Late-onset lethal complication of non-surgically managed massive gastric conduit necrosis after esophagectomy: a case report.

BACKGROUND: Gastric conduit necrosis (GCN) after esophagectomy is a serious complication that can prove fatal. Herein, we report a rare case of GCN with a severe course that improved with conservative treatment. CASE PRESENTATION: We present the case of a 78-year-old male patient who underwent an Ivor Lewis esophagectomy and developed a massive GCN. The patient was critically ill in the initial phase but recovered quickly; he also had a ruptured gallbladder and a bleeding jejunal ulcer. On the 22nd postoperative day, massive GCN was revealed on endoscopy. Considering the recovery course, careful observation with a decompressing nasal gastric tube was the treatment of choice. The GCN was managed successfully, having been completely replaced by fine mucosa within 9 months postoperatively. The patient completed his follow-up visit 5 years after surgery without any evident disease recurrence. Five and a half years after the surgery, the patient presented with progressive weakness and deterioration of renal function. Gastrointestinal endoscopy revealed a large ulcer at the anastomotic site. Three months later, computed tomography revealed a markedly thin esophageal wall, accompanied by adjacent lung consolidation. An esophagopulmonary fistula was diagnosed; surgery was not considered, owing to the patient's age and markedly deteriorating performance status. He died 2013 days after the diagnosis. CONCLUSIONS: Massive GCN after esophagectomy often requires emergency surgery to remove the necrotic conduit. However, this report suggests that a conservative approach can save lives and preserve the gastric conduit in these cases, thereby augmenting the quality of life.

Prediction of low-addition segmented refractive intraocular lens position and deviation using anterior-segment optical coherence tomography.

This study aimed to develop and analyze the accuracy of predictive formulae for postoperative anterior chamber depth, tilt, and decentration of low-added-segment refractive intraocular lenses. This single-center, retrospective, observational study included the right eyes of 96 patients (mean age: 72.43 ± 6.58 years), who underwent a cataract surgery with implantation of a low-added segmented refractive intraocular lens at the Medical University Hospital between July 2019 and January 2021, and were followed up for more than 1 month postoperatively. The participants were divided into an estimation group to create a prediction formula and a validation group to verify the accuracy of the formula. Anterior segment optical coherence tomography (CASIA 2, Tomey Corporation, Japan) and swept-source optical coherence tomography biometry (IOL Master 700, Carl Zeiss Meditec AG) were used to measure the anterior ocular components. A predictive formula was devised for postoperative anterior chamber depth, intraocular lens tilt, and intraocular lens decentration (p <0.01) in the estimation group. A significant positive correlation was observed between the estimated values calculated using the prediction formula and the measured values for postoperative anterior chamber depth (r = 0.792), amount of intraocular lens tilt (r = 0.610), direction of intraocular lens tilt (r = 0.668), and amount of intraocular lens decentration (r = 0.431) (p < 0.01) in the validation group. In conclusion, our findings reveal that predicting the position of the low-added segmented refractive intraocular lens enables the prognosis of postoperative refractive values with a greater accuracy in determining the intraocular lens adaptation.

Progressive hyperopic refractive changes after posterior capsule tear following blunt ocular trauma.

Purpose: To describe the mechanism of progressive hyperopia and its management in the long-term course of traumatic cataract with a posterior capsule tear (PCT) following blunt ocular trauma. Observation: A 37-year-old woman presented with blurry vision and photophobia after being hit in the right eye by a slipper. She was found to have PCT with the formation of a traumatic cataract with emmetropia (0 diopters [D]). Three years after the injury, a broader hyperopic change of +8.0 D was found in the patient at her first visit to our clinic. Optical coherence tomography (OCT) analysis of the anterior segment of the eye revealed damage to the posterior capsule and cataracts due to disorganization of the lens fibers and liquefaction of the lens. Femtosecond laser-associated cataract surgery was performed for anterior capsulotomy and segmentation of the nucleus without further enlargement of the PCT, facilitating the placement of a capsular tension ring segment and a multifocal intra ocular lens (IOL) in the capsular bag. At 1-month post-operation, her uncorrected visual acuity was 20/20 in the right eye, with a well-centered IOL. Conclusions and Importance: Isolated PCT due to blunt trauma is rare, and there have been no reports of progressive hyperopia after three years of follow-up. In such cases, the lens may liquefy, resulting in decreased refraction and significant hyperopia.

A multicenter validation study for determining the condition of nonanatomical or minor anatomical hepatectomies satisfying technical difficulty of current high-level hepatectomy certificated by the Japanese Society of Hepato-Biliary-Pancreatic Surgery.

BACKGROUND: The current high-level hepatectomy (HLH) is certified by the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS), comprising only anatomical hepatectomies above Couinaud's segmentectomy. This multicenter study aimed to identify the conditions of non-HLH that satisfy equivalent technical difficulties to HLH. METHODS: Between 2018 and 2021, 595 first open hepatectomies without biliary reconstruction (374 HLHs and 221 non-HLHs) were performed in the five institutions. Non-HLHs belonging to at least one of the three conditions; depth of hepatectomy ≥5 cm, number of resections ≥3 locations and at least one location with a depth of hepatectomy ≥3 cm, and hepatectomy involving the paracaval portion of the caudate lobe was proposed as the candidate for difficult non-HLH. The technical difficulty was estimated by the operative time and blood loss. RESULTS: Difficult non-HLHs were neither associated with shorter operative time (373 min vs. 354 min, p = .184) nor lesser blood loss than those with HLHs (503 mL vs. 436 mL, p = .126). Postoperative complications such as Clavien-Dindo classification grade III or more were not significant between the two groups (18.6% vs. 13.4%, p = 0212). CONCLUSIONS: Difficult non-HLHs were associated with no lesser technical difficulty than those with HLH.

Posthepatectomy but not prehepatectomy chemotherapy was associated with a longer time to recurrence in patients with resectable colorectal liver metastases: Inverse probability of treatment weighting analysis.

BACKGROUND: Patients with resectable colorectal liver metastases (CLM) are treated with surgery alone, surgery and posthepatectomy chemotherapy, or prehepatectomy chemotherapy and surgery. The optimal approach in terms of survival is unclear. We compared survival in the three treatment groups using inverse probability of treatment weighting (IPTW) analysis. METHODS: Data from patients undergoing initial CLM resection in 2005-2018 were obtained from a prospectively maintained database. Our group treated resectable CLM with surgery alone but gradually adopted post- and prehepatectomy chemotherapy for patients with CLM number ≥5 after 2015. IPTW analysis was employed to adjust the characteristics of the three groups. RESULTS: Of the 439 patients meeting the inclusion criteria, 175 underwent surgery alone, 135 underwent surgery and posthepatectomy chemotherapy, and 129 underwent prehepatectomy chemotherapy and surgery. After the IPTW adjustment, the demographic and clinicopathological characteristics were well balanced. The IPTW analysis revealed that the recurrence-free survival was better in patients undergoing surgery and posthepatectomy chemotherapy than in patients undergoing surgery alone (median recurrence-free survival, 1.3 years vs 0.7 years; P = .018). Overall survival was not significantly different between the three treatment approaches. CONCLUSION: Posthepatectomy but not prehepatectomy chemotherapy prolongs the time to recurrence after curative-intent resection of CLM.

Influence of protozoan grazing on magnetotactic bacteria on intracellular and extracellular iron content.

Magnetotactic bacteria (MTB) ubiquitously inhabit the oxic-anoxic interface or anaerobic areas of aquatic environments. MTB biomineralize magnetite or greigite crystals and synthesize an organelle known as magnetosome. This intrinsic ability of MTB allows them to accumulate iron to levels 100-1000 times higher than those in non-magnetotactic bacteria (non-MTB). Therefore, MTB considerably contributes to the global iron cycle as primary iron suppliers in the aquatic environmental food chain. However, to the best of our knowledge, there have been no reports describing the effects of trophic interactions between MTB and their protist grazers on the iron distributions in MTB grazers and the extracellular milieu. Herein, we evaluated the effects of MTB grazing using a model species of protist (Tetrahymena pyriformis) and a model species of MTB (Magnetospirillum magneticum AMB-1). MTB-fed T. pyriformis exhibited a magnetic response and contained magnetite crystals in their vacuoles. Fluorescence imaging using a ferrous ion-specific fluorescent dye revealed that the cellular ferrous ion content was five times higher in MTB-fed T. pyriformis than in non-MTB grazers. Moreover, soluble iron concentrations in the spent media increased with time during MTB predation. This study provides experimental evidence to delineate the importance of trophic interactions of MTB on iron distributions.

Development of a simple and reliable LC-MS/MS method to simultaneously detect walnut and almond as specified in food allergen labelling regulations in processed foods.

We developed a simple and reliable analytical method using high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) to simultaneously detect walnut and almond as specified in regulations for food allergen labelling in processed foods. Five specific target peptides derived from walnut 2S albumin and 7S globulin and three target peptides from almond 11S globulin were selected by analysing several varieties of walnut and almond, eight kinds of other nuts, and ten kinds of major allergen ingredients or cereals. The limit of detection for the walnut 2S albumin peptide GEEMEEMVQSAR (m/z 698.3 [precursor] > 316.1 [product]) was 0.22 ± 0.02 µg/g, and that for almond 11S globulin peptide GNLDFVQPPR (m/z 571.8 [precursor] > 369.2 [product]) was 0.08 ± 0.02 µg/g when extracted walnut and almond protein were spiked into butter cookie chocolate ice cream. These peptides had good linearity (R2 > 0.999) for each calibration curve with a range of 0.1-50 µg/mL protein concentration in the sample solutions, and sufficient recovery rates (90.4-101.5%) from the spiked samples. The developed analytical approach is applicable to a wide variety of processed foods for food allergen labelling.

Impact of Recovery from Acute Kidney Injury After Aortic Arch Repair.

BACKGROUND: The impact of recovery from acute kidney injury (AKI) after open thoracic aortic surgery on follow-up outcomes is unclear. METHODS: This retrospective study included 214 patients who underwent aortic arch surgery requiring hypothermic circulatory arrest between 2007 and 2019. Patients who required preoperative renal replacement therapy and patients who died within 7 postoperative days were excluded. The incidence of recovery from AKI was examined. Renal outcomes were compared among patients with no AKI (Group N), recovery from AKI (Group R), and persistent AKI (Group P). RESULTS: Preoperative kidney function was similar among the 3 groups. Among the 115 patients who developed postoperative AKI, 80.9% recovered from AKI at discharge. The 5-year cumulative mortality rate was 18.0%, 24.5%, and 68.4% in Group N, R, and P, respectively (P < .001, Group R vs Group P). The 5-year cumulative incidence of renal replacement therapy dependency was 0.0%, 5.4%, and 22.7%, respectively (P = .04, Group N vs Group R; P = .01, Group R vs Group P). The medians (interquartile range) of estimated glomerular filtration rate (mL/min/1.73 m2) 2 years after surgery were 65.2 (50.4-80.2), 54.3 (41.4-65.9), and 56.9 (40.2-67.5), respectively (P = .03, Group N vs Group R). CONCLUSIONS: The majority of patients recovered from AKI after thoracic aortic repair by discharge. However, the prolonged impact of AKI recovery on kidney function was observed during the follow-up period. Diligent follow-up after discharge is warranted for early identification of patients at high risk of kidney disease progression.

Synergistic Effect of FeII and MnII Ions in Cyano-Bridged Heterometallic Coordination Polymers on Catalytic Selectivity of Benzene Oxygenation to Phenol.

A cyano-bridged heterometallic coordination polymer with partial deficiencies of CN- ligands, [MnII(H2O)8/3]3/2[FeII(CN)5(NH3)], forms open metal sites both on MnII and FeII ions by liberation of monodentate ligands such as NH3 and H2O. [MnII(H2O)8/3]3/2[FeII(CN)5(NH3)] exhibits high catalytic activity and selectivity of benzene oxygenation to phenol in the presence of m-chloroperoxybenzoic acid as an oxidant. The postcatalytic spectroscopy of [MnII(H2O)8/3]3/2[FeII(CN)5(NH3)] and catalysis comparison with a physical mixture of [MnII(H2O)3]2[FeII(CN)6] and [Fe(H2O)3/2]4/3[Fe(CN)6], which has open metal sites on both MnII and Fe ions separately, indicated that the high activity resulted from high oxidation ability and phenol adsorption ability of FeII and MnII ions, respectively.

Vision With Retrodots and Factors for Declining Visual Function.

Purpose: We investigated decline in the visual function of eyes with retrodots (RDs)-a subtype of cataract. Method: This study included 57 eyes with RD opacity only (mean age 72.3 ± 5.2 years) and 34 eyes with transparent lenses (mean age 71.4 ± 3.7 years). A physician diagnosed lens opacity. Using the Kanazawa Medical University Classification and Grading System, the eyes were classified into the RD-1 (37 eyes, RDs <25% of the 3-mm pupil area) and RD-2 (20 eyes, RDs ≥25% of the 3-mm pupil area) groups. Corrected distance visual acuity, contrast visual acuity, ocular refractive power, lens power, straylight, and backward light-scattering intensity and their relationship with visual function decline and optical characteristics of the eyeball were evaluated. Results: Corrected distance visual acuity was significantly lower in the RD eyes than in controls. Contrast visual acuity decreased significantly in the RD-2 eyes in all environments and in the RD-1 eyes in the evening (EVE) and EVE + glare. Straylight was significantly higher in the RD-2 eyes than in the controls and RD-1 eyes but not different between the RD-1 eyes and controls. The RD-2 eyes were significantly more myopic than the controls and RD-1 eyes. Conclusion: When the opacity of RD eyes is ≥25%, the visual acuity and contrast visual acuity decrease and straylight increases. Furthermore, myopia occurs as the refractive power of the lens increases. Moreover, visual function decline may be due to an increase in the straylight value, which is necessary for determining surgical indications.

Analyzing Effect of Waterclefts on Visual Functions Via Optical Simulations.

Purpose: To investigate the impact of the size and location of waterclefts (WC), which are one of several cataract subtypes, on visual function by optical simulation analysis. Methods: An optical simulation software (CODE V) was used to develop a schematic eye model and several sizes of WC central and peripheral types that were located below the anterior and posterior subcapsules of the crystalline lens, and analyses of refraction, higher-order aberrations (HOA), and the modulation transfer function (MTF) were performed. Results: An increase in the WC size increased the refraction and HOA and decreased the MTF. The impact of the WC below the posterior subcapsule on the visual function was more enhanced than that below the anterior subcapsule. Large WC demonstrated a remarkable hyperopic shift in refractive power as well as an increase in HOA. The MTF decreased slightly with increasing WC size at a spatial frequency of 20 cycles/mm, and it decreased remarkably at 60 cycles/mm. Conclusions: The impact on the visual function increased with increasing WC size. It was revealed that eyes with WC below the posterior subcapsule are more hyperopic than those with WC below the anterior subcapsule, and the former have a higher HOA and lower MTF than the latter.

Benzalkonium Chloride-Induced Corneal Epithelial Injury in Rabbit Reduced by Rebamipide.

Purpose: We assessed the effect of rebamipide ophthalmic solution on corneal epithelial injury due to benzalkonium chloride (BAK) by fluorescein (FL) staining and corneal resistance (CR). Methods: After determining the absence of corneal epithelial damage by FL and CR, rebamipide ophthalmic solution (50 µL) was instilled five times, each interspaced by 5 min, into one eye of mature New Zealand white rabbits, and likewise physiological saline was instilled into the contralateral eye as the control. After 30 min, eyes were similarly treated with one of the following solutions: BAK solution 0.02%, latanoprost ophthalmic solution (0.02% BAK), or latanoprost ophthalmic solution without BAK. The presence of corneal epithelial damage was quantitated at 10, 30, and 60 min by CR after the last instillation. FL staining was also performed at 60 min after the last instillation. Results: CR ratios (%) at 60 min after the last instillation in rebamipide/BAK and rebamipide/latanoprost (0.02% BAK) groups were significantly increased by 18.3% and 25.6% compared with saline/BAK and saline/latanoprost (0.02% BAK) groups, respectively (P < 0.05). Findings by FL staining were consistent with those by CR; BAK and latanoprost with BAK groups were positive, and eyes with the most severe area and density of corneal epithelial damage (A2D2) were in the saline/BAK group. Conclusion: The rebamipide ophthalmic solution reduces the severity of corneal epithelial injury caused by BAK, an ophthalmic solution preservative.

Quantitative assessment of photic phenomena in the presbyopia-correcting intraocular lens.

This was a prospective study to evaluate the feasibility of the photic phenomena test (PPT) for quantifying glare, halo, and starburst. We compared two presbyopia-correcting intraocular lenses (IOLs), the Symfony IOL and the PanOptix IOL, as well as the monofocal Clareon IOL in 111 IOL-implanted eyes of 111 patients who underwent the PPT 1 month postoperatively. The reproducibility of photic phenomena with the PPT was assessed in 39 multifocal IOL-implanted eyes of 20 patients and among the examiners. Patients with ocular diseases, except for refractive errors, were excluded. The mean values of the groups were evaluated. Bland-Altman plots were used to analyze statistical data (Easy R version 1.37; R Foundation for Statistical Computing, Vienna, Austria). The PPT reproducibility assessment revealed no fixed bias or regressive significance. Reproducibility was confirmed. The glare size did not differ significantly between the Symfony, PanOptix, and Clareon groups. The halo size was significantly larger in the Symfony group (p < 0.01) than in the PanOptix group. The halo intensity was significantly brighter in the PanOptix group (p < 0.01) than in the Symfony group. In contrast, no halos were perceived in the Clareon group. The starburst size or intensity did not differ significantly between the Symfony, PanOptix, and Clareon groups. We identified the photic phenomenon related to various IOLs.

Primary hepatic neuroendocrine carcinoma diagnosed by needle biopsy: a case report.

BACKGROUND: Primary hepatic neuroendocrine carcinomas (NECs) are extremely rare. The rate of recurrence after resection is extremely high, and the prognosis is poor. It is debatable whether chemotherapy or surgical resection is the optimal initial treatment for primary hepatic NECs. Therefore, selecting an appropriate therapeutic approach for patients with primary hepatic NECs remains clinically challenging. We present a case of primary hepatic NEC in a patient who developed recurrence after undergoing surgical resection. CASE PRESENTATION: A 78-year-old man with bone metastases of prostate cancer was referred to our department because of a solitary 66-mm tumor in the left lateral segment of the liver, which was detected on annual follow-up by computed tomography after prostate resection. A biopsy and preoperative diagnostic workup identified the lesion as a primary hepatic neuroendocrine carcinoma; therefore, left lateral segmentectomy was performed. Immunohistochemically, the tumor was positive for chromogranin A, synaptophysin, and CD 56, and the Ki-67 index was 40%. This neuroendocrine carcinoma was classified as a large cell type. Adjuvant chemotherapy with carboplatin + etoposide was initially administered a month after surgery. However, lymph node recurrence occurred 4 months after surgery, and the patient died of systemic metastases 15 months after surgical resection. CONCLUSIONS: Due to the lack of availability of abundant quantities of relevant, high-quality data, there is no standard therapy for primary hepatic NECs. Selecting the most appropriate treatment for patients depending on several factors, such as the stage and differentiation of a tumor and a patient's performance status and clinical course, is consequently preferred. More cases need to be studied to establish the best treatment strategy for primary hepatic NEC.

UV Index Does Not Predict Ocular Ultraviolet Exposure.

Purpose: The ultraviolet index (UVI), available online, is an international linear scale of levels from 0 to 13+ that warns about the risk of sunburn; however, it does not address the risk to eyes. Our purpose was to develop a useful instrument to warn the public against ocular ultraviolet (OUV) exposure and to serve as a tool for researching UV-induced ocular diseases. Methods: A rotating model head that included ultraviolet B (UVB) sensors documented UV irradiance at the crown and at the eyes spanning eight azimuths from sunrise to sunset under different climatic conditions in each season. The dose intensities obtained were compared with their respective UVI levels. Doses to the eyes were mathematically transformed to develop an OUV index with linear levels from 0 to 13+, similar to the UVI. Then, readings from both instruments were compared. Results: UV exposure at the crown increases with solar culmination, whereas that to the eye is greater under low rather than maximum solar altitude. The OUV index levels were higher than recorded UVI levels in the summer under low solar altitude in the early morning and mid- to late afternoon and were markedly higher all day in winter when solar altitude remains low. Conclusions: The UVI does not provide sufficient warning about the risks of ocular UV damage. The proposed OUV index is a useful instrument to warn the public against OUV exposure and to serve as a tool for researching UV-induced ocular diseases. Translational Relevance: The OUV index is useful to prevent ocular UV-related diseases.

Development of a simple and reliable high-performance liquid chromatography-tandem mass spectrometry approach to simultaneously detect grains specified in food allergen labeling regulation on processed food commodities.

An analytical approach using high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) was developed to simultaneously detect Fagopyrum esculentum Moench (buckwheat) and cereals containing gluten (Triticum species including wheat and spelt, rye, barley, and oats) that were specified in regulations for food allergen labeling on processed foods. Trypsin-digested peptides were purified from different processed food commodities and heptapeptides derived from buckwheat 13S globulin (GFIVQAR, m/z 395.8 [precursor] > 177.0 [product]) and Triticum low molecular weight glutenin (QIPEQSR, m/z 429.3 [precursor] > 616.2 [product]) were specifically detected each species at levels as low as 0.050-0.056 µg/L and 0.028-0.032 µg/L, respectively. Detection of these synthetic peptides was quantitative to over 100 µg/L by reference to the synthetic peptide calibration curves and at recovery rates, 76.6 ± 4.1%-104.8 ± 17.1% and 82.4 ± 2.0%-105.8 ± 5.3%, for GFIVQAR and QIPEQSR, respectively, when 1-1,000 µg of these peptides were spiked into a retort tomato sauce for pasta or dried instant soup. In combination with LC-MS/MS detection methods specific to other cereals containing gluten (rye, barley, and oats), the developed analytical approach was applicable to a wide variety of processed food commodities for food allergen labeling.

Distribution of corneal spherical aberration in a Tanzanian population.

PURPOSE: To investigate the distribution of corneal spherical aberration (SA) in Tanzanian people of African descent, and to examine the correlation between corneal SA and ocular parameters. DESIGN: Cross-sectional population-based study. METHODS: Residents aged 40 years and older in three villages in the Mkuranga district in Tanzania were enlisted as study participants. Corneal higher-order aberrations (HOAs) for the right eye were measured with a wavefront analyzer (KR-1W, Topcon) and calculated for the central 6.0-mm zone. Corneal curvature radius (CR), corneal astigmatism, and axial length (AL) were also measured and their correlation with corneal SA was assessed. RESULTS: The right eyes of 657 participants (336 male, 321 female) were analyzed. The mean age of the subjects was 57.2 ± 10.3 years (mean ± SD). The mean corneal SA (Zernike spherical aberration coefficient C40) was 0.188 ± 0.095 µm (-0.242 to 0.613). The SAs in about three-quarters of all subjects were between 0.10 and 0.30 µm. The root mean squares of total corneal HOAs and the third- and fourth-order aberrations were 0.629 ± 0.250 µm, 0.539 ± 0.236 µm, and 0.269 ± 0.110 µm, respectively. Corneal SA showed weak significant correlations with CR (Spearman's rank correlation coefficient, r = -0.177, p < 0.001), corneal astigmatism (r = -0.142, p < 0.001), AL (r = -0.168, p < 0.001), and age (r = -0.085, p < 0.05). CONCLUSIONS: This finding may be beneficial for selecting aspheric intraocular lens in this population.

Thrombocytopenia recovered by surgical resection of a myxoma.

Myxoma is the most common primary cardiac neoplasm, and causes a variety of symptoms, including hematological disorder. An 82-year-old man with anorexia was diagnosed with a gastrointestinal stromal tumor. Computed tomography and echocardiography showed a 2-cm tumor in the left atrium. The patient had a history of lung and skin sarcoidosis, and interstitial pneumonia. Laboratory examination showed thrombocytopenia with a platelet count of 23 × 103/µL and elevation of IgA and platelet-associated IgG (PAIgG). We suspected that the thrombocytopenia was caused by the left atrial tumor. He successfully underwent resection of the tumor with cardiopulmonary bypass. The platelet count increased to 166 × 103/µL after surgery. Pathological examination showed Alcian blue staining of the extracellular and intracellular matrix, suggesting a mucopolysaccharide matrix. Immunohistochemical examination of the tumor revealed expression of CD31, CD34, and calretinin, which was consistent with a myxoma. The PAIgG level decreased to the normal range at 36 days postoperatively. Thrombocytopenia is a relatively rare finding in patients with myxomas. However, in addition to mobility of the mass, thrombocytopenia should be kept in mind as an indication for surgery. .

A Case Report of an Intrathoracic Mass Lesion Caused by Arcanobacterium haemolyticum that Required Exclusion of a Malignant Tumor Diagnosis.

A 57-year-old man with untreated diabetes mellitus was admitted to our hospital due to an intrathoracic mass lesion infiltrating the vertebral body and mediastinum. The mass was suspected to be invasive lung cancer; however, percutaneous needle biopsy revealed that the mass was inflammatory granulation tissue caused by an Arcanobacterium haemolyticum infection. To the best of our knowledge, this is the first report of an intrathoracic mass lesion caused by an A. haemolyticum infection. When an intrathoracic mass lesion is suspected, clinicians should consider possible infections that cause granulation tissue, such as A. haemolyticum. This is particularly important in immunocompromized hosts such as patients with diabetes.

Photoexcited Ag ejection from a low-temperature He cluster: a simulation study by nonadiabatic Ehrenfest ring-polymer molecular dynamics.

Ring-polymer molecular dynamics (RPMD) simulations have been performed to understand the photoexcitation dynamics of an Ag atom embedded in a low-temperature cluster consisting of 500 helium atoms, after the electronic excitation 5p 2P1/2 ← 5p 2S1/2 and 5p 2P3/2 ← 5p 2S1/2 of the Ag atom. Along the RPMD trajectory the time evolution of electronic wavefunction within the spin-orbit 2P manifold is calculated, whereby the time-dependent Schrödinger equation and the RPMD equation of motion are coupled, using the à la Ehrenfest mean field approach. It is found from the simulations that the Ag atom is ejected from the helium cluster with the average time of 100 ps after photoexcitation with the average ejection velocity being 60-70 m s-1, which is roughly in line with experiment. Meanwhile it is also found that the present simulations do not agree with experiment as to the final state of the ejected Ag atom.