RESUMEN
The coordinated interspecific variation in leaf traits and leaf lifespan is known as the leaf economic spectrum (LES). The limitation of CO2 diffusion to chloroplasts within the lamina is significant in C3 photosynthesis, resulting in a shortage of CO2 for Rubisco. Although Rubisco CO2/O2 specificity (SC/O) should be adaptively adjusted in response to the interspecific variation in CO2 concentrations [CO2] associated with Rubisco, SC/O variations across species along the LES remain unknown. We investigated the coordination among leaf traits, including SC/O, CO2 conductance, leaf protein content, and leaf mass area, across 23 woody C3 species coexisting on an oceanic island through phylogenetic correlation analyses. A high SC/O indicates a high CO2 specificity of Rubisco. SC/O was negatively correlated with [CO2] at Rubisco and total CO2 conductance within lamina, while it was positively correlated with leaf protein across species, regardless of phylogenetic constraint. A simulation analysis shows that the optimal SC/O for maximizing photosynthesis depends on both [CO2] at Rubisco sites and leaf protein per unit leaf area. SC/O is a key parameter along the LES axis and is crucial for maximizing photosynthesis across species and the adaptation of woody plants.
Asunto(s)
Dióxido de Carbono , Magnoliopsida , Fotosíntesis , Filogenia , Hojas de la Planta , Ribulosa-Bifosfato Carboxilasa , Especificidad de la Especie , Ribulosa-Bifosfato Carboxilasa/metabolismo , Ribulosa-Bifosfato Carboxilasa/genética , Dióxido de Carbono/metabolismo , Hojas de la Planta/metabolismo , Magnoliopsida/genética , Magnoliopsida/fisiología , Islas del Pacífico , MaderaRESUMEN
BACKGROUND: Neuroleptic malignant syndrome (NMS) is a rare and occasionally fatal undesirable reaction to dopamine antagonists, and its phenotype is diverse owing to causative drugs. Classically, elevation of serum creatine kinase is described in NMS. Some reports have described muscular pathological findings; however, muscle magnetic resonance imaging (MRI) has not been reported previously. CASE PRESENTATION: A 63-year-old woman with a history of schizophrenia presented to our hospital with a high fever, excessive sweating, muscle weakness, and elevated serum creatine kinase levels. Muscle MRI revealed T2 high-intensity lesions in several muscles with gadolinium enhancement, and the pathology of the muscle biopsy showed a very mild presence of muscle fiber necrosis and regeneration with type 2c fibers without inflammation. Her symptoms resolved by treatment with levodopa/carbidopa, dantrolene. Finally, the patient was diagnosed with NMS. CONCLUSIONS: This is the first report of muscle MRI abnormalities in a patient with NMS. Muscle MRI abnormalities in NMS may be associated with non-inflammatory myopathic changes. The cause of creatine kinase elevation cannot be explained by abnormal strong muscle contraction nor inflammation.
Asunto(s)
Antipsicóticos , Síndrome Neuroléptico Maligno , Femenino , Humanos , Antipsicóticos/efectos adversos , Medios de Contraste , Creatina Quinasa , Gadolinio , Inflamación/complicaciones , Imagen por Resonancia Magnética , Músculos , Síndrome Neuroléptico Maligno/diagnóstico por imagen , Síndrome Neuroléptico Maligno/etiología , Persona de Mediana EdadRESUMEN
PURPOSE: Refractory prolactinomas resistant to dopamine agonists (DAs) pose a clinical challenge. Temozolomide (TMZ) is a recommended treatment option, but its effects are difficult to predict, and the alternatives are limited. Recent reports suggested that TMZ combined with capecitabine (CAPTEM) can be effective for the treatment of aggressive pituitary tumors. This study sought to evaluate the effect of TMZ in an ex vivo three-dimensional (3D) spheroid culture assay and determine if this assay could be used to predict the therapeutic effect of CAPTEM in actual refractory prolactinomas. METHODS: Surgically resected tumor tissues from two patients with refractory prolactinoma were cultured as 3D spheroids. The effects of TMZ were assessed based on its suppression of cell viability and reduction of prolactin (PRL) levels. RESULTS: In Case 1, the 3D culture assay showed no effect of TMZ on cell viability or PRL suppression. Clinically, TMZ treatment did not reduce PRL levels (8870â8274 ng/mL) and the tumor progression. However, CAPTEM partially reduced PRL levels (9070â4046 ng/mL) and suppressed the tumor growth. In Case 2, TMZ in the 3D culture assay showed a 50% reduction of cell viability and 40% reduction of PRL levels. Clinically, CAPTEM was highly effective, with a considerable reduction in PRL level (17,500â210 ng/mL), and MRI showed almost no residual tumor. CONCLUSIONS: This is the first report to describe the effects of CAPTEM treatment on refractory prolactinomas. The ex vivo 3D spheroid culture assay reliably predicted TMZ sensitivity and informed the selection between TMZ or CAPTEM treatment for refractory prolactinomas.
Asunto(s)
Neoplasias Hipofisarias , Prolactinoma , Capecitabina/uso terapéutico , Agonistas de Dopamina/uso terapéutico , Humanos , Neoplasias Hipofisarias/tratamiento farmacológico , Prolactinoma/tratamiento farmacológico , Temozolomida/uso terapéuticoRESUMEN
Ongoing global warming increases the frequency and severity of tropical typhoons and prolonged drought, leading to forest degradation. Simultaneous and/or successive masting events and climatic extremes may thus occur frequently in the near future. If these climatic extremes occur immediately after mass seed reproduction, their effects on individual trees are expected to be very severe because mass reproduction decreases carbohydrate reserves. While the effects of either a single climate extreme or masting alone on tree resilience/growth have received past research attention, understanding the cumulative effects of such multiple events remains challenging and is crucial for predicting future forest changes. Here, we report tree hazards compound by two successive climate extremes, a tropical typhoon and prolonged drought, after mass reproduction in an endemic tree species (Distylium lepidotum Nakai) on oceanic islands. Across individual trees, the starch stored within the sapwood of branchlets significantly decreased with reproductive efforts (fruit mass/shoot mass ratio). Typhoon damage significantly decreased not only the total leaf area of apical shoots but also the maximum photosynthetic rates. During the 5-month period after the typhoon, the mortality of large branchlets (8-10-mm diameter) increased with decreasing stored starch when the typhoon hit. During the prolonged summer drought in the next year, the recovery of total leaf area, stored starch, and hydraulic conductivity was negatively correlated with the stored starch at the typhoon. These data indicate that the level of stored starch within branchlets is the driving factor determining tree regrowth or dieback, and the restoration of carbohydrates after mass reproduction is synergistically delayed by such climate extremes. Stored carbohydrates are the major cumulative factor affecting individual tree resilience, resulting in their historical effects. Because of highly variable carbohydrate levels among individual trees, the resultant impacts of such successive events on forest dieback will be fundamentally different among trees.
Asunto(s)
Sequías , Árboles , Bosques , Islas , JapónRESUMEN
Cushing's disease (CD), which manifests as excess cortisol secretion, is caused by adrenocorticotrophic hormone (ACTH)-secreting pituitary adenomas. Such adenomas are occasionally difficult to identify on magnetic resonance imaging (MRI), and thorough endocrinological examination may be required to detect them. Inferior petrosal sinus (IPS) sampling (IPSS) has been the gold standard test for distinguishing CD from ectopic ACTH syndrome (EAS). However, IPSS is an invasive procedure, and proper catheterization is occasionally challenging due to anatomical variations. Thus, there have been ongoing debates regarding the necessity of this procedure. Here, we present our recent IPSS data derived from the analysis of 65 patients who were referred to us for possible CD between April 2018 and December 2020 after undergoing meticulous endocrinological testing. Even with detailed MRI, no obvious lesions were identified in 19 patients. IPSS performed on these 19 individuals identified an IPS-to-peripheral ACTH gradient in 15 of them. The four patients who lacked this gradient were subjected to a classical algorithm using concurrently measured prolactin levels, the results of which were consistent with their ultimately confirmed diagnoses: two true-positive and two true-negative diagnoses. These findings support the validity of the algorithm and demonstrate that the prolactin-adjusted IPS-to-peripheral ACTH ratio can improve the differentiation between CD and EAS. We had no false-negative results, but three patients were false-positive. Consequently, those three patients in which no apparent tumor was clarified during surgery could not have any endocrinological improvement postoperatively.
Asunto(s)
Síndrome de ACTH Ectópico/diagnóstico , Adenoma Hipofisario Secretor de ACTH/diagnóstico , Adenoma/diagnóstico , Muestreo de Seno Petroso/métodos , Hipersecreción de la Hormona Adrenocorticotrópica Pituitaria (HACT)/diagnóstico , Adenoma Hipofisario Secretor de ACTH/sangre , Adenoma/sangre , Hormona Adrenocorticotrópica/sangre , Adulto , Anciano , Anciano de 80 o más Años , Hormona Liberadora de Corticotropina , Diagnóstico Diferencial , Técnicas de Diagnóstico Endocrino , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Hipersecreción de la Hormona Adrenocorticotrópica Pituitaria (HACT)/sangre , Prolactina/sangre , Reproducibilidad de los Resultados , Estudios RetrospectivosRESUMEN
Maternal alloantibody-mediated hemolytic disease of the fetus and newborn (HDFN) ranges from no or mild symptoms to severe hydrops and intrauterine fetal demise. Hemolytic anti-D-mediated HDFN proceeds via a long-known mechanism, to which three other pathways to fetal/neonatal anemia may be added: (0) Fetal erythrocyte destruction can proceed by extravascular phagocytosis. (1) An apoptotic pathway has been described for anti-Kell, and anti-Ge3. (2) Erythropoietic suppression may arise from altered or deformed erythroblast architecture in anti-M-mediated disease. (3) Clonal escape from erythropoietic suppression is hypothesized to arise from maternal anti-Jra immune pressure, albeit this requires further elucidation. Alloantibody-mediated anemic disease of the fetus and newborn (ADFN) is a designation we favor for cases when hemolysis or hyperbilirubinemia are not the dominant features, such as those provoked by anti-Kell, anti-Ge3, anti-M, and anti-Jra.
Asunto(s)
Anemia/genética , Eritroblastosis Fetal/inmunología , Hemólisis/inmunología , Sistema del Grupo Sanguíneo de Kell/inmunología , Anemia/fisiopatología , Femenino , Feto , Humanos , Recién NacidoRESUMEN
The density and architecture of leaf veins determine the network and efficiency of water transport within laminae and resultant leaf gas exchange and vary widely among plant species. Leaf hydraulic conductance ( Kleaf) can be regulated by vein architecture in conjunction with the water channel protein aquaporin. However, our understanding of how leaf veins and aquaporins affect leaf hydraulics and stomatal conductance ( gs) remains poor. By inducing blockage of the major veins and inhibition of aquaporin activity using HgCl2, we examined the effects of major veins and aquaporins on Kleaf and gs in species with different venation types. A vine species, with thick first-order veins and low vein density, displayed a rapidly declined gs with high leaf water potential in response to vein blockage and a greatly reduced Kleaf and gs in response to aquaporin inhibition, suggesting that leaf aquaporins are involved in isohydric/anisohydric stomatal behaviour. Across species, the decline in Kleaf and gs due to aquaporin inhibition increased linearly with decreasing major vein density, possibly indicating that a trade-off function between vein architecture (apoplastic pathway) and aquaporin activity (cell-to-cell pathway) affects leaf hydraulics.
Asunto(s)
Hojas de la Planta/metabolismo , Estomas de Plantas/fisiología , Plantas/anatomía & histología , Acuaporinas/antagonistas & inhibidores , Hidrodinámica , Compuestos de Mercurio/farmacología , Hojas de la Planta/anatomía & histología , Hojas de la Planta/efectos de los fármacos , Fenómenos Fisiológicos de las Plantas , Estomas de Plantas/efectos de los fármacosRESUMEN
Physiological mechanisms of irreversible hydraulic dysfunction in seedlings infected with pine wilt disease (PWD) are still unclear. We employed cryo-scanning electron microscopy (cryo-SEM) to investigate the temporal and spatial changes in water distribution within the xylem of the main stem of 2-year-old Japanese black pine seedlings infested by pine wood nematodes (PWNs). Our experiment was specifically designed to compare the water relations among seedlings subjected to the following water treatment and PWN combinations: (i) well-watered versus prolonged drought (no PWNs); and (ii) well-watered with PWNs versus water-stressed with PWNs (four treatments in total). Cryo-SEM imaging observations chronicled the development of patchy cavitations in the xylem tracheids of the seedlings influenced by PWD. With the progression of drought, many pit membranes of bordered pits in the xylem of the main stem were aspirated with the decrease in water potential without xylem cavitation, indicating that hydraulic segmentation may exist between tracheids. This is the first study to demonstrate conclusively that explosive and irreversible cavitations occurred around the hydraulically vulnerable resin canals with the progression of PWD. Our findings provide a more comprehensive understanding of stressors on plant-water relations that may eventually better protect trees from PWD and assist with the breeding of trees more tolerant to PWD.
Asunto(s)
Sequías , Pinus/fisiología , Enfermedades de las Plantas/parasitología , Tylenchida/fisiología , Xilema/parasitología , Animales , Pinus/parasitología , Xilema/fisiologíaRESUMEN
Hemolytic disease of the newborn (HDN) arising from MNSs incompatibility is rare, with few reports of prolonged anemia and reticulocytopenia following HDN. We report the younger of 2 male siblings, both of whom had anti-M-induced HDN and anemia persisting for over a month. Peripheral reticulocytes remained inappropriately low for the degree of anemia, and they needed multiple red cell transfusions. Viral infections were ruled out. Corticosteroids were given for suspected pure red cell aplasia. Anemia and reticulocytopenia subsequently improved. Colony-forming unit erythroid assay revealed erythropoietic suppression of M antigen-positive erythroid precursor cells cultured with maternal or infant sera containing anti-M. In conclusion, maternal anti-M caused HDN and prolonged anemia by erythropoietic suppression in 2 siblings.
Asunto(s)
Anemia/etiología , Eritroblastosis Fetal/etiología , Células Precursoras Eritroides/patología , Eritropoyesis/inmunología , Inmunoglobulina M/inmunología , Isoanticuerpos/inmunología , Aplasia Pura de Células Rojas/complicaciones , Adulto , Anemia/patología , Diferenciación Celular , Ensayo de Unidades Formadoras de Colonias , Eritroblastosis Fetal/patología , Células Precursoras Eritroides/inmunología , Femenino , Humanos , Inmunoglobulina M/sangre , Lactante , Recién Nacido , Masculino , Embarazo , Pronóstico , HermanosRESUMEN
The theory of optimal leaf N distribution predicts that the C gain of plants is maximized when the N content per unit area (N(area)) scales with light availability, but most previous studies have demonstrated that the N distribution is not proportional to light availability. In tall trees, the leaves are often clustered on twigs (leaf cluster) and not evenly distributed within the crowns. Thus, we hypothesized that the suboptimal N distribution is partly caused by the limited capacity to translocate N between leaf clusters, and consequently, the relationship between light and N(area) differs for leaves in different clusters. We investigated the light availability and N content of all individual leaves within several leaf clusters on tall trees of a deciduous canopy species Fagus crenata in Japan. We observed that the within-cluster leaf N distribution patterns differed from the between-cluster patterns and the slopes of the relationships between light and N(area) were lower within clusters than between clusters. According to the detailed analysis of the N distribution within leaf clusters, N(area) was greater for current-year shoots with greater light availability or a larger total leaf area. The latter pattern was probably caused by the greater sink strength of the current-year shoots with a larger leaf area. These N distribution patterns suggest that leaf clusters are fairly independent with respect to their N use, and the productivity of real F. crenata crowns may be less than optimal.
Asunto(s)
Fagus/metabolismo , Nitrógeno/metabolismo , Fotosíntesis , Hojas de la Planta/metabolismo , Japón , LuzRESUMEN
Invasive species are frequently found in recently disturbed sites. To examine how these disturbance-dependent invasive species exploit resource pulses resulting from disturbance, twelve physiological and morphological traits, including age-dependent responsiveness in leaf traits to nitrogen pulse, were compared between Bischofia javanica, an invasive tree species in Ogasawara islands, and three native Ogasawara species, each having a different successional status. When exposed to a nitrogen pulse, invasive B. javanica showed higher increases in photosynthetic capacity, leaf area, epidermal cell number and cell size in leaves of broad age classes, and root nitrogen absorption ability than two native mid-/late or late-successional species, but showed no particular superiority to a native pioneer species in these responses. Under low nitrogen, however, it showed the largest relative growth rate among the four species, while the native pioneer showed the lowest growth. From these results, we concluded that the combination of moderately high responsiveness to resource pulses and the ability to maintain steady growth under resource limitations may give B. javanica a competitive advantage over a series of native species with different successional status from early to late-successional stages.
Asunto(s)
Magnoliopsida/fisiología , Nitrógeno/metabolismo , Fotosíntesis , Elaeocarpaceae/anatomía & histología , Elaeocarpaceae/crecimiento & desarrollo , Elaeocarpaceae/fisiología , Elaeocarpaceae/efectos de la radiación , Especies Introducidas , Islas , Japón , Luz , Magnoliopsida/anatomía & histología , Magnoliopsida/crecimiento & desarrollo , Magnoliopsida/efectos de la radiación , Océano Pacífico , Fenotipo , Hojas de la Planta/anatomía & histología , Hojas de la Planta/crecimiento & desarrollo , Hojas de la Planta/fisiología , Hojas de la Planta/efectos de la radiación , Raíces de Plantas/anatomía & histología , Raíces de Plantas/crecimiento & desarrollo , Raíces de Plantas/fisiología , Raíces de Plantas/efectos de la radiación , Transpiración de Plantas , Plantones/anatomía & histología , Plantones/crecimiento & desarrollo , Plantones/fisiología , Plantones/efectos de la radiación , Especificidad de la Especie , Factores de Tiempo , Árboles , Trema/anatomía & histología , Trema/crecimiento & desarrollo , Trema/fisiología , Trema/efectos de la radiaciónRESUMEN
In a national park in Northeast Thailand, agricultural land has been converted from natural forest by small-scale farmers for cassava agriculture. We hypothesise that long-termed cassava monoculture leads to the degradation of soil properties. To test the hypothesis, we conducted a five-year (2016-2020) study on the physical and chemical properties of soil in cassava farmland, and also examined the soil properties of its adjacent natural forests, as a control. The examined cassava farmland was converted from the natural forest during the five years from 2011 to 2015. The significant decrease in organic carbon and the increases in exchangeable potassium and bulk density were found in 2016, indicating that these soil properties varied quickly following the farmland conversion. On the other hand, the significant increase in soil nitrogen and the decrease in pH were found later in 2020, indicating that these soil properties were gradually altered by repeated agricultural activities, such as fertilizer application and trampling. In contrast, there were no significant differences in available phosphate, electrical conductivity, cation exchange capacity, and the soil texture (the fractions of sand, silt, and clay) among the forest and farmland soils. The cation exchange capacity was positively correlated to the fraction of clay, the organic carbon, and pH. The use of glyphosate and paraquat herbicides is prohibited within national parks in Thailand. However, in 2020, glyphosate was detected in farmland soil (up to 5.0 mg kg-1) during both the rainy and dry seasons, and glyphosate (up to 2.5 mg l-1) was detected in stream water from the farmland during the dry season at least in 2020. Soil degradation and herbicide pollution may carry a high risk of causing irreversible changes in terrestrial ecosystems. We discuss the root causes of this issue from perspectives of agricultural production, economy, and the environmental impact, and propose effective policy measures.
Asunto(s)
Agricultura , Herbicidas , Manihot , Suelo , Tailandia , Manihot/química , Manihot/crecimiento & desarrollo , Suelo/química , Herbicidas/análisis , Contaminantes del Suelo/análisis , Glicina/análogos & derivados , Glicina/análisis , Granjas , Conservación de los Recursos Naturales , Bosques , Concentración de Iones de HidrógenoRESUMEN
Objective: Postoperative nonfunctioning pituitary tumor (NFPT) regrowth is a significant concern, but its predictive factors are not well established. This study aimed to elucidate the pathological characteristics of NFPTs indicated for reoperation for tumor regrowth. Methods: Pathological, radiological, and clinical data were collected from patients who underwent repeat operation for NFPT at Moriyama Memorial Hospital (MMH) between April 2018 and September 2023. For comparison, we also gathered data from patients who underwent initial surgery for NFPT during the same period at MMH. Results: Overall, 61 and 244 NFPT patients who respectively underwent reoperation and initial operation were evaluated. The mean period between the previous operation and reoperation was 113 months. Immunonegativity for any adenohypophyseal hormone was significantly more frequent in the reoperation group than in the initial operation group. In addition, the rate of hormone-negative but transcription factor-positive (H-/TF+) tumors among silent gonadotroph tumors was significantly higher in the reoperation group than in the initial operation group. Furthermore, seven silent corticotroph tumors (SCTs) in the reoperation group were ACTH-negative but TPIT-positive. Because most of the previous surgeries were performed in other hospitals a long time ago, we could procure the previous pathological results with immunohistochemistry (IHC) only from 21 patients. IHC for TF had not been performed in all the previous specimens. IHC for adenohypophyseal hormone was almost the same as the current results, and many H-/TF+ tumors were previously diagnosed as NCT. In addition, the reoperated patients were classified into 3 groups on the basis of the condition of the previous operation: gross total resection (GTR), 12 patients; subtotal resection (STR), 17 patients; and partial resection (PR), 32 patients. The mean Ki-67 LI in the GTR, STR, and PR subgroups were 1.82, 1.37, and 0.84, respectively, with the value being significantly higher in the GTR subgroup than in the PR subgroup (P < 0.05). Conclusions: The ratio of H-/TF+ tumors is significantly higher in symptomatically regrown tumors than in the initial cases, which used to be diagnosed as NCT. PR cases tend to grow symptomatically in a shorter period, even with lower Ki-67 LI than GTR cases.
Asunto(s)
Recurrencia Local de Neoplasia , Neoplasias Hipofisarias , Reoperación , Humanos , Masculino , Neoplasias Hipofisarias/cirugía , Neoplasias Hipofisarias/patología , Neoplasias Hipofisarias/metabolismo , Femenino , Persona de Mediana Edad , Adulto , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/cirugía , Anciano , Estudios RetrospectivosRESUMEN
Amyloid ß-peptide (Aß) synthesis and deposition are the primary factors underlying the pathophysiology of Alzheimer's disease (AD). Aß oligomer (Aßo) exerts its neurotoxic effects by inducing oxidative stress and lesions by adhering to cellular membranes. Though several antidepressants have been investigated as neuroprotective agents in AD, a detailed comparison of their neuroprotection against Aßo-induced neurotoxicity is lacking. Here, we aimed to elucidate the neuroprotective effects of clinically prescribed selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and noradrenergic and specific serotonergic antidepressants at the cellular level and establish the underlying mechanisms for their potential clinical applications. Therefore, we compared the neuroprotective effects of three antidepressants, fluoxetine (Flx), duloxetine (Dlx), and mirtazapine (Mir), by their ability to prevent oxidative stress-induced cell damage, using SH-SY5Y cells, by evaluating cell viability, generation of reactive oxygen species (ROS) and mitochondrial ROS, and peroxidation of cell membrane phospholipids. These antidepressants exhibited potent antioxidant activity (Dlx > Mir > Flx) and improved cell viability. Furthermore, pretreatment with a 5-hydroxytryptamine 1A (5-HT1A) antagonist suppressed their effects, suggesting that the 5-HT1A receptor is involved in the antioxidant mechanism of the antidepressants' neuroprotection. These findings suggest the beneficial effects of antidepressant treatment in AD through the prevention of Aß-induced oxidative stress.
RESUMEN
BACKGROUND AND PURPOSE: Takotsubo cardiomyopathy (TCM) is a serious autonomic complication of Guillain-Barré syndrome (GBS). However, the association between TCM and GBS has not been investigated in detail. We investigated the characteristics of GBS patients with TCM (GBS-TCM). METHODS: Clinical features and anti-ganglioside antibody between the GBS-TCM patients and 62 classical GBS patients without TCM as control patients were compared. RESULTS: Eight GBS-TCM patients were identified, in whom TCM was diagnosed at a mean of 6.5 [range 3-42] days after the onset of GBS. The age at onset of GBS was elder in the GBS-TCM patients than in the control GBS patients (76.5 [56-87] vs. 52 [20-88] years, p < 0.01). Notably, cranial nerve deficits, particularly in the lower cranial nerves, were observed in all GBS-TCM patients (100% vs. 41.9%, p < 0.01). Additionally, the GBS-TCM patients showed a higher GBS disability score at nadir (5 [4-5] vs. 4 [1-5], p < 0.01), and lower Medical Research Council sum scores at admission and nadir (37 [30-44] vs. 48 [12-60] at admission, p < 0.05, and 20 [12-44] vs. 40 [0-60] at nadir, p < 0.05, respectively). Mechanical ventilation was more frequently required in the GBS-TCM patients (62.5% vs. 11.3%, p < 0.01). Three GBS-TCM patients were positive for anti-ganglioside antibodies. CONCLUSIONS: TCM occurred at a relatively early phase of GBS. The characteristics of GBS-TCM were the elder, lower cranial nerve involvements, severe limb weakness, and respiratory failure.
Asunto(s)
Síndrome de Guillain-Barré , Cardiomiopatía de Takotsubo , Humanos , Cardiomiopatía de Takotsubo/etiología , Cardiomiopatía de Takotsubo/complicaciones , Síndrome de Guillain-Barré/complicaciones , Síndrome de Guillain-Barré/fisiopatología , Femenino , Persona de Mediana Edad , Anciano , Masculino , Anciano de 80 o más Años , Adulto , Adulto Joven , Gangliósidos/inmunología , Autoanticuerpos/sangre , Estudios RetrospectivosRESUMEN
Large tumors invading the dorsal part of the anterior third ventricle are difficult to manage. The anterior transcallosal approach is usually used to manage these tumors. In our clinic, anterior callosal section was combined with the anterior interhemispheric (AIH) translamina terminalis approach for these tumors with excellent results. The AIH approach is useful for removing tumors in and around the anterior part of the third ventricle. However, AIH alone is insufficient for large tumors invading the dorsal part of the anterior third ventricle. In such situations, simple anterior callosal section enables the neurosurgeon to extirpate the caudal part of the tumors deeply hidden from operative field, sparing the foramen of Monro, fornix, etc. We treated four large tumors (malignant teratoma, recurrent chordoid glioma, recurrent papillary tumor of pineal region occupying the third ventricle, and paraventricular meningioma) without major complications. The malignant teratoma case exhibited no recurrence with >10 years follow-up. The chordoid glioma and papillary tumor of pineal region were totally removed. The meningioma was subtotally removed except only a small tumor around the bilateral anterior cerebral artery. This simple technique is a new way to manage difficult large lesions in and around the third ventricle.
Asunto(s)
Neoplasias del Ventrículo Cerebral/cirugía , Cuerpo Calloso/cirugía , Procedimientos Neuroquirúrgicos/métodos , Tercer Ventrículo/cirugía , Adulto , Quistes del Sistema Nervioso Central/cirugía , Niño , Craneotomía , Femenino , Fórnix/cirugía , Humanos , Imagen por Resonancia Magnética , Masculino , Trastornos de la Memoria/etiología , Memoria a Corto Plazo , Trastornos Mentales/etiología , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/fisiopatología , Resultado del Tratamiento , Adulto JovenRESUMEN
The scaling of respiratory metabolism with body mass is one of the most pervasive phenomena in biology. Using a single allometric equation to characterize empirical scaling relationships and to evaluate alternative hypotheses about mechanisms has been controversial. We developed a method to directly measure respiration of 271 whole plants, spanning nine orders of magnitude in body mass, from small seedlings to large trees, and from tropical to boreal ecosystems. Our measurements include the roots, which have often been ignored. Rather than a single power-law relationship, our data are fit by a biphasic, mixed-power function. The allometric exponent varies continuously from 1 in the smallest plants to 3/4 in larger saplings and trees. Therefore, our findings support the recent findings of Reich et al. [Reich PB, Tjoelker MG, Machado JL, Oleksyn J (2006) Universal scaling of respiratory metabolism, size, and nitrogen in plants. Nature 439:457-461] and West, Brown, and Enquist [West GB, Brown JH, Enquist BJ (1997) A general model for the origin of allometric scaling laws in biology. Science 276:122 -126.]. The transition from linear to 3/4-power scaling may indicate fundamental physical and physiological constraints on the allocation of plant biomass between photosynthetic and nonphotosynthetic organs over the course of ontogenetic plant growth.
Asunto(s)
Biomasa , Botánica/métodos , Gases/análisis , Transpiración de Plantas , Plantones/química , Árboles/química , Gases/metabolismo , Plantones/fisiología , Árboles/fisiologíaRESUMEN
OBJECTIVE: Diagnosis and accurate localization of recurrent tumors in Cushing's disease (CD) are challenging, especially after multiple transsphenoidal surgeries (TSSs) or radiosurgery. Even experts face difficulties in detecting these recurrent tumors, and a favorable surgical outcome is not guaranteed. In this report, the authors aimed to determine the usefulness of 11C-methionine positron emission tomography (MET-PET) for evaluating patients with recurrent CD with inconclusive magnetic resonance imaging (MRI) lesions and to develop a treatment protocol for these cases. METHODS: In this retrospective study of patients with recurrent CD in the period between April 2018 and December 2022, the authors assessed the usefulness of MET-PET in determining whether equivocal MRI findings were recurrent tumors or postsurgical cavities and deciding further treatment options. All patients had undergone at least one TSS, and most had undergone multiple TSSs and had pathologically confirmed corticotroph tumors with hypercortisolemia. RESULTS: Overall, 15 patients with recurrent CD (10 females and 5 males) were included, all of whom had undergone MET-PET. All patients had been subjected to multiple treatments, including TSSs or radiosurgeries. Their MRI scans demonstrated less-enhanced lesions that were not confirmed as recurrences even with cutting-edge MRI because they could not be distinguished from postsurgical changes with confidence. MET uptake was positive in 8 patients (9 examinations) and negative in 7. Following MET-PET, repeat TSS was performed in 5 patients. Corticotroph tumors were identified in all 5 patients, even though one of them had negative MET uptake. The MET uptake precisely identified a tumor location on the opposite side of the MRI-suspected lesion in 2 patients. Meanwhile, patients with negative uptake and mild hypercortisolism were only observed. Nonsurgical options were also used in other patients: temozolomide (TMZ) was administered in 2 patients owing to a prior history of multiple TSSs and radiosurgery and the drug-resistant nature of the disease. TMZ was highly effective in these patients; their Cushing's symptoms ameliorated, and their adrenocorticotropic hormone and cortisol levels continued to decline. Interestingly, MET uptake disappeared following TMZ treatment. CONCLUSIONS: MET-PET is extremely useful for confirming equivocal lesions on MRI in patients with recurrent CD and for deciding further treatment options. The authors propose a novel protocol based on MET-PET results for treating patients with relapsing CD in whom the recurrent tumors cannot be confirmed with MRI.
Asunto(s)
Neoplasias , Hipersecreción de la Hormona Adrenocorticotrópica Pituitaria (HACT) , Masculino , Femenino , Humanos , Radioisótopos de Carbono , Hipersecreción de la Hormona Adrenocorticotrópica Pituitaria (HACT)/diagnóstico por imagen , Hipersecreción de la Hormona Adrenocorticotrópica Pituitaria (HACT)/cirugía , Estudios Retrospectivos , Tomografía de Emisión de Positrones , Imagen por Resonancia Magnética , Metionina , Racemetionina , Toma de Decisiones ClínicasRESUMEN
Touch imprint cytology (TIC) and frozen section (FS) procedures are essential for intraoperative pathological diagnosis (IPD). They are invaluable tools for therapeutic decision-making, helping surgeons avoid under or overtreatment of patients. Pituitary neuroendocrine tumors (PitNETs) are generally small, slow-growing tumors with low-grade malignancy located at the base of the skull where it is impossible to maintain a wide tumor margin. Therefore, transsphenoidal surgery (TSS) should be performed with necessary caution, and with sufficient and minimal resection. Thus, this study aimed to evaluate the diagnostic accuracy of TIC for the diagnosis of PitNET and determine its ability to accurately evaluate the surgical margin compared to the FS procedure. A total of 104 fresh specimens from 28 patients who underwent TSS for PitNETs were examined using TIC and FS. TIC specimens were categorized according to the cell imprinting pattern. All specimens with a large number of neuroendocrine cells diffusely attached to the glass surfaces had PitNET components. Contrarily, no rich or diffuse cell attachments were observed in any non-tumoral endocrine cells. In conclusion, recognizing a pattern of endocrine cell adherence to glass is highly effective in IPD to certify the existence of a PitNET component.
Asunto(s)
Tumores Neuroendocrinos , Neoplasias Hipofisarias , Humanos , Tacto , Márgenes de Escisión , Citodiagnóstico/métodos , Neoplasias Hipofisarias/diagnóstico , Neoplasias Hipofisarias/cirugía , Tumores Neuroendocrinos/diagnóstico , Tumores Neuroendocrinos/cirugíaRESUMEN
The typical seasonally dry forests in Southeast Asia are the mixed deciduous forest (MDF), dry dipterocarp (deciduous) forest (DDF), and dry evergreen forest (DEF). We obtained 21 physiological traits in the top/sunlit leaves of 107, 65 and 51 tree species in MDF, DEF and DDF, respectively. Approximately 70%, 95% and 95% of canopy tree species which consist of MDF, DEF and DDF are sampled, respectively. Light-saturated photosynthetic rates (Asat) exhibit a positive correlation with foliar nitrogen (N) and phosphorus (P) on leaf mass and area bases across tree species. Decreased leaf mass-based P reduces the positive slope of the mass-based N and Asat relationship across species and habitats. The differences in nutrient and water use and leaf habits are well matched to the variation in soil properties among the forest types, highlighting the reliability of this comprehensive database for revealing the mechanism of niche segregation based on edaphic factors.