BackgroundThe central role of Type III secretion systems (T3SS) in bacteria-plant interactions is well established, yet unexpected findings are being uncovered through bacterial genome sequencing. Some Pseudomonas syringae strains possess an uncharacterized cluster of genes encoding putative components of a second T3SS (T3SS-2) in addition to the well characterized Hrc1 T3SS which is associated with disease lesions in host plants and with the triggering of hypersensitive response in non-host plants. The aim of this study is to perform an in silico analysis of T3SS-2, and to compare it with other known T3SSs.ResultsBased on phylogenetic analysis and gene organization comparisons, the T3SS-2 cluster of the P. syringae pv. phaseolicola strain is grouped with a second T3SS found in the pNGR234b plasmid of Rhizobium sp. These additional T3SS gene clusters define a subgroup within the Rhizobium T3SS family. Although, T3SS-2 is not distributed as widely as the Hrc1 T3SS in P. syringae strains, it was found to be constitutively expressed in P. syringae pv phaseolicola through RT-PCR experiments.ConclusionsThe relatedness of the P. syringae T3SS-2 to a second T3SS from the pNGR234b plasmid of Rhizobium sp., member of subgroup II of the rhizobial T3SS family, indicates common ancestry and/or possible horizontal transfer events between these species. Functional analysis and genome sequencing of more rhizobia and P. syringae pathovars may shed light into why these bacteria maintain a second T3SS gene cluster in their genome.

Aphasia is the difficulty in reproducing or understanding speech, and affects 21-38% of patients with stroke immediately after onset. In addition, disregarding improvement in the first weeks after stroke, ~20% of patients present with chronic deficiencies 6 months later. Consequently, speech and language therapy appears to be the optimal choice of treatment for chronic aphasia. The present study aimed to systematically investigate the effects of experimental/traditional music therapy (MT) in combination with transcranial direct current stimulation (tDCS) on improving aphasia in patients following a stroke in regular stroke rehabilitation services. For this purpose, 98 eligible participants who had suffered a single cerebrovascular accident were divided into three groups as follows: Group A, no MT or tDCS (only standard treatment); group B, daily MT; group C, combined treatment with daily MT and tDCS at a 1:1.21:1.28 ratio for the three groups, respectively. Statistically significant differences between groups were found either in terms of the interval of the Aachen Aphasia Test [(T 1 -T 0 ) mean] (P<0.05) or in terms of the mean cerebral blood flow in the damaged regions (P= 0.042), the mean mini-mental test (P<0.05) and the mean Barthel index (P=0.004). On the whole, the present study demonstrates that following a stroke, recovery from aphasia can by promoted by a regular exercise, training and rehabilitation program, as well as an improved acoustic environment and tDCS.

Organizing pneumonia (OP) is a type of diffuse interstitial lung disease, which may be induced in the context of several clinical conditions, such as drug reactions, infections, autoimmune diseases and cancer. Coronavirus disease 2019 (COVID-19)-associated OP has been reported as a late-stage consequence of the infection or a histological form of COVID-19-associated pneumonia. Autopsies and postmortem lung biopsies have demonstrated that the majority of patients with COVID-19-associated pneumonia develop secondary OP, and COVID-19-associated pneumonia and OP have common radiological features. The diagnosis of COVID-19-associated OP should be suspected in patients with severe acute respiratory syndrome coronavirus 2 infection who exhibit clinical deterioration despite optimal care, or who have aggravating symptoms following an initial recovery. The use of corticosteroids is a typical treatment for OP. However, to date, at least to the best of our knowledge, there are a few reports regarding the role of corticosteroids in COVID-19-associated pneumonia; thus, the optimal time for administration, the dose and treatment duration have not yet been determined. The present study presents two cases of patients with COVID-19, who exhibited clinical deterioration following the initial phase of infection and with radiological characteristics of OP who received corticosteroids and had a favorable outcome. The early diagnosis of COVID-19-associated OP may lead to targeted treatment, decreased requirements for ventilatory support and an improved survival rate.

Meningiomas constitute the most common extra-axial tumor of the central nervous system and can have a wide-ranging manifestation of imaging. There are several types of unusual depictions depicted with the magnetic resonance imaging (MRI) of meningiomas that have been established thus far. It is thus crucial for the reporting radiologist or neurosurgeon to have an in-depth knowledge of their variable manifestations in order to be able to differentiate these neoplasms from the numerous tumors that can mimic their appearance. Meningioma is frequently challenging to diagnose when imaging variants are present. Nevertheless, a number of unusual histological variants have imaging or clinical features which are related to typical meningiomas and, in numerous cases, these require specific surgical management. The present study describes 7 cases of meningiomas, which were either simple atypical, unusual gigantic extracranial intracranial parasagittal, or not visible meningiomas. These uncommon and atypical imaging variants of meningiomas are described herein in an aim to underline their various potential presentations.

For a number of years, the microscopic sublabial transsphenoidal (MSt) approach was considered the gold standard approach for the treatment of pituitary macroadenomas. Nonetheless, the trend is currently shifting away from the MSt to the endonasal transsphenoidal (EEt) approach. the aim of the present study was to examine the post-operative outcomes of the first cases operated by a team of two young surgeons using the EEt approach, compared to the cases operated by a team of senior neurosurgeons with extensive experience with the MSt approach. For this purpose, data from 20 patients with pituitary adenoma were retrospectively collected from a single center who were operated by the current and previous pituitary-surgery teams. all the patients who presented with visual impairment in the EEt group recovered completely (5/5), whereas 4/5 patients in the MSt group recovered completely. Primary hospitalization duration was similar in the two groups. Gross tumor removal was achieved in 90% of patients in the EEt group compared to 70% of the patients operated with the MSt technique. Intraoperative complications were comparable between the two groups. The first cases operated at the center with EEt proved to have better visual outcomes and a larger tumor removal when compared to the MSt group. a greater experience in using this technique could exponentiate the differences in the post-operative outcomes, such as a lower hospitalization duration and fewer intraoperative complications. on the whole, colleagues who have yet to familiarize themselves with the EEt approach could perhaps be encouraged to learn to utilize this technique, provided that their center is staffed with an experienced team of skull base surgeons to intervene in an intraoperative complication.