Granulomatous lobular mastitis could be categorized into IgG4-related and non-IgG4-related granulomatous lobular mastitis. IgG4 immunohistochemistry serum IgG4 might be useful for diagnosis of IgG4-related granulomatous lobular mastitis and could help to avoid overtreatment such as wide excision.
Omental torsion is a rare cause of acute abdomen and sometimes requires surgery. Recently, we encountered a case of omental torsion diagnosed as omental infarction preoperatively. An 18-year-old male presented to our emergency room with a chief complaint of lower abdominal pain since previous 2 days. Because of his history of Down syndrome, an abdominal examination was very difficult. Plain abdominal computed tomography (CT) suggested omental hernia adhering to the right paracolic gutters. Two days after hospital admission, symptoms did not improve, and contrast-enhanced abdominal CT suggested omental infarction. We performed an emergency surgery. Upon exploration of the abdominal cavity, the greater omentum was found to be twisted four times and adhered to the right paracolic gutters. We performed a partial omentectomy. He was discharged 9 days after the surgery. There was no cause of omental torsion in the abdominal cavity, and he was diagnosed as having idiopathic omental torsion. In cases wherein the cause of acute abdomen cannot be detected, omental torsion should be considered, and abdominal CT could be helpful for the diagnosis.
Primary small cell carcinoma of the breast is a rare breast cancer. We report two cases of this entity showing a non-mass-like pattern on multimodality images and histopathology. Both women presented with a breast mass, and one had axillary lymphadenopathy. Both cases revealed fine calcification on mammography (MMG) and an irregularly shaped, hypoechoic lesion on ultrasonography. Computed tomography (CT) and magnetic resonance imaging (MRI) showed non-mass-like enhancement in both cases. Dynamic MRI showed medium initial enhancement followed by persistent delayed enhancement in one patient, whereas rapid initial enhancement with plateau delayed enhancement was observed in the other. The breast lesions showed very high signal intensity on diffusion-weighted MRI. Positron emission tomography showed moderate accumulation of 2-fluoro-2-deoxyglucose in the breast tumor and lymph node metastasis. The non-mass-like enhancement on CT and MRI and the segmental fine calcification on MMG indicate the abundance of components of ductal carcinoma in situ and the breast origin of the small cell carcinoma.
An on-line biosensor consisting of immobilized Thiobacillus ferrooxidans and an oxygen electrode was developed for automated monitoring of acute toxicity in water samples. T. ferrooxidans is an obligatory acidophilic, autotrophic bacterium and derives its energy by the oxidation of ferrous ion, elemental sulfur, and reduced sulfur compounds including metal sulfides. The assay is based on the monitoring of a current increase by addition of toxicoids, which is caused by the inhibition of bacterial respiration and decrease in oxygen consumption. Optimum cell number on the membrane was 5.0 x 10(8) cells. The steady-state current was obtained when concentration of FeSO4 was above 3.6 mM at pH 3. The sensor response of T. ferrooxidans immobilized membrane for 5.0 microM KCN was within an error of 10% for 30 membranes. A linear relationship was obtained at KCN concentration in the range of 0.5-3.0 microM in a flow-type monitoring system. Minimum detectable concentrations of KCN, Na2S, and NaN3 were 0.5, 1.2, and 0.07 microM, respectively. The monitoring system contained two biosensors and these sensors were cleaned with sulfuric acid (pH 1.5) twice a day. This treatment could remove fouling on microbial immobilized membrane by natural water and ferrous precipitation in the flow cell. This flow-type monitoring sensor was operated continuously for 5 months. Also, T. ferrooxidans immobilized membrane can be stored for one month at 4 degrees C when preserved with wet absorbent cotton under argon gas.
We investigated the effectiveness of peptide nucleic acid (PNA) clamp PCR for detecting KRAS mutations in peripheral blood samples of colorectal cancer (CRC) patients. We compared KRAS point mutations between tumour tissue and blood samples. Forty-two patients were included in this study. We observed KRAS mutations in formalin-fixed, paraffin-embedded tissues by PCR direct sequencing and in blood samples by PNA clamp PCR. KRAS point mutations were detected in primary tumour tissue samples of 13 patients (31.0%) and in peripheral blood samples of 10 patients (23.8%). KRAS point mutations were detected in both samples for 8 patients (19.0%). The sensitivity, specificity and accuracy for detecting KRAS mutations in peripheral blood and tumour tissue samples were 61.5, 93.1 and 83.3%, respectively. The positive and negative predictive values were 80.0 and 84.4%, respectively. Five patients with mutant KRAS in their plasma preoperatively, did not exhibit KRAS mutations postoperatively. Our method detected KRAS point mutations in peripheral blood samples of CRC patients, which contained extremely small amounts of mutant cells. This method is helpful for identifying metastatic CRC patients in whom metastases will respond to EGFR-targeted monoclonal antibody therapy.
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