Visual change as the presenting symptom of a suspected metastatic brain lesion in esophageal cancer: A case report.

INTRODUCTION: Esophageal cancer is the seventh most common malignancy worldwide and the sixth leading cause of cancer mortality with an overall survival rate of <20%. Esophageal cancer frequently metastasizes to distant lymph nodes, lungs, liver, and bones. Cerebral metastases originating from esophageal cancer are rare and often carry a poor prognosis as do most all metastatic lesions in esophageal cancer. CASE PRESENTATION: In this report, we describe a 55-year-old patient with past history of esophageal carcinoma who presented with blurred vision after taking ethambutol for tuberculosis. Ethambutol-induced optic neuropathy was the lead diagnosis. Initial vision testing was normal so additional testing with visual field examination was warranted. The visual field examination revealed homonymous hemianopsia. Subsequent magnetic resonance imaging of his brain, demonstrated a focal lesion, consistent with but not diagnostic of a brain metastasis likely from his primary esophageal malignancy. CONCLUSION: We conclude that a careful review of the medical history and comprehensive assessment are essential in establishing an obscure clinical diagnosis especially in the event that an uncommon metastatic lesion is encountered.

Effects of Saccharomyces cerevisiae and phytase co-fermentation of wheat bran on growth, antioxidation, immunity and intestinal morphology in broilers.

OBJECTIVE: The aim of this study was to investigate the effects of different amounts of wheat bran (WB) inclusion and postbiotics form by Saccharomyces cerevisiae and phytase cofermented wheat bran (FWB) on the growth performance and health status of broilers. METHODS: Study randomly allocated a total of 300 male broilers to a control and 4 treatment groups (5% WB, 5% FWB, 10% WB, and 10% FWB inclusion, respectively) with each pen having 20 broilers and 3 pens per treatment. RESULTS: The WB does not contain enzymes, but there are 152.8, 549.2, 289.5, and 147.1 U/g dry matter xylanase, protease, cellulase and ß-glucanase in FWB, respectively. Furthermore, FWB can decrease nitric oxide release of lipopolysaccharide stimulated chicken peripheral blood mononuclear cells by about two times. Results show that 10% FWB inclusion had significantly the highest weight gain (WG) at 1 to 21 d; 5% FWB had the lowest feed conversion rate at 22 to 35 d; 10% WB and 10% FWB inclusion have the highest villus height and Lactobacillus spp. number in caecum; and both 5% and 10% FWB can increase ash content in femurs. Compared to control group, all treatments increase mucin 2, and tight junction (TJ), such as occludin, claudin-1, zonula occludens-1, and mRNA expression in ileum by at least 5 folds. In chicken peripheral blood mononuclear cells, nicotinamide adenine dinucleotide phosphate-oxidase-1 mRNA expression decreases from 2 to 5 times, and glutamate-cysteine ligase catalytic subunit mRNA expression also increases in all treatment groups compared to control group. The mRNA expression of pro-inflammatory cytokines, including interleukin-6 (IL-6), nuclear factor-κB, and IL-1ß, decreases in 5% and 10% FWB groups compared to control group. CONCLUSION: To summarize, both WB and FWB inclusion in broilers diets increase TJ mRNA expression and anti-oxidation and anti-inflammation, but up to 10% FWB groups have better WG in different stages of broiler development.

Flower-visiting insects of genus Melastoma (Myrtales: Melastomataceae) at the Fushan Botanical Garden, Taiwan.

BACKGROUND: We investigated the diversity and behaviour of insects that visit flowers of four native Melastoma (Family Melastomataceae) species of Taiwan and a horticultural hybrid Melastoma species at the Fushan Botanical Garden, Taiwan biweekly from May to August 2020. Visits of flower-visiting insects were classified into seven behavioural categories, based on the insects' behaviour and positions on the flower. The data are further assigned into four insect-flower interactions, namely pollination, herbivory, commensalism and neutralism. Our goal is to provide baseline data of insect-plant interactions of Melastoma, which is a common, but understudied plant genus in the country. NEW INFORMATION: A total of 1,289 visits to flowers were recorded by at least 63 insect morphospecies belonging to seven orders. The number of insect species recorded per Melastoma species ranged from 9 to 39. Visiting, sonication and passing were the three most frequently recorded types of behaviour, collectively accounting for 90.2% (n = 1,240) of the total observations. Pollination was the most dominant insect-flower interaction, accounting for 70.2% of the total observations, followed by neutralism (20.0%), herbivory (6.3%) and commensalism (3.5%). Sweat bees of the genera Lasioglossum and Maculonomia (Hymenoptera: Halictidae) are considered key pollinators to Melastoma species in Fushan Botanical Garden, based on their high number of visits and sonication behaviour. Our study provides the first list of insects that visit the flowers of all Taiwan's known Melastoma species and description of their interactions with the plants.

Paliperidone Inhibits Glioblastoma Growth in Mouse Brain Tumor Model and Reduces PD-L1 Expression.

A previous study from our group reported that monocyte adhesion to glioblastoma (GBM) promoted tumor growth and invasion activity and increased tumor-associated macrophages (TAMs) proliferation and inflammatory mediator secretion as well. The present study showed that prescribed psychotropic medicine paliperidone reduced GBM growth and immune checkpoint protein programmed death ligand (PD-L)1 expression and increased survival in an intracranial xenograft mouse model. An analysis of the database of patients with glioma showed that the levels of PD-L1 and dopamine receptor D (DRD)2 were higher in the GBM group than in the low grade astrocytoma and non-tumor groups. In addition, GFP expressing GBM (GBM-GFP) cells co-cultured with monocytes-differentiated macrophage enhanced PD-L1 expression in GBM cells. The enhancement of PD-L1 in GBM was antagonized by paliperidone and risperidone as well as DRD2 selective inhibitor L741426. The expression of CD206 (M2 phenotype marker) was observed to be markedly increased in bone marrow-derived macrophages (BMDMs) co-cultured with GBM. Importantly, treatment with paliperidone effectively decreased CD206 and also dramatically increased CD80 (M1 phenotype marker) in BMDMs. We have previously established a PD-L1 GBM-GFP cell line that stably expresses PD-L1. Experiments showed that the expressions of CD206 was increased and CD80 was mildly decreased in the BMDMs co-cultured with PD-L1 GBM-GFP cells. On the other hands, knockdown of DRD2 expression in GBM cells dramatically decreased the expression of CD206 but markedly increased CD80 expressions in BMDMs. The present study suggests that DRD2 may be involved in regulating the PD-L1 expression in GBM and the microenvironment of GBM. Our results provide a valuable therapeutic strategy and indicate that treatments combining DRD2 antagonist paliperidone with standard immunotherapy may be beneficial for GBM treatment.

Active Vitamin D3 Treatment Attenuated Bacterial Translocation via Improving Intestinal Barriers in Cirrhotic Rats.

SCOPE: Pathological bacterial translocation from the disrupted intestinal barrier leads to substantial complications and mortality in liver cirrhosis. Vitamin D is reported as beneficial to gut barriers in some animal models. However, its effect on cirrhotic bacterial translocation is unknown. The authors aim to investigate the effects of calcitriol on bacterial translocation in cirrhotic rats. METHODS AND RESULTS: Cirrhotic rats are administrated with a 2-week course of active vitamin D3 (calcitriol, 0.1 µg kg-1  per day) or vehicle by oral gavage after thioacetamide (TAA) injection for 16 weeks. Bacterial translocation, gut permeability, gut microbiota, and associated mechanisms are investigated. Calcitriol treatment significantly attenuates bacterial translocation and reduces intestinal permeability in TAA-induced cirrhotic rats. It upregulates the expressions of occludin in the small intestine and claudin-1 in the colon of cirrhotic rats directly independent of intrahepatic status. Even when a short period of calcitriol treatment do not reduce intestinal bacterial overgrowth, it induces a remarkable change of bacterial diversities and enrichment of Muribaculaceae, Bacteroidales, Allobaculum, Anaerovorax, and Ruminococcaceae. CONCLUSION: Calcitriol treatment attenuates intestinal permeability, reduces bacterial translocation, and enriches potentially beneficial gut microbiota in cirrhotic rats that may enable it as a potential therapeutic agent to prevent cirrhotic complications.

Descemetocele and bilateral, severe Pseudomonas keratitis in an intensive care unit patient with Graves' orbitopathy: A case report.

RATIONALE: Exposure keratopathy (EK) is common among intensive care unit (ICU) patients, especially those under sedation and with incomplete eyelid closure. EK can be mild punctate epithelial erosions exhibiting spontaneous recovery; rarely, severe complications including bacterial ulcers causing corneal perforation or opacity could occur. We describe a patient with pre-existing Graves' orbitopathy (GO) who developed bilateral, rapidly progressing bacterial keratitis due to EK with secondary aerosol inoculation from respiratory pathogens in ICU. PATIENT CONCERNS: A 49-year-old intubated and sedated woman who underwent urgent craniotomy was admitted to ICU. The ophthalmology department was consulted for progressive chemosis. History of poorly controlled GO was revealed based on external ocular signs, including proptosis with lid retraction, and careful ophthalmological history taking. After 2 days of ICU admission, slit lamp examination revealed large inferior corneal epithelial defects and dellen (OU). Despite prescribing gentamicin ointment and lubricants, purulent discharge with corneal infiltration and thinning (OU) was observed 2 days later. Owing to a characteristic Pseudomonas odor from her endotracheal tube, corneal and endotracheal sputum cultures were obtained, which revealed Pseudomonas aeruginosa infection. DIAGNOSIS: Pseudomonas keratitis secondary to EK INTERVENTIONS:: Topical fortified anti-Pseudomonas antibiotic eye drops with temporary tarsorrhaphy and lubricants OUTCOMES:: Despite multiple treatments, she developed enlarging descemetocele in the left eye with severe corneal stromal destruction and severe visual impairment due to central corneal scar formation in the right eye. After 2 months, the descemetocele ruptured owing to generalized tonic-clonic seizures after cranioplasty. Therefore, she underwent urgent penetrating keratoplasty in the left eye. LESSONS: GO increases ocular surface inflammation and exposure, which may exacerbate EK and subsequent complication risks. Careful monitoring and aggressive treatment through appropriate eye care regimen are required in these patients.

The Effects of Fungal Feed Additives in Animals: A Review.

As probiotics, fungi enhance animal health and are suitable animal feed additives. In addition to brewing fungi, there are also edible and medicinal fungi. Common fungi utilized in feeding programs include Saccharomyces cerevisiae, Aspergillus oryzae, Pleurotus spp., Antrodia cinnamomea, and Cordyceps militaris. These fungi are rich in glucans, polysaccharides, polyphenols, triterpenes, ergosterol, adenosine, and laccases. These functional components play important roles in antioxidant, anti-inflammatory, anti-obesity, and immune system regulation. As such, fungal feed additives could be of potential use when breeding livestock. In previous studies, fungal feed additives enhanced body weight and egg production in poultry and improved the feed conversion rate. Several mycotoxins can be produced by hazardous fungi but fortunately, the cell walls constituents and enzymes of fungal probiotics can also act to decrease the toxicity of mycotoxins. Overall, fungal feed additives are of value, but their safety and usage must be studied further, including cost-benefit economic analyses.

Evaluation of the Relationship between Adipose Metabolism Patterns and Secretion of Appetite-Related Endocrines on Chicken.

In addition to the influence of genes, the quality of poultry products is mainly controlled by the rearing environment or feed composition during rearing, and has to meet human use and economical needs. As the only source of energy for poultry, feed considerably affects the metabolic pattern of poultry and further affects the regulation of appetite-related endocrine secretion in poultry. Under normal circumstances, the accumulation of lipid in adipose reduces feed intake in poultry and increases the rate of adipose metabolism. When the adipose content in cells decreases, endocrines that promote food intake are secreted and increase nutrient concentrations in serum and cells. By regulating the balance between appetite and adipose metabolism, the poultry's growth and posture can maintain a balanced state. In addition, increasing fiber composition in feed can effectively increase poultry welfare, body weight, lean composition and antioxidant levels in poultry. According to this, the concept that proper fiber content should be added to feed should be considered for better economic benefits, poultry welfare and meat productivity.

Antibiotic use in patients with acute cholecystitis after percutaneous cholecystostomy.

BACKGROUND: Currently, evidence regarding the strategies of antibiotic use in patients with acute cholecystitis after receiving percutaneous cholecystostomy is limited. Hence, we aimed to investigate the outcomes in patients with inoperable acute cholecystitis receiving narrow or broad-spectrum antibiotics after percutaneous cholecystostomy. METHODS: A total of 117 patients receiving percutaneous cholecystostomy were categorized into moderate and severe acute cholecystitis defined by the Tokyo guideline and then divided into group A (narrow-spectrum antibiotic use) and group B (broad-spectrum antibiotic use). The clinical outcomes and complications were analyzed. RESULTS: In moderate acute cholecystitis (n = 80), group A patients (n = 62) had similar early recurrent rate (11.3% vs 16.7%; p = 0.544) and a shorter length of hospital stay (13.4 ± 8.6 vs 18.6 ± 9.4 days; p = 0.009) as compared with group B patients (n = 18). No in-hospital mortality occurred in moderate acute cholecystitis. In severe acute cholecystitis (n = 37), both groups had similar length of hospital stay (16.3 ± 12.2 vs 20.9 ± 9.5 days; p = 0.051), early recurrent rate (0% vs 16.7%; p = 0.105), and in-hospital mortality rate (5.3% vs 16.7%; p = 0.340). Although group B patients with severe cholecystitis had higher serum levels of alkaline phosphatase (Alk-P) and higher proportion of underlying malignancy, American Society of Anesthesiologists (ASA) class IV and septic shock, the clinical outcomes were not inferior to patients in group A. CONCLUSION: In moderate acute cholecystitis after percutaneous cholecystostomy, patients receiving narrow-spectrum antibiotics have comparable clinical outcomes as those treated with broad-spectrum antibiotics. However, in severe acute cholecystitis, broad-spectrum antibiotics might still be necessary to rescue these patients.

Evaluation of the Combined Use of Saccharomyces Cerevisiae and Aspergillus Oryzae with Phytase Fermentation Products on Growth, Inflammatory, and Intestinal Morphology in Broilers.

Saccharomyces cerevisiae and Aspergillus oryzae are both ancient probiotic species traditionally used as microbes for brewing beer and soy sauce, respectively. This study investigated the effect of adding these two probiotics with phytase fermentation products to the broilers diet. Fermented products possess protease and cellulase, and the activities were 777.1 and 189.5 U/g dry matter (DM) on S. cerevisiae fermented products (SCFP) and 190 and 213.4 U/g DM on A. oryzae fermented products (AOFP), respectively. Liposaccharides stimulated PBMCs to produce nitric oxide to 120 µmol. Both SCFP and AOFP reduced lipopolysaccharides stimulated peripheral blood mononuclear cells (PBMCs) nitric oxide release to 40 and 60 µmol, respectively. Nevertheless, in an MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, SCFP and AOFP also increased the survival rate of lipopolysaccharides stimulated PBMCs by almost two-fold compared to the negative control. A total of 240 broilers were divided into four groups as Control, SCFP 0.1% (SCFP), SCFP 0.05% + AOFP 0.05% (SAFP), and AOFP 0.1% (AOFP) groups, respectively. Each group had 20 broilers, and three replicate pens. The results showed that the addition of SCFP, SAFP, and AOFP groups did not affect the growth performances, but increased the jejunum value of villus height and villus: crypt ratio on SAFP and AOFP groups compared to the control and SCFP groups. Furthermore, adding SCFP, SAFP, and AOFP significantly reduced the number of Clostridium perfringens in ileum chyme. SCFP, SAFP, and AOFP significantly reduced the amount of interleukin-1ß, inducible nitric oxide synthases, interferon-γ, and nuclear factor kappa B mRNA expression in PBMCs, especially in the AOFP group. In summary, all the SCFP, SAFP, and AOFP groups can be suggested as a functional feed additive since they enhanced villus: crypt ratio and decreased inflammation-related mRNA expression, especially for AOFP group in broilers.