ABSTRACT
A man in his 30s with ulcerative colitis (UC) on immunosuppressive agents and extensive travel history presented with subacute dyspnoea and dry cough. CT of the chest demonstrated numerous cavitary pulmonary nodules. An extensive infectious, malignant and autoimmune evaluation was pursued, ultimately with histopathology most consistent with necrobiotic lung nodules as an extraintestinal manifestation of UC. Steroids and ustekinumab were initiated with improvement in symptoms and resolution of cavitary lesions on follow-up imaging. In a patient with inflammatory bowel disease and cavitary lung lesions, necrobiotic lung nodules should be considered, particularly when evaluation for infectious causes is negative.
Subject(s)
Colitis, Ulcerative , Inflammatory Bowel Diseases , Multiple Pulmonary Nodules , Colitis, Ulcerative/complications , Colitis, Ulcerative/diagnosis , Colitis, Ulcerative/drug therapy , Humans , Immunosuppressive Agents/therapeutic use , Lung , Male , Multiple Pulmonary Nodules/diagnostic imaging , Multiple Pulmonary Nodules/etiology , UstekinumabABSTRACT
We present a patient case of a 73-year-old man with new-onset substernal chest pain and B symptoms, found on computed tomography imaging to have massive mediastinal lymphadenopathy of more than 6 cm. Positron emission tomography imaging revealed fluorodeoxyglucose-avid nodes further extending to the axillary, abdominal, and inguinal regions. After a broad patient work-up for infectious, malignant, and rheumatic causes, he was ultimately diagnosed with Rosai-Dorfman disease, a rare histiocytic neoplasm, by excisional lymph node biopsy.
ABSTRACT
Despite increased rates of disease, disability, and social losses with aging, seniors consistently report higher levels of subjective well-being (SWB), a construct closely related to happiness, than younger adults. In this exploratory study, we utilized an available dataset to investigate how aspects of health commonly deteriorating with age, including sensory (i.e., vision and hearing) and cognitive status, relate to variability in self-described contributors to happiness. Community-dwelling seniors (n = 114) responded to a single-item prompt: "name things that make people happy." 1731 responses were categorized into 13 domains of SWB via structured content analysis. Sensory health and cognition were assessed by Snellen visual acuity, pure-tone audiometry, and in-person administration of the Brief Test of Adult Cognition by Telephone (BTACT) battery. A subset of eligible participants (n = 57) underwent functional magnetic resonance imaging (fMRI) to assess resting state functional connectivity (FC) within a previously described dopaminergic network associated with reward processing. SWB response patterns were relatively stable across gender, sensory status, and cognitive performance with few exceptions. For example, hearing-impaired participants listed fewer determinants of SWB (13.59 vs. 17.16; p < 0.001) and were less likely to name things in the "special events" category. Participants with a higher proportion of responses in the "accomplishments" domain (e.g., winning, getting good grades) demonstrated increased FC between the ventral tegmental area and nucleus accumbens, regions implicated in reward and motivated behavior. While the framework for determinants of happiness among seniors was largely stable across the factors assessed here, our findings suggest that subtle changes in this construct may be linked to sensory loss. The possibility that perceptions about determinants of happiness might relate to differences in intrinsic connectivity within reward-related brain networks also warrants further investigation.
ABSTRACT
Haem-dependent catalase is an antioxidant enzyme that degrades H2O2, producing H2O and O2, and is common in aerobes. Catalase is present in some strictly anaerobic methane-producing archaea (methanogens), but the importance of catalase to the antioxidant system of methanogens is poorly understood. We report here that a survey of the sequenced genomes of methanogens revealed that the majority of species lack genes encoding catalase. Moreover, Methanosarcina acetivorans is a methanogen capable of synthesizing haem and encodes haem-dependent catalase in its genome; yet, Methanosarcina acetivorans cells lack detectable catalase activity. However, inducible expression of the haem-dependent catalase from Escherichia coli (EcKatG) in the chromosome of Methanosarcina acetivorans resulted in a 100-fold increase in the endogenous catalase activity compared with uninduced cells. The increased catalase activity conferred a 10-fold increase in the resistance of EcKatG-induced cells to H2O2 compared with uninduced cells. The EcKatG-induced cells were also able to grow when exposed to levels of H2O2 that inhibited or killed uninduced cells. However, despite the significant increase in catalase activity, growth studies revealed that EcKatG-induced cells did not exhibit increased tolerance to O2 compared with uninduced cells. These results support the lack of catalase in the majority of methanogens, since methanogens are more likely to encounter O2 rather than high concentrations of H2O2 in the natural environment. Catalase appears to be a minor component of the antioxidant system in methanogens, even those that are aerotolerant, including Methanosarcina acetivorans. Importantly, the experimental approach used here demonstrated the feasibility of engineering beneficial traits, such as H2O2 tolerance, in methanogens.
Subject(s)
Catalase/biosynthesis , Escherichia coli/enzymology , Gene Expression , Hydrogen Peroxide/metabolism , Methanosarcina/enzymology , Methanosarcina/metabolism , Oxygen/metabolism , Catalase/genetics , Escherichia coli/genetics , Escherichia coli Proteins/biosynthesis , Escherichia coli Proteins/genetics , Hydrogen Peroxide/toxicity , Methanosarcina/drug effects , Methanosarcina/genetics , Microbial Viability/drug effects , Oxygen/toxicity , Recombinant Proteins/biosynthesis , Recombinant Proteins/geneticsABSTRACT
All methane-producing Archaea (methanogens) are strict anaerobes, but the majority of species are tolerant to oxidants. Methanosarcina species are important environmental and industrial methanogens as they are one of only two genera capable of producing methane with acetate. Importantly, Methanosarcina species appear to be the most oxidant-tolerant; however, the mechanisms underlying this tolerance are poorly understood. We report herein two similar methods (spot-plating and microtiter plate) developed to examine the oxidant tolerance of Methanosarcina acetivorans by viability assessment. Both methods revealed that M. acetivorans can tolerate exposure to millimolar levels of hydrogen peroxide (H2O2 ) without a complete loss of viability. The exogenous addition of catalase was also shown to protect M. acetivorans from H2O2 toxicity, indicating catalase can serve as an antioxidant enzyme in methanogens even though oxygen is a byproduct. Of the two methods, the microtiter plate method provided a simple, reliable, and inexpensive method to assess viability of M. acetivorans. Combined with recent advances in the genetic manipulation of methanogens, methods in assessment of methanogen oxidant tolerance will aid in the identification of components of the antioxidant defense systems.