 0.6% magnesium sulfate) according to their composition. The characteristic symptoms and severity of each drug extravasation revealed in this study will provide basic information for preparation of guidelines for treatment of extravasation.

Low Body Mass Index as a Predictive Factor for Postoperative Infectious Complications after Ureterorenoscopic Lithotripsy.

Background and Objectives: In this study, we aimed to evaluate predictive factors of postoperative fever (POF) after ureterorenoscopic lithotripsy (URSL). Materials and Methods: A total of 594 consecutive patients who underwent URSL for urinary stone disease at Gifu Municipal Hospital and Chuno Kosei Hospital between April 2016 and January 2021 were enrolled in this study. In all patients, antibiotics were routinely administered intraoperatively and the next day after surgery. We used rigid and/or flexible ureterorenoscopes depending on the stone location for URSL. Stones were fragmented using a holmium: YAG laser. The fragments of the stone were manually removed as much as possible using a stone basket catheter. A ureteral stent was placed at the end of the surgery in all cases. Results: The median age and body mass index (BMI) in all patients were 62 years and 23.8 kg/m2, respectively. The median operation duration was 52 min. The most common URSL-related complication was POF in 28 (4.7%) patients. In these patients, the rates of antibiotic administration and ureteral stent insertion before surgery were significantly higher than in those without POF. In multivariate analysis, BMI was associated with POF after URSL. There were no significant differences in predicting POF after surgery in patients who had bacteriuria or received antibiotics before surgery. Conclusions: A low BMI was significantly associated with POF after URS or URSL.

Lifetime eurythermy by seasonally matched thermal performance of developmental stages in an annual aquatic insect.

Organisms with annual life cycles are exposed to life stage specific thermal environments across seasons. Seasonal variation in thermal environments can vary across years and among sites. We investigated how organisms with annual life cycles respond to predictable seasonal changes in temperature and unpredictable thermal variation between habitats and years throughout their lives. Field surveys and historical records reveal that the spatially and temporally heterogeneous thermal environments inhabited by the annual mayfly Ephemerella maculata (Ephemerellidae) shift the date for transition to the next, life stage, so that the thermal phenotype of each life stage matches the thermal environment of the specific habitat and year. Laboratory studies of three distinct life stages of this mayfly reveal that life stage transitions are temperature dependent, facilitating timing shifts that are synchronized with the current season's temperatures. Each life stage exhibited specific thermal sensitivity and performance phenotypes that matched the ambient temperature typically experienced during that life stage. Our study across the whole life cycle reveals mechanisms that allow organisms to achieve lifetime eurythermy in a dynamic seasonal environment, despite having narrower thermal ranges for growth and development in each life stage.

Stream thermal heterogeneity prolongs aquatic-terrestrial subsidy and enhances riparian spider growth.

Emerging aquatic insects from streams are important food sources for riparian predators, yet their availability is seasonally limited. Spatial heterogeneity in stream water temperature was found to spatially desynchronize the emergence timing of aquatic insects, and prolong their flight period, potentially enhancing consumer growth. While a mayfly Ephemerella maculata emergence lasted for 12-22 d in local sites along a river, mayflies emerged 19 days earlier from warmer than cooler sites. Therefore, the overall emergence of E. maculata from the river lasted for 37 d, and adult swarms were observed over that same period in an adjacent reproductive habitat. A feeding experiment with the riparian spider Tetragnatha versicolor showed that a prolonged subsidy, as would occur in a heterogeneous river, led to higher juvenile growth than a synchronous pulsed subsidy of equal total biomass, as would typify a more homogeneous river. Since larger female adult spiders produce more eggs, spiders that received prolonged subsidy as juveniles should achieve higher fecundity. Restoring spatial heterogeneity in streams may benefit not only stream communities but also riparian predators.

Mainstem-tributary linkages by mayfly migration help sustain salmonids in a warming river network.

Animal migrations can link ecosystems across space. We discovered an aquatic insect that migrates between a river mainstem and its tributaries, and provides an important trophic subsidy for tributary predators. A mayfly, Ephemerella maculata, rears in a warm, sunlit productive river mainstem, then migrates as adults to cool, shaded unproductive tributaries where they oviposit and die. This migration tripled insect flux into a tributary for 1 month in summer. A manipulative field experiment showed that this E. maculata subsidy nearly tripled the growth of the young of the year steelhead trout (Oncorhynchus mykiss) in the recipient tributary over the summer months, and was more important than terrestrial invertebrate subsidies, which have been considered the primary food source for predators in small, forested creeks. By delivering food subsidies from productive but warming river mainstems to cool but food-limited tributaries, aquatic insect migrations could enhance resilience to cool-water predators in warming river networks.

Anomalomermis ephemerophagis n. g., n. sp. (Nematoda: Mermithidae) parasitic in the mayfly Ephemerella maculata Traver (Ephermeroptera: Ephermerellidae) in California, USA.

A new nematode, Anomalomermis ephemerophagis n. g., n. sp. (Nematoda: Mermithidae) is described from the mayfly Ephemerella maculata Traver (Ephermeroptera: Ephermerellidae) in California. The new species is characterised by six cephalic papillae and four additional disk papillae located on the head between the cephalic papillae and stoma. Additional diagnostic characters are: a terminal mouth opening; absence of X-fibers in the cuticle of both postparasitic juveniles and adults; paired, curved, medium-sized spicules; a straight barrow-shaped vagina and large eggs. Two infectious agents were present in some specimens. This is the first description of an adult nematode from a mayfly.

A Case Report of Syphilis That Was Difficult to Distinguish From Penile Carcinoma.

A 43-year-old man presented with penile induration and lymphadenopathy. Computed tomography revealed multiple enlarged lymph nodes (LNs). Penile cancer was suspected, and a LN biopsy was performed. Histopathological examination revealed inflammation and fibrosis, with no findings indicating malignancy. Serological examination confirmed syphilis and treatment with amoxicillin was initiated. Thereafter, swelling in the LNs improved quickly. Penile cancer is usually suspected in the presence of penile induration. However, syphilis can also present with similar symptoms. To distinguish between syphilis and penile cancer, the patient's history, results of physical examination, and presence of tumor and infectious markers should be considered.

Perilesional Targeted Biopsy Combined with MRI-TRUS Image Fusion-Guided Targeted Prostate Biopsy: An Analysis According to PI-RADS Scores.

A prostate-targeted biopsy (TB) core is usually collected from a site where magnetic resonance imaging (MRI) indicates possible cancer. However, the extent of the lesion is difficult to accurately predict using MRI or TB alone. Therefore, we performed several biopsies around the TB site (perilesional [p] TB) and analyzed the association between the positive cores obtained using TB and pTB and the Prostate Imaging Reporting and Data System (PI-RADS) scores. This retrospective study included patients who underwent prostate biopsies. The extent of pTB was defined as the area within 10 mm of a TB site. A total of 162 eligible patients were enrolled. Prostate cancer (PCa) was diagnosed in 75.2% of patients undergoing TB, with a positivity rate of 50.7% for a PI-RADS score of 3, 95.8% for a PI-RADS score of 4, and 100% for a PI-RADS score of 5. Patients diagnosed with PCa according to both TB and pTB had significantly higher positivity rates for PI-RADS scores of 4 and 5 than for a PI-RADS score of 3 (p < 0.0001 and p = 0.0009, respectively). Additional pTB may be performed in patients with PI-RADS ≥ 4 regions of interest for assessing PCa malignancy.

The accuracy of prostate cancer diagnosis in biopsy-naive patients using combined magnetic resonance imaging and transrectal ultrasound fusion-targeted prostate biopsy.

BACKGROUND: This study aimed to estimate whether multiparametric magnetic resonance imaging (mpMRI)-transrectal ultrasound (TRUS) fusion biopsy (FUS-TB) increases the detection rates of clinically significant prostate cancer (csPCa) compared with TRUS-guided systematic biopsy (TRUS-GB). METHODS: This retrospective study focused on patients who underwent mpMRI before prostate biopsy (PB) with Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) scores ≥3 and prostate-specific antigen (PSA) level between 2.5 and 20 ng/mL. Before FUS-TB, the biopsy needle position was checked virtually using three-dimensional mapping. After confirming the position of the target within the prostate, biopsy needle was inserted and PB was performed. Suspicious lesions were generally targeted with 2 to 4 cores. Subsequently, 10-12 cores were biopsied for TRUS-GB. The primary endpoint was the PCa detection rate (PCDR) for patients with PCa who underwent combined FUS-TB and TRUS-GB. RESULTS: According to PI-RADS v2, 76.7% of the patients with PI-RADS v2 score ≥3 were diagnosed with PCa. The PCDRs in patients with PI-RADS v2 score of 4 or 5 were significantly higher than those in patients with PI-RADS v2 score of 3 (3 vs. 4, P<0.001; 3 vs. 5, P<0.001; 4 vs. 5, P=0.073). According to PCDR, the detection rates of PCa and csPCa in the FUS-TB were significantly higher than that in the TRUS-GB. CONCLUSIONS: Following detection of suspicious tumor lesions on mpMRI, FUS-TB use detects a higher number of PCa cases compared with TRUS-GB.

[Discrepancy between Gleason score of needle biopsies and radical prostatectomy specimens--current situation of general pathologists].

We retrospectively reviewed the discrepancy in Gleason score between needle biopsy and radical prostatectomy specimens. Specimens from 153 patients who underwent radical retropubic prostatectomy at Gifu University Hospital and 9 community-based institutions between January 2001 and December 2005, were studied. Gleason score was determined by the general pathologist at each institution. The coincidence rate of Gleason score between biopsy and prostatectomy specimens was 49.7%. In contrast, 37.4% of biopsy specimens were undergraded. In biopsy specimens given a Gleason score of 5 or less, the Gleason score was coincident or undergraded compared with prostatectomy specimens. In biopsy specimens given a Gleason score of 6, the coincidence rate was 39.6%. In 56% in biopsy specimens of cancers with a Gleason score of 6 the Gleason score was undergraded compared with the prostatectomy specimen. In this group, extra-prostatic extention was found significantly more often than in other groups (p = 0.04). In patients, who underwent extended biopsy, or had a more positive biopsy core (> or = 25%), the coincidence rate was significantly greater (p = 0.03). We should be aware of the limitations of Gleason scores based on biopsy specimens, and give treatment opinions careful consideration.

Effect of edema on postimplant dosimetry in prostate brachytherapy using CT/MRI fusion.

PURPOSE: To investigate the time course of prostatic edema and the effect on the dose-volume histograms of the prostate for patients treated with brachytherapy. METHODS AND MATERIALS: A total of 74 patients with prostate cancer were enrolled in this prospective study. A transrectal ultrasound-based preplan was performed 4 weeks before implantation and computed tomography/magnetic resonance imaging fusion-based postimplant dosimetry was performed on the day after implantation (Day 1) and 30 days after implantation (Day 30). The prostate volume, prostate volume covered by 100% of the prescription dose (V100), and dose covering 90% of the prostate (D90) were evaluated with prostatic edema over time. RESULTS: Prostatic edema was greatest on Day 1, with the mean prostate volume 36% greater than the preplan transrectal ultrasound-based volume; it thereafter decreased over time. It was 9% greater than preplan volume on Day 30. The V(100) increased 5.7% from Day 1 to Day 30, and the D90 increased 13.1% from Day 1 to Day 30. The edema ratio (postplan/preplan) on Day 1 of low-quality implants with a V(100) of <80% was significantly greater than that of intermediate- to high-quality implants (>80% V100; p = 0.0272). The lower V100 on Day 1 showed a greater increase from Day 1 to Day 30. A V100 on Day 1 of >92% is unlikely to increase >0% during the interval studied. CONCLUSION: Low-quality implants on Day 1 were highly associated with edema; however, such a low-quality implant on Day 1, with significant edema, tended to improve by Day 30. If a high-quality implant (V100 >92%) can be obtained on Day 1, a re-examination is no longer necessary.

Migration of prostate brachytherapy seeds to the vertebral venous plexus.

PURPOSE: We report two cases of seed migration to the vertebral venous plexus after iodine-125 (I-125) transperineal interstitial permanent prostate brachytherapy. METHODS AND MATERIALS: Case 1: A 67-year-old Japanese man underwent percutaneous transperineal interstitial permanent prostate brachytherapy at our institution. Three months after brachytherapy, routine followup kidney-urinary bladder (KUB) radiography showed two seeds that had migrated to the pelvic area and were overlapped by sacral bone. It was very difficult to detect the seeds by visceral CT, because seeds were in contact with to vertebral bone, and seeds and bone were of the same CT value in visceral CT. But bone CT could distinguish seeds and bone, and it showed seed migration to the vertebral venous plexus in the sacral vertebral canal. Case 2: A 75-year-old Japanese man underwent percutaneous transperineal interstitial permanent prostate brachytherapy at our institution. The day after seed implantation, routine followup KUB radiography showed that a seed had migrated to the pelvic area and was overlapped by sacral bone. Bone CT clearly showed seed migration to the vertebral venous plexus in the vertebral canal in comparison with visceral CT. RESULTS: Seeds that have migrated to the vertebral venous plexus are difficult to be detected by visceral CT or KUB radiography. In visceral CT, it is difficult to distinguish seed and bone, especially when they are touching each other because they have the same CT value in visceral CT. It is therefore necessary to perform bone CT to detect such migrating seeds. CONCLUSIONS: To our knowledge, this is the first report of seed migration to the vertebral venous plexus after prostate brachytherapy. We thought that seeds migrate to the vertebral plexus via the pelvic venous pathway. If seed migration to the pelvic area and the overlapped sacral bone area is found after brachytherapy, bone CT should be performed, especially when it is difficult to detect the seed in visceral CT.

[Renal cell carcinoma metastatic to the ovary].

A 45-year-old woman underwent left radical nephrectomy in April 2002. Pathological diagnosis was a renal cell carcinoma, clear cell subtype, pT3a, v(-), NO. One year later, abdominal ultrasound revealed a left ovarian tumor which had an enlargement tendency. A laparoscopic bilateral salpingooophorectomy was performed. Immunohistochemical analysis confirmed the diagnosis of metastatic ovarian renal cell carcinoma. This is the 20th case in the literature.

Indications for extended 14-core transrectal ultrasound-guided prostate biopsy.

OBJECTIVES: We compared the cancer detection rate of extended 14-core biopsy with that of sextant biopsy to assess whether additional biopsy cores are useful for detection of prostate cancer and to clarify the indications for obtaining additional cores. METHODS: Study subjects were 313 patients who underwent transrectal ultrasound-guided 14-core biopsy because of a prostate-specific antigen (PSA) level greater than 4.0 ng/mL and/or abnormalities found on digital rectal examination (DRE). In addition to the standard 6 biopsy cores, 6 lateral cores were obtained as well as 2 transition zone cores. PSA density (PSAD) was determined as the total PSA level divided by the prostate volume as estimated by transrectal ultrasound. RESULTS: Prostate cancer was diagnosed in 127 patients (40.6%). In 28 (22%) patients, the cancer would not have been detected by the sextant method alone. Among 211 patients with normal DRE findings, the cancer detection rate with 14-core biopsy was statistically higher than that with 6-core biopsy in the 141 patients with a PSA level of 4.01 ng/mL to 10.0 ng/mL, and 14 (38.9%) of 36 cancers were diagnosed in additional cores only, not in the standard sextant biopsy cores. Among the 141 patients with a gray-zone PSA level, the cancer detection rate with extended biopsy was statistically higher in those with PSAD greater than 0.13 ng/mL. CONCLUSIONS: Lateral biopsy should be used in conjunction with sextant biopsy in patients with a PSA level of 4.01 ng/mL to 10.0 ng/mL with normal DRE findings, especially in those with PSAD greater than 0.13 ng/mL.

Retrospective study of 101 cases with incidental prostate cancer stages T1a and T1b.

PURPOSE: The purpose of this retrospective study was to clarify the character of incidental prostate cancer, stages T1a and T1b. METHODS: We analysed 101 cases of incidental prostate cancer. Incidental prostate cancer was diagnosed on the basis of normal digital rectal examination findings, a serum prostate-specific antigen (PSA) level of less than 4.0 ng/mL, and no abnormal computed tomography or ultrasonography findings. All patients were treated at Gifu University Hospital or an affiliated hospital during the period January 1992 through December 2001. RESULTS: There were 64 stage T1a cancers and 37 stage T1b cancers. The mean age of patients was 71.3 years (range 51-87 years). The mean serum PSA level was 1.63 ng/mL (range 0.2-4.0 ng/mL). Thirty-five stage T1a patients (56.5%) and thirty-two stage T1b patients (86.5%) underwent some type of treatment. Total prostatectomy was performed in eight stage T1a cases and fifteen stage T1b cases. Pathological diagnoses were as follows: pTx (n = 1), pT0 (n = 5) and pT2 (n = 2) for stage T1a cancers, and pT0 (n = 6), pT2 (n = 8) and pT3 (n = 1) for stage T1b cancers. Only one stage T1b cancer recurred. CONCLUSION: The outcome of patients with incidental prostate cancer was satisfactory; disease recurred in only one case of stage T1b cancer and there were no cases of PSA failure, although the pathological diagnosis in nine of the fifteen stage T1b cases (60.0%) treated with total prostatectomy was pT2 or pT3. Careful monitoring was indicated for stage T1a cancer, and some treatment was necessary for stage T1b cancer.