Soft Tissue Reconstruction After Revascularization.

Diabetic foot ulcer represents the primary cause of hospital admissions, amputations, and mortality in diabetic patients. The development of diabetic foot ulcers is influenced by peripheral neuropathy, infection, and ischemia, with diabetes contributing to peripheral artery disease. Free tissue transfer combined with revascularisation of the lower extremity provides the potential opportunity for limb salvage in individuals with lower extremity defects due to critical limb ischemia and diabetic foot.

Clinical features predictive of vision loss in patients with vitreoretinal lymphoma: a single tertiary center experience.

To clarify the long-term visual prognosis and prognostic factors for vision loss in patients with vitreoretinal lymphoma (VRL). This retrospective longitudinal study included 64 consecutive patients with VRL. We analyzed the best-corrected visual acuity (BCVA), optical coherence tomography findings, and clinical features at every visit. Significant vision loss was defined as a final BCVA ≥ 0.5 logMAR. Predictors of significant vision loss following treatment were evaluated using univariate and multivariate linear regression analyses. We included 113 eyes of 64 patients (mean age, 64.2 ± 10.9 years), and 49 patients (76.6%) showed bilateral ocular involvement. The mean follow-up duration was 35.4 ± 25.8 months. At diagnosis, 36 (56.3%), 17 (26.6%), and 11 (17.2%) patients had primary, secondary, and concurrent VRL, respectively. All eyes received intraocular methotrexate injections (mean, 17.1 ± 5.5 injections). The mean BCVA improved from 0.44 ± 0.28 at diagnosis to 0.33 ± 0.29 1 month after treatment initiation. Vision improved significantly after treatment (final mean BCVA, 0.24 ± 0.21). Univariate and multivariate analyses showed that baseline BCVA and retinal/subretinal infiltration were significantly correlated with vision loss. In this study, a good visual outcome was maintained for > 35 months in patients with VRL. Baseline BCVA and retinal/subretinal infiltration were significant predictors of vision loss after treatment for VRL.

Clinical Utility of Bioelectrical Impedance Analysis Parameters for Evaluating Patients with Lower Limb Lymphedema after Lymphovenous Anastomosis.

BACKGROUND: In lymphedema, lymphatic fluid accumulates in the interstitial space, and localized swelling appears. Lymphovenous anastomosis (LVA) is the most widely used surgery to rebuild a damaged lymphatic system; however, assessing outcome of LVA involves performing volume measurements, which provides limited information on body composition changes. Therefore, we analyzed the bioelectrical impedance analysis (BIA) parameters that can reflect the status of lymphedema patients who underwent LVA. METHODS: We retrospectively reviewed records of 42 patients with unilateral lower extremity lymphedema who had LVA. We measured the perioperative BIA parameters such as extracellular water (ECW) ratio and volume as defined by the percentage of excess volume (PEV). We evaluated the relationship between the amount of change in PEV and in BIA parameters before and after surgery. We confirmed the correlation between ΔPEV and BIA parameters using Spearman's correlation. RESULTS: Most patients included had secondary lymphedema due to cancer. Average age was 51.76 years and average body mass index was 23.27. PEV and all BIA parameters after surgery showed a significant difference (p < 0.01) compared with preoperative measurements. The ECW ratio aff/unaff showed the strongest correlation with PEV with a correlation coefficient of 0.473 (p < 0.01). CONCLUSION: Our findings suggest that BIA parameters, especially ECW ratio aff/unaff could reflect the status of patients with lower limb lymphedema after LVA. Appropriate use of BIA parameters may be useful in the postoperative surveillance of patients.

Quantitative analysis of ultra-widefield fluorescein angiography in uveitis associated with sarcoidosis.

Purpose: To quantitatively assess the angiographic features of uveitis associated with sarcoidosis on ultra-widefield fluorescein angiography (UWFA) and determine their correlations with clinical features. Design: A retrospective cohort study. Methods: Sixty-four eyes (64 patients) with sarcoidosis uveitis were included. On UWFA, presence of vasculitis, macular leakage, and optic disc leakage were assessed and features including peripheral ischemic area, vascular leakage area, and punched out lesions were quantitatively analyzed using FIJI (ImageJ2) and correlated with clinical features. Results: The mean peripheral ischemic area and leakage area were 0.0419 ± 0.113% and 0.0333 ± 0.0287% of the total retinal area, respectively. Macular and optic disc leakage were present in 18.8% and 59.4% of eyes, respectively. The average number of punched out lesions was 10.02 ± 21.95. Those changes were most abundant in the inferotemporal area. The presence of disc leakage correlated with all the other UWFA parameters (all r ≥ 0.260; all P ≤ 0.038). The leakage area correlated with vitreous cells, baseline and 6-month logMAR visual acuity, steroid dose and duration, erythrocyte sedimentation rate, and C-reactive protein (r = 0.472, 0.288, 0.321, 0.374, 0.250, 0.251, and 0.277; all P ≤ 0.46). Conclusions: This study quantitatively analyzed UWFA data in sarcoidosis uveitis. Angiographic changes were most frequent in the inferotemporal area. UWFA parameters correlated with one another and clinical variables. These quantitative imaging results warrant a subjective analysis of sarcoidosis uveitis.

Development of a C-C Bond Cleavage/Vinylation/Mizoroki-Heck Cascade Reaction: Application to the Total Synthesis of 14- and 15-Hydroxypatchoulol.

A C-C bond cleavage/vinylation/Mizoroki-Heck cascade reaction has been developed to provide access to densely functionalized bicyclo[2.2.2]octane frameworks. The sequence proceeds through the coupling of dihydroxylated pinene derivatives, prepared from carvone, with gem-dichloroalkenes. The method was applied to 12-step total syntheses of both 14- and 15-hydroxypatchoulol, which provided unambiguous support for the structure of the natural products and corrects a misassignment in the isolation report.

Embedding Financial Services in Frequented, Trusted Settings: Building on Families' Pre-existing Economic Mobility Efforts.

OBJECTIVE: The aim of this study was to understand parents'/guardians' experiences and aspirations around economic mobility and their impact on the acceptability and use of financial services embedded in frequented, trusted settings such as schools and pediatric clinics. METHOD: We recruited 18 English-speaking guardians with at least 1 child enrolled in a school for low-income families and eligible for Internal Revenue Service-sponsored free tax preparation. Each participant completed a semistructured interview before tax filing; a subset completed follow-up interviews. We used grounded theory analysis. RESULTS: We developed the following theoretical model based on our key thematic findings to describe the acceptability and use of financial services within the context of guardians' lived experiences and pre-existing efforts to build economic mobility: Families experience multilevel barriers to economic mobility. Despite these barriers, guardians are proactively working to build economic mobility by empowering the next generation with knowledge, skills, and assets and resiliently pursuing economic goals. As a result, guardians will accept empowering, nonjudgmental, expert, and trustworthy financial services that contribute to their existing efforts. To move from acceptance to use, financial services must be effectively publicized, accessible, and supportive. CONCLUSION: Financial services may be more acceptable and used if they are embedded in trusted organizations and have expert, supportive staff with lived experience who empower guardians to work toward their economic goals, accessible platforms, and effective publicity. These characteristics may facilitate uptake and economic mobility. Trusted organizations serving young families can partner with financial services to test these findings and help families build economic mobility.

Comparison of Two Types of 1-L Polyethylene Glycol-ascorbic Acid as Colonoscopic Bowel Preparation: A Prospective Randomized Study.

Background/Aims: Recently, 1-L polyethylene glycol-ascorbic acid (PEG-Asc) has been used to reduce the volume of preparation agents in colonoscopy. This clinical trial aimed to compare the efficacy and safety of two types of 1-L PEG-Asc (CleanViewAL® [Tae Joon Pharmaceutical Company, Seoul, Korea] and Plenvu® [Norgine, Harefield, United Kingdom]) in average-aged adults. Methods: This study was a prospective, randomized, non-inferiority, open-label, phase 4 clinical trial. The primary endpoint was the efficacy evaluated using the Boston bowel preparation scale (BBPS), and the secondary endpoint was clinical safety. Results: In total, 173 patients were assigned to either the CleanViewAL® (n=84) or Plenvu® (n=89) group. Overall cleansing successes of 97.6% (82/84) and 98.8% (88/89) were achieved in the CleanViewAL® group and in the Plenvu® group, respectively, showing that CleanViewAL® has similar bowel cleansing efficacy to Plenvu® (95% CI, -0.052 to 0.027; p=0.207). The total BBPS score was 8.67±1.00 and 8.70±0.76 in the CleanViewAL® group and Plenvu® group, respectively (p=0.869). The most common adverse symptom was nausea, and no adverse symptoms requiring hospitalization were reported in either group. There were no cases of critical hypernatremia and liver dysfunction exceeding the common terminology criteria for adverse events grade I. An overall satisfaction score (scale of 1 to 10) showed no difference between the two groups (p=0.289). However, the CleanViewAL® group showed a higher taste satisfaction score (scale of 1 to 5) than the Plenvu® group (CleanViewAL®: 2.90±0.91, Plenvu®: 2.60±0.86, p=0.028). Conclusions: Both types of 1-L PEG-Asc, CleanViewAL® and Plenvu®, are effective and safe bowel cleansing agents in average-aged adults. CleanViewAL® was preferred in terms of taste satisfaction.

Choroidal vascularity index change in macular telangiectasia type 2.

PURPOSE: To analyze choroidal structure using subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) in Macular Telangiectasia (MacTel) type 2. METHODS: Medical records of 43 eyes with MacTel type 2 and 30 sex and age-matched healthy eyes were retrospectively reviewed. Their SFCT and CVI were measured using the SS-OCT scan passing through the central fovea and image binarization. The difference in baseline SFCT and CVI from each group and their yearly changes up to second year of follow up were analyzed. The baseline characteristics of the groups were also compared. RESULTS: The baseline characteristics, including CVI and SFCT, of the MacTel group and the control group were not significantly different, except for BCVA. The mean CVI of MacTel group were 64.59 ± 2.92%, 63.76 ± 2.67%, and 62.97 ± 2.74% (p < 0.001) whereas that of control group were 63.33 ± 2.45%, 63.04 ± 2.46%, and 63.43 ± 2.25% (p = 0.636) at baseline, 1 and 2 years, respectively. The mean SFCT of MacTel group were 324.65 ± 89.65µm, 326.14 ± 93.11µm, and 322.65 ± 91.77µm (p = 0.436), whereas that of control group were 304.30 ± 51.86 µm, 300.86 ± 52.64µm, and 298.55 ± 53.71µm (p = 0.275) at baseline, 1 and 2 years, respectively. CONCLUSION: CVI decreases at a faster rate in MacTel type 2 in comparison with healthy subjects. This may suggest possible choroidal involvement in the progression of MacTel type 2.

Comparison of Two Types of 1-L Polyethylene Glycol-ascorbic Acid as Colonoscopic Bowel Preparation: A Prospective Randomized Study / 대한소화기학회지

Background/Aims@#Recently, 1-L polyethylene glycol-ascorbic acid (PEG-Asc) has been used to reduce the volume of preparation agents in colonoscopy. This clinical trial aimed to compare the efficacy and safety of two types of 1-L PEG-Asc (CleanViewAL ® [Tae Joon Pharmaceutical Company, Seoul, Korea] and Plenvu ® [Norgine, Harefield, United Kingdom]) in average-aged adults. @*Methods@#This study was a prospective, randomized, non-inferiority, open-label, phase 4 clinical trial. The primary endpoint was the efficacy evaluated using the Boston bowel preparation scale (BBPS), and the secondary endpoint was clinical safety. @*Results@#In total, 173 patients were assigned to either the CleanViewAL ® (n=84) or Plenvu ® (n=89) group. Overall cleansing successes of 97.6% (82/84) and 98.8% (88/89) were achieved in the CleanViewAL ® group and in the Plenvu ® group, respectively, showing that CleanViewAL ® has similar bowel cleansing efficacy to Plenvu ® (95% CI, -0.052 to 0.027; p=0.207). The total BBPS score was 8.67±1.00 and 8.70±0.76 in the CleanViewAL ® group and Plenvu ® group, respectively (p=0.869). The most common adverse symptom was nausea, and no adverse symptoms requiring hospitalization were reported in either group. There were no cases of critical hypernatremia and liver dysfunction exceeding the common terminology criteria for adverse events grade I. An overall satisfaction score (scale of 1 to 10) showed no difference between the two groups (p=0.289). However, the CleanViewAL ® group showed a higher taste satisfaction score (scale of 1 to 5) than the Plenvu ® group (CleanViewAL ® : 2.90±0.91, Plenvu ® : 2.60±0.86, p=0.028). @*Conclusions@#Both types of 1-L PEG-Asc, CleanViewAL ® and Plenvu ® , are effective and safe bowel cleansing agents in average-aged adults. CleanViewAL ® was preferred in terms of taste satisfaction.

Differential impact of prostaglandin analogues on agreement of intraocular pressure measurements obtained by Goldmann applanation, rebound, and noncontact tonometry.

BACKGROUND: To evaluate the effect of topical prostaglandin analogues on agreement of IOP measurements obtained by Goldmann applanation tonometry (GAT), rebound tonometry (RBT), and noncontact tonometry (NCT) in eyes with primary open- angle glaucoma (POAG). METHODS: Intraocular pressure measurements were obtained using GAT, RBT, and NCT in patients with POAG with or without prostaglandin analogues. The agreement between each tonometry was analysed using Bland-Altman analyses in those with or without prostaglandin analogues. The effect of average IOP on IOP differences was also evaluated. RESULTS: Among a total of 86 subjects included in the study, 44 patients were using prostaglandin analogues. The difference in IOP measured by GAT and RBT was marginally greater in those with (GAT-RBT: - 0.94 ± 1.63 mmHg) prostaglandin analogues than in those without (- 0.33 ± 1.22 mmHg, P = 0.06). The difference in IOP measured by GAT and NCT was significantly greater in the prostaglandin group (GAT-NCT: 2.40 ± 2.89 mmHg) than in the group without prostaglandin analogues (0.41 ± 1.63 mmHg, P < 0.01). While there was no significant relationship between the average of all tonometries and the difference between tonometries in those without prostaglandin analogues, both RBT and NCT underestimated IOP relative to GAT at higher IOP in those using prostaglandin analogues. CONCLUSION: Intraocular pressure measured by RBT and NCT was similar to that measured by GAT in those without prostaglandin analogues. RBT overestimated and NCT underestimated IOP compared to GAT in those using prostaglandin analogues.

Prognostic Significance of Epidermal Growth Factor Receptor Expression in Distant Metastatic Melanoma from Primary Cutaneous Melanoma.

BACKGROUND: Epidermal growth factor receptor (EGFR) is overexpressed in many cancers. However, EGFR expression in melanoma and its role are conflicting. OBJECTIVE: This study aimed to evaluate EGFR expression in distant metastatic melanoma and analyze its relationship with histologic and clinical characteristics and survival. METHODS: Diagnostic tissues from 55 cases of distant metastatic melanoma was evaluated by immunohistochemistry for EGFR expression. Clinicopathologic features and survival outcomes were analyzed according to EGFR expression. RESULTS: The positive EGFR expression in distant metastatic melanoma was significantly correlated with the absence of ulceration. The EGFR expression in distant metastatic melanoma was significantly associated with poor survival, under the conditions of male sex and primary cutaneous melanoma without ulceration or Breslow thickness ≤4.0 mm. This study bears limitations of a retrospective study in a single institution. CONCLUSION: EGFR immunostaining had predictive values for survival outcome. The EGFR expression in distant metastatic melanoma in male, no ulcer, or Breslow thickness ≤4.0 mm appeared to be involved in disease progression.

Comparing axon regeneration in male and female mice after peripheral nerve injury.

Axons in the adult mammalian central nervous system fail to regenerate after injury. By contrast, spontaneous axon regeneration occurs in the peripheral nervous system (PNS) due to a supportive PNS environment and an increase in the intrinsic growth potential induced by injury via cooperative activation of multifaceted biological pathways. This study compared axon regeneration and injury responses in C57BL/6 male and female mice after sciatic nerve crush (SNC) injury. The extent of axon regeneration in vivo was indistinguishable in male and female mice when observed at 3 days after SNC injury, and primary dorsal root ganglion (DRG) neurons from injured, male and female mice extended axons to a similar length. Moreover, the induction of selected regeneration-associated genes (RAGs), such as Atf3, Sprr1a, Gap43, Sox11, Jun, Gadd45a, and Smad1 were comparable in male and female DRGs when assessed by quantitative real-time reverse transcription polymerase chain reaction. Furthermore, the RNA-seq analysis of male and female DRGs revealed that differentially expressed genes (DEGs) in SNC groups compared to sham-operated groups included many common genes associated with neurite outgrowth. However, we also found that a large number of genes in the DEGs were sex dependent, implicating the involvement of distinct gene regulatory network in the two sexes following peripheral nerve injury. In conclusion, we found that male and female mice mounted a comparable axon regeneration response and many RAGs were commonly induced in response to SNC. However, given that many DEGs were sex-dependently expressed, future studies are needed to investigate whether they contribute to peripheral axon regeneration, and if so, to what extent.

High-Throughput Phenotyping Approach for the Evaluation of Heat Stress in Korean Ginseng (Panax ginseng Meyer) Using a Hyperspectral Reflectance Image.

Panax ginseng has been used as a traditional medicine to strengthen human health for centuries. Over the last decade, significant agronomical progress has been made in the development of elite ginseng cultivars, increasing their production and quality. However, as one of the significant environmental factors, heat stress remains a challenge and poses a significant threat to ginseng plants' growth and sustainable production. This study was conducted to investigate the phenotype of ginseng leaves under heat stress using hyperspectral imaging (HSI). A visible/near-infrared (Vis/NIR) and short-wave infrared (SWIR) HSI system were used to acquire hyperspectral images for normal and heat stress-exposed plants, showing their susceptibility (Chunpoong) and resistibility (Sunmyoung and Sunil). The acquired hyperspectral images were analyzed using the partial least squares-discriminant analysis (PLS-DA) technique, combining the variable importance in projection and successive projection algorithm methods. The correlation of each group was verified using linear discriminant analysis. The developed models showed 12 bands over 79.2% accuracy in Vis/NIR and 18 bands with over 98.9% accuracy at SWIR in validation data. The constructed beta-coefficient allowed the observation of the key wavebands and peaks linked to the chlorophyll, nitrogen, fatty acid, sugar and protein content regions, which differentiated normal and stressed plants. This result shows that the HSI with the PLS-DA technique significantly differentiated between the heat-stressed susceptibility and resistibility of ginseng plants with high accuracy.

Review: Application of Artificial Intelligence in Phenomics.

Plant phenomics has been rapidly advancing over the past few years. This advancement is attributed to the increased innovation and availability of new technologies which can enable the high-throughput phenotyping of complex plant traits. The application of artificial intelligence in various domains of science has also grown exponentially in recent years. Notably, the computer vision, machine learning, and deep learning aspects of artificial intelligence have been successfully integrated into non-invasive imaging techniques. This integration is gradually improving the efficiency of data collection and analysis through the application of machine and deep learning for robust image analysis. In addition, artificial intelligence has fostered the development of software and tools applied in field phenotyping for data collection and management. These include open-source devices and tools which are enabling community driven research and data-sharing, thereby availing the large amounts of data required for the accurate study of phenotypes. This paper reviews more than one hundred current state-of-the-art papers concerning AI-applied plant phenotyping published between 2010 and 2020. It provides an overview of current phenotyping technologies and the ongoing integration of artificial intelligence into plant phenotyping. Lastly, the limitations of the current approaches/methods and future directions are discussed.

Urine osmolality predicts calcium-oxalate crystallization risk in patients with recurrent urolithiasis.

Our aim was to investigate the validity of osmolality from 24-h urine collection in examining the risk for calcium-oxalate (CaOx) kidney stone formation in patients with recurrent urolithiasis. Three hundred and twelve subjects (males/females: 184/128) from France with a history of recurrent kidney stones from confirmed or putative CaOx origin were retrospectively included in the study (46 ± 14 years, BMI: 25.3 ± 5.0 kg·m-2). Tiselius' crystallization risk index (CRI) was calculated based on urinary calcium, oxalate, citrate, magnesium, and volume from 24-h samples. The diagnostic ability of 24-h urine osmolality to classify patients as high risk for kidney stone crystallization was examined through the receivers operating characteristics analysis. High risk for CaOx crystallization was defined as CRI > 1.61 and > 1.18, for males and females, respectively. The accuracy of urine osmolality to diagnose risk of CaOx stone formation (AUC, area under the curve) for females was 84.6%, with cut-off point of 501 mmol·kg-1 (sensitivity: 83.3%, specificity: 76.0%). Males had AUC of 85.8% with threshold of 577 mmo·kg-1 (sensitivity: 85.5%, specificity: 77.6%). A negative association was found between 24-h urine volume and osmolality (r = - 0.63, P < 0.001). Also, a positive association was found between 24-h urine osmolality and CRI (r = 0.65, P < 0.001), as well as urea excretion with CRI (r = 0.37, P < 0.001). In conclusion, urine osmolality > 501 and > 577 mmol·kg-1, in female and in male, respectively, was associated with a risk for CaOx kidney stone formation in patients with a history of recurrent urolithiasis. Thus, when CaOx origin is confirmed or suspected, 24-h urine osmolality provides a simple way to define individualized target of urine dilution to prevent urine crystallization and stone formation.

Enhancement of isoflavone aglycone, amino acid, and CLA contents in fermented soybean yogurts using different strains: Screening of antioxidant and digestive enzyme inhibition properties.

This study was the first to evaluate changes in isoflavone, amino acid, conjugated linoleic acid (CLA), antioxidant effect, and digestive enzyme inhibition during fermentation of soy-milk to soy-yogurt with L. brevis and L. plantarum. Total average isoflavones were reduced (1318.2 â†’ 971.1 µg/g) with an increase of aglycones (60.2 â†’ 804.9 µg/g, genistein > daidzein > glycitein) in soy powder yogurts (SPYs). Amino acids increased considerably, as did ornithine (average 4.1 â†’ 551.0 mg/g), and CLA showed high variations from not-detected (ND) to 0.5, 0.9 mg/g (cis-9, trans-11) and ND to 0.3, 0.2 mg/g (trans-10, cis-12). Digestive enzyme inhibitions (α-glucosidase, α-amylase, and pancreatic lipase) displayed high activities (average 50.6 â†’ 67.2, 5.2 â†’ 46.4, 10.6 â†’ 51.4%). Moreover, the antioxidant abilities against radicals were elevated as follows: ABTS > DPPH > hydroxyl (average 63.5 â†’ 86.5, 50.2 â†’ 70.3, 39.3 â†’ 55.2%). Specifically, SPY using mixed strains exhibited the greatest enzymatic inhibition and antioxidant capacities.

Clinical improvement of photoaging-associated facial hyperpigmentation in Korean skin with a picosecond 1064-nm neodymium-doped yttrium aluminum garnet laser.

Traditional attempts at alleviating photoaging-associated facial pigmentation conditions such as melasma, mottled hyperpigmentation, and post-inflammatory hyperpigmentation have yielded disfiguring cosmetic results. Laser toning using a low-fluence Q-switched 1064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser has been more commonly applied to date. However, the treatment efficacy and safety of this approach have not been widely reported. This study therefore evaluated the efficacy and safety of picosecond 1064-nm Nd:YAG laser application for photoaging-associated facial pigmentation treatment in Korean subjects. Forty-seven Korean subjects with photoaging-associated facial pigmentation underwent picosecond 1064-nm laser application. The clinical improvement of 17 patients was assessed by objective measurements such as melanin and erythema indices. All subjects received six biweekly treatments with the laser in a three-pass fashion delivering approximately 2000 to 2500 shots using a zoom handpiece with a spot size of 7 mm, fluence ranging from 0.4 to 0.7 J/cm2, and a repetition rate of 10 Hz. Clinicians evaluated the improvement of pigmentation using the pigmentation area and severity index (PSI), and subjects reported their satisfaction level on a four-point scale. Statistical analyses were performed using the SPSS version 19.0 for Windows software program (IBM Corp., Armonk, NY, USA). Forty-seven subjects (45 females and two males) completed this study with a 12-week follow-up period. The average decrease in PSI value at 12 weeks after treatment was 6.85 ± 6.35 points (p < 0.001). The average decreases in the values of the erythema and melanin indices were 19.41 ± 64.64 points (p = 0.234) and 28.88 ± 32.89 points (p = 0.002). An analysis of 32 subjects' reports (68.1%) suggested good or excellent improvement. No serious adverse effects were observed during treatment or the follow-up period. Picosecond 1064-nm Nd:YAG laser application appears to be safe and effective in improving various photoaging-associated facial pigmentation conditions in Korean skin.

Ectopic Cushing's syndrome associated with a pheochromocytoma in a dog: a case report.

BACKGROUND: Ectopic Cushing's syndrome (ECS) associated with malignant tumors, such as small cell lung carcinoma, bronchial carcinoids, and pheochromocytoma, has been reported in human medicine. However, ECS related to pheochromocytoma has not been reported in dogs. CASE PRESENTATION: An 11-year-old castrated, male Scottish terrier was diagnosed with a left adrenal mass. Cushing's syndrome was suspected based on clinical signs, including pot belly, polyuria, polydipsia, bilateral alopecia, recurrent pyoderma, and calcinosis cutis. Cushing's syndrome was diagnosed on the basis of consistent clinical signs and repeated adrenocorticotropic hormone (ACTH) stimulation tests. In addition, tests for fractionated plasma metanephrine/normetanephrine suggested a pheochromocytoma. Unilateral adrenalectomy was performed after medical management with trilostane and phenoxybenzamine. Histopathology confirmed a diagnosis of pheochromocytoma without cortical lesions. After surgery, fractionated metanephrine/normetanephrine and the findings of low-dose dexamethasone suppression and ACTH stimulation tests were within the normal ranges without any medication. There were no clinical signs or evidence of recurrence and metastasis on thoracic and abdominal X-rays and ultrasonography up to 8 months after surgery. CONCLUSIONS: Pheochromocytoma should be considered a differential diagnosis for dogs with Cushing's syndrome with an adrenal tumor. A good prognosis can be expected with prompt diagnosis and surgical intervention.

Inactivation of Mycobacteria by Radicals from Non-Thermal Plasma Jet.

Mycobacterial cell walls comprise thick and diverse lipids and glycolipids that act as a permeability barrier to antibiotics or other chemical agents. The use of OH radicals from a non-thermal plasma jet (NTPJ) for the inactivation of mycobacteria in aqueous solution was adopted as a novel approach. Addition of water vapor in a nitrogen plasma jet generated OH radicals, which converted to hydrogen peroxide (H2O2) that inactivated non-pathogenic Mycobacterium smegmatis and pathogenic Mycobacterium tuberculosis H37Rv. A stable plasma plume was obtained from a nitrogen plasma jet with 1.91 W of power, killing Escherichia coli and mycobacteria effectively, whereas addition of catalase decreased the effects of the former. Mycobacteria were more resistant than E. coli to NTPJ treatment. Plasma treatment enhanced intracellular ROS production and upregulation of genes related to ROS stress responses (thiolrelated oxidoreductases, such as SseA and DoxX, and ferric uptake regulator furA). Morphological changes of M. smegmatis and M. tuberculosis H37Rv were observed after 5 min treatment with N2+H2O plasma, but not of pre-incubated sample with catalase. This finding indicates that the bactericidal efficacy of NTPJ is related to the toxicity of OH and H2O2 radicals in cells. Therefore, our study suggests that NTPJ treatment may effectively control pulmonary infections caused by M. tuberculosis and nontuberculous mycobacteria (NTM) such as M. avium or M. abscessus in water.