[MSI-high ascending colon cancer treated with second-line ipilimumab plus nivolumab for conversion surgery:a case report].

A 68-year-old woman with ascending colon cancer was the patient (cT4bN2M1a [LYM] cStage IVA, BRAF V600E mutation-positive, and MSI-high). She was given modified FOLFOXIRI as first-line therapy but did not respond. The infiltration of the primary lesion in the abdominal wall was alleviated, allowing conversion surgery to be performed.

Ochroconis Species Isolated from Limestone Areas as the Origin of Indoor Ochroconis.

The molecular, morphological, and physiological features of 42 strains of Ochroconis collected from many limestone areas were studied. Ochroconis strains are often found in limestone areas, although they have rarely been found in other wild areas, e. g. forests. Moreover, many strains from these areas grew on alkaline media (pH 9.7) and media with soap. They were phylogenetically more variable than Ochroconis strains previously found indoors or at city parks. Thus, the Ochroconis strains are thought to have adapted to the alkaline soil, specifically found in limestones. It is assumed that some strains of Ochroconis originally grew in the limestones and immigrated into park soils with the fine dust of cement and into indoor environments. More species of Ochroconis, with the ability to use surfactants as nutrients, are distributed in limestone areas than indoors or in city parks. Moreover, these fungi were found randomly in the phylogenetic trees of Ochroconis. Although only O. humicola was often found indoors and used surfactants, this fungus was newly found in the limestone areas of Okinawa Prefecture. Ochroconis humicola originally grew outdoors and seems to have immigrated to and propagated indoors. Thus, this species may have originated from the subtropical limestone areas.

Molecular and Biological Differences Among Ochroconis Strains Collected from Indoor and Outdoor Environments.

The molecular, morphological, and physiological characters of 55 Ochroconis strains collected from indoor and outdoor environments were studied. In Japan, Ochroconis species are often found in indoor detergent-rich environments, such as bathrooms and washing machines, and the predominant species have been identified as O. humicola, similar to that in other Asian and European countries. Although Ochroconis species have rarely been found in outdoor environments such as mountains, forests, and agricultural fields, in the present study, Ochroconis strains were specifically isolated from the soils of urban city parks. Phylogenetic analysis conducted using the 28S ribosomal RNA (28S rDNA) gene sequence showed that almost all of the Ochroconis strains found in indoor environments (i.e., water supply) were O. humicola. Although city parks were often surrounded by residences, more than half of the Ochroconis strains collected from the soils of city parks examined in this study were different Ochroconis species. The ability to use detergents as nutrients was found in a new genetic group (probably a new species) isolated from the soils of city parks as well as in O. humicola and O. constricta. Ochroconis humicola is assumed to adapt mostly to indoor environments and to penetrate from the outdoors, e.g., soils of urban areas. To elucidate the factors promoting indoor fungal predominance, the ability of using surfactants as nutrients was compared among these three species. Additionally, growth under alkaline and drought conditions, and heat tolerance were examined. Indoor predominance of O. humicola compared to that of the other two species was attributed to the ability of using a non-ionic surfactant as nutrient and to growth under alkaline conditions.

Polyketides from the cultured lichen mycobiont of a Vietnamese Pyrenula sp.

A spore-derived mycobiont of a crustose Pyrenula sp. lichen collected in Vietnam was cultivated on a malt-yeast extract medium supplemented with 10% sucrose. Chemical investigation of the cultivated colonies led to the isolation of eight new alkylated decalin-type polyketides (1-8) along with three known compounds. The structures of these compounds were elucidated by spectroscopic and chemical means. This is the first instance of this type of polyketide being isolated from a cultured lichen mycobiont. The isolated polyketides 1 and 7 exhibited inhibitory activities against mammalian DNA polymerases α and ß with IC50 values ranging from 8.1 to 19.5 µM. Compound 1 showed cytotoxic effects against the HCT116 human colon carcinoma cultured cell line with an IC50 value of 6.4 ± 0.7 µM.

Case study of airborne fungi according to air temperature and relative humidity in houses with semi-basements adjacent to a forested hillside.

We studied airborne concentrations of fungal spores and the thermal environment in houses with semi-basements surrounded by a natural forest. We examined the relationship between airborne fungi and the thermal environment, surrounding natural environment, structures of houses and use of a dehumidifier. The subject residential area was located in the northern part of Nara city, Nara prefecture, Japan. Six detached houses were included in this study. In residential areas, outdoor airborne concentrations were high during summer and autumn, correlated with humidity. The presence of Basidiomycetes was particularly notable, although the indoor concentration was lower than the outdoor level. In the semi-basement rooms, relative humidity was nearly always >80% when the residence was built; however, both the indoor humidity and fungal concentrations decreased greatly when a dehumidifier was used in this study. High levels of Aspergillus and Basidiomycetes were detected in semi-basements. Basidiomycetes are likely of outdoor origin, whereas Aspergillus might grow indoors. Moreover, the composition of fungal species differed according to room-structure and usage. Due to the health risks associated with high indoor concentrations of fungi, the utilization of the semi-basement or basement space requires adequate ventilation and dehumidification, beginning immediately after construction.

Eremophilane-type sesquiterpenes from cultured lichen mycobionts of Sarcographa tricosa.

Spore-derived mycobionts of the crustose lichen Sarcographa tricosa were cultivated on a malt-yeast extract medium supplemented with 10% sucrose. Chemical investigation of the cultivated colonies led to isolation of three eremophilane-type sesquiterpenes, 3-epi-petasol (1), dihydropetasol (2) and sarcographol (3), together with six known eremophilanes and ergosterol peroxide. These structures were elucidated by spectroscopic and chemical methods. This is the first report of eremophilane-type sesquiterpenes from the cultured mycobionts of lichen.

A 14-membered macrolide and isocoumarin derivatives from the cultured lichen mycobionts of Graphis vestitoides.

Spore-derived mycobionts of the crustose lichen Graphis vestitoides collected in Vietnam were cultivated on a malt-yeast extract medium supplemented with 10% sucrose. The investigation of their metabolites resulted in isolation of a novel 14-membered macrolide and a new isocoumarin, together with five known isocoumarin derivatives. Their structures were determined by spectroscopic and chemical means. This is the first instance of isolation of a 14-membered macrolide from a lichen mycobiont.

Molecular characterization and surfactant utilization of Scolecobasidium isolates from detergent-rich indoor environments.

Scolecobasidium, generally found in outdoor samples, were isolated from detergent-rich indoor environments. The isolates from bathrooms and washing machines, because of their exposure to detergents, might be genetically and biologically distinct from outdoor isolates. In this study, 11 Scolecobasidium isolates from detergent-rich indoor environments were examined to find the genetic and biological differences between the indoor and outdoor isolates. One isolate from a wall of a soap factory, showing similar conidia morphology with S. constricta, was phylogenetically distinct from the other Scolecobasidium spp. The 10 isolates from washing machines and bathrooms were identified as S. humicola, but these were classified into 2 groups that differed from the reference strain of S. humicola from leaves. All 11 isolates and the 4 reference strains of S. constricta and S. humicola grew on the medium containing sodium oleate and polyoxyethylene-(9)-lauryl ether, but the reference strains of the other Scolecobasidium spp. grew only on the medium containing sodium oleate. The results showed that S. humicola and S. constricta could utilize both surfactants generally included in soaps or synthetic detergents as nutrients. A further implication is that the genetic variation found in the S. humicola isolates from detergent-rich indoor environments can occur as a result of adaptation to such an environment.

Phenolic compounds from the cultured mycobionts of Graphis proserpens.

Spore-derived mycobionts of the lichen Graphis proserpens were cultivated on a malt-yeast extract medium supplemented with 10% sucrose and their metabolites were investigated. Isocoumarin derivatives 1-3 and 7-oxo-5,7-dihydrooxepino[4,3,2-de]isochromene derivatives, proserins A-C (4-6), were isolated along with three known isocoumarin derivatives and three benzoic acid derivatives. Their structures were determined by spectroscopic methods.

Growth characteristics of four fungal species in bathrooms.

The growth of four fungal species (four isolates) from bathrooms was examined under various environmental conditions. These fungi were found several times in bathrooms and washing machines, but not in other indoor environments such as house dust or windows. The four species (Ramichloridium strelitziae, Cyphellophora laciniata, Phoma fimeti, and Exophiala sp.) were identified using DNA and morphological analyses. These bathroom fungi were able to consume surfactants, soap and shampoo, but were unable to grow well in high-temperature or dry conditions. Soap and shampoo seem to affect fungal flora in the bathroom.

Comparison of fungi found in bathrooms and sinks.

To identify the pathogenic fungi present in bathrooms, the growth of fungi collected from the drains of bathrooms was studied at various temperatures and compared with that of fungi from kitchen sink drains. Only a small number of fungi from bathrooms and sinks grew on media incubated at 37 degrees C, at which temperature the fungal count was about 1/600 of that at 25 degrees C. Although hot water is used more frequently in bathrooms than in sinks, the fungal counts at 37 degrees C were similar for bathrooms and sinks. Five species of fungus that can grow at 37 degrees C and were found to grow prolifically in bathrooms were identified using DNA and morphological analysis. In both bathrooms and sinks, Exophiala dermatitidis was predominant in culture at 37 degrees C. Moreover, E. dermatitidis grew at 40 degrees C and used surfactant as a nutrient. Thermotolerant fungi appear to inhabit bathrooms and all residential water appliances.

Structure and biosynthesis of lecanopyrone, a naphtho[1,8-cd]pyran-3-one derivative from cultured lichen mycobionts of Lecanora leprosa.

From the cultures of spore-derived mycobionts of the lichen Lecanora leprosa a novel naphtho[1,8-cd]pyran-3-one derivative, lecanopyrone, was isolated. Its structure was determined by spectroscopic methods. The assembly pattern of acetate units in its biosynthesis was verified using sodium [1-13C]-acetate and sodium [1,2-13C2]-acetate.

Synchronous bilateral breast cancer in a male patient following hormone therapy for prostate cancer.

We report an unusual case of bilateral, synchronous breast cancer in a male patient who had a history of estrogen therapy for prostate cancer. A 64-year-old Japanese man was diagnosed with T1N0M0 prostate cancer and received a total prostatectomy. Twenty months after the resection, the patient developed multiple bone metastases, and received radiation therapy, systemic chemotherapy, and hormone therapy for 15 months. After completing this treatment, he was diagnosed with T1N0M0 primary breast cancer in his left breast and underwent a modified mastectomy. Five months after the mastectomy he received systemic chemotherapy followed by estrogen therapy because of the progression of prostate cancer. Three months after this treatment, he was diagnosed with T1N0M0 primary breast cancer in his right breast. To the best of our knowledge, this is a rare case of synchronous bilateral male breast cancer following hormone therapy for prostate cancer.

Fungal growth on anion surfactant medium.

Before the present study, no fungi using anion surfactant as a nutrient had been identified, although some fungi were known to use nonion surfactant. Washing water collected from 63 washing machines was inoculated onto 0.1% LAS (Sodium dodecyl benzenesulfonate) anion surfactant media to identify fungi that can feed on anion-surfactant. Small dark colonies of fungi were found on several of the Petri-dishes from 12 days after inoculation. These were identified as Cladophialophora boppii and Exophiala spinifera using morphological features and rDNA data. A number of the isolates of C. boppii specifically were recognized as using anion surfactant as a nutrient. The growth characteristics of the two fungal species were examined on surfactant media of three kinds. Apart from anion surfactant, the fungi were also able to grow on nonion surfactant and on soap. The application of these fungi for environmental cleansing after detergent pollution is also discussed.

Biosynthetic origin of graphenone in cultured lichen mycobionts of Graphis handelii.

The biosynthetic origins of the carbon skeleton in graphenone were verified by feeding the culture of spore-derived mycobionts of the lichen Graphis handelii with sodium [1-13C]-acetate, sodium [1,2-13C2]-acetate, sodium [2-13C]-pyruvate, [1,2,3-13C]-glycerol, [13CH3]-methionine and sodium [1,4-13C2]-succinate.

Expression of estrogen receptor-alpha protein in the rat digestive tract.

The current study evaluates the expression of estrogen receptor-alpha (ER-alpha) protein in the digestive tract and other organs using immunohistochemistry in male and female intact rats. As a result, the expression of ER-alpha protein was intensively immunoreactive in the nuclei of squamous epithelium of the forestomach connected to the limiting ridge and the anus connected to the anorectal junction. Rat ER-alpha mRNA signals were also detected in the epithelium of the limiting ridge using in situ hybridization. The incidence of ER-alpha protein in the limiting ridge decreased with age in both males and females. The incidence of ER-alpha protein in the anorectal junction strongly decreased with age in males, although the incidence did not decrease with age in females. In conclusion, it was suggested that estrogen may be involved in the proliferation and differentiation of these cells in the limiting ridge of the stomach and anorectal junction of rats.

Porcine model of auxiliary partial orthotopic liver transplantation for acute liver failure.

BACKGROUND: Auxiliary partial orthotopic liver transplantation (APOLT) has been an effective alternative in acute liver failure (ALF), but clinically several problems remain to be resolved. Thus, we attempt to establish an APOLT model for ALF using a large animal and demonstrate the validity of our model. METHODS: In experiment 1, we created an animal model of ALF using pig. ALF was induced by resection of 70% of the whole liver under total hepatic vascular exclusion (THVE). The duration of ischemia was 90 minutes. In experiment 2, we tried to make an APOLT model by using this ALF model as a recipient. That is, during 90 minutes of THVE, 70% hepatectomy and subsequent partial orthotopic transplantation was completed. RESULTS: In experiment 1, six of seven pigs died within three days with jaundice and massive ascites. Based on microcirculatory disturbance of the remnant liver and hepatocellular necrosis, 70% hepatectomy with 90 minutes of THVE was considered a proper model of ALF. In experiment 2, six out of seven APOLT model animals survived more than four days. T. Bil levels in the APOLT model remained consistently within the normal range throughout the observation period. In immunohistochemistry, several labeled nuclei stained with Ki67 were identified in native liver of the APOLT model. CONCLUSIONS: This APOLT procedure provided temporary liver function support and enabled the recipient to survive until the failing native liver had regenerated. Our APOLT model could be suitable and useful for understanding the role of APOLT in ALF.

99mTc-DTPA-galactosyl-human-serum-albumin liver scintigraphy for evaluating hepatic functional reserve before hepatectomy in a patient with indocyanine green excretory defect: report of a case.

A 78-year-old woman with indocyanine green (ICG) excretory defect underwent left hepatectomy for cystadenocarcinoma. The retention rate of ICG at 15 min (ICGR(15)) was high, at 79.3%, despite all other liver function tests showing normal values. Conversely, 99mTc-DTPA-galactosyl-human-serum-albumin (GSA) liver scintigraphy showed a reduced accumulation of GSA in the left lateral lobe, the hepatic uptake ratio of the GSA scintigraphy was 0.96, and the arterial ketone body ratio was 1.67. Based on these results, we judged that the hepatic functional reserve of this patient was adequate for left hepatectomy, which was subsequently performed uneventfully. Histopathological examination of the resected liver showed neither fibrosis nor inflammatory cell infiltration. Thus, we consider that GSA liver scintigraphy is the best diagnostic modality for evaluating hepatic functional reserve in a patient with ICG excretory defect.

Advantage of ischemic preconditioning for hepatic resection in pigs.

BACKGROUND: Ischemic preconditioning (IP) and intermittent inflow occlusion (IO) have provided beneficial outcomes in hepatic resection. However, comparison of these two procedures against warm hepatic ischemia-reperfusion injury has not been studied enough. MATERIALS AND METHODS: Pigs that had undergone 65% hepatectomy were subjected to Control (120 min continuous ischemia, n = 6), IP (10 min ischemia and 10 min reperfusion, followed by 120 min continuous ischemia, n = 6), and IO (120 min ischemia in the form of eight successive periods of 15 min ischemia and 5 min reperfusion, n = 6). We evaluated hepatocyte injury by aspartate aminotransferase, lactate dehydrogenase and hepaplastin test, hepatic microcirculation by hepatic tissue blood flow (HTBF) and endothelin (ET)-1, inflammatory response by tumor necrosis factor-alpha (TNF-alpha), and histopathology after reperfusion. RESULTS: IP prevented hepatocyte injury, HTBF disturbance, and hepatocyte necrosis in histopathology as well as IO. These two groups showed significantly better outcomes than Control. IP produced significantly less ET-1 and TNF-alpha than IO. CONCLUSIONS: IP ameliorated hepatic warm ischemia-reperfusion injury. Furthermore, IP gained more advantages in preventing chemokine production such as ET-1 and inflammatory response over IO. IP could take the place of IO for hepatectomy.