A hemophagocytic lymphohistiocytosis case with newly defined UNC13D (C.175G>C; p.Ala59Pro) mutation and a rare complication

Hemophagocytic lymphohistiocytosis (HLH) represents a severe hyperinflammatory condition with cardinal symptoms of prolonged fever, cytopenias, hepatosplenomegaly, and hemophagocytosis by activated, morphologically benign macrophages with impaired function of natural killer cells and cytotoxic T lymphocytes. A 2-month-old girl, who was admitted with fever, was diagnosed with HLH and her genetic examination revealed a newly defined mutation in the UNC13D (c.175G>C; p.Ala59Pro) gene. She was treated with dexamethasone, etoposide, and intrathecal methotrexate. During the second week of treatment, after three doses of etoposide, it was noticed that there was a necrotic plaque lesion on the soft palate. Pathologic examination of debrided material in PAS and Grocott staining revealed lots of septated hyphae, which was consistent with aspergillosis infection. Etoposide was stopped and amphotericin B treatment was given for six weeks. HLH 2004 protocol was completed to eight weeks with cyclosporine A orally. There was no patient with invasive aspergillosis infection as severe as causing palate and nasal septum perforation during HLH therapy. In immuncompromised patients, fungal infections may cause nasal septum perforation and treatment could be achieved by antifungal therapy and debridement of necrotic tissue. © 2015 Turkish Society of Hematology. All rights reserved

Effect of dietary fish meal replacement by poultry by-product meal on muscle fatty acid composition and liver histology of fry of Nile tilapia, Oreochromis niloticus (Actinopterygii: Perciformes: Cichlidae)

Background. Poultry by-product meal (PBM) has been used as a potential substitute for fish meal (FM) in aquaculture feeds. However, there are concerns that high replacement of FM protein with PBM protein could adversely affect of the fish flesh quality, due to lowered (Σ n-3 PUFA) fatty acids content. While fatty acid composition of fish muscle has critical importance in human nutrition, the fish liver is a key organ that facilitates digestion of feed and plays an important role in fish digestive system. As has been recently demonstrated, the monitoring of this organ is important in FM replacement experiments. The aim of this study was to evaluate the potential use of PBM on the fatty acid composition of the muscles and on the histological structure of the liver of fry of Nile tilapia, Oreochromis niloticus (Linnaeus, 1758). Materials and methods. Five isonitrogenous (34%, crude protein), isolipidic (9%, crude lipid), and isoenergetic (15 MJ · kg–1, digestible energy) diets were formulated to contain graded levels of PBM, where FM protein was replaced with PBM protein at 0%, 25%, 50%, 75%, and 100% level with lysine-, methionine-, and threonine supplementation. Triplicate groups of 20 fish (mean weight 0.879 g) were fed three times daily to apparent satiation for 12 weeks. Results. At the end of the experiment, the fatty acid contents of the fish muscle were significantly affected by the experimental diets. As the FM content decreased, there was no reduction of saturated fatty acids; the diet with lowest FM protein percentage having the highest monounsaturated fatty acids and lowest polyunsaturated fatty acids (PUFA) proportions. The replacement of FM by PBM had a profound impact on the fatty acid composition of tilapia muscle with an increase in Σ n-6 PUFA and a decrease in the Σ n-3 and Σ n-3 : Σ  n-6 PUFA ratio.  The histological examination of liver tissue in all treatments of this study, revealed no histological abnormalities. Conclusion. The replacement of FM with PBM (range 0%–100%) significantly decreases the amount of docosahexaenoic acid (12.2%–1.2%) and eicosapentaenoic acid (4.4%–0.4%) in the muscle of fish. Therefore, further study is needed with PBM as a substitute of FM to determine acceptable fatty acid composition for commercial production

Rearrangement of unsaturated cyclic peroxides obtained by photooxygenation of 2,3-dimethylene-7-oxabenzonorbornene and 2,3-dimethylene-1,4-etheno-1,2,3,4-tetrahydronaphthalene

Cobalt(II) tetraphenylporphyrin (CoTPP)-catalyzed rearrangement of peroxide 11 obtained by the photooxygenation of 5 gave a mixture of epoxides 15 (or 16) and 17. However, CoTPP-catalyzed rearrangement of peroxide 20 arising by photooxygenation of 2,3-dimethylene-1,4-etheno-1,2,3,4-tetrahydronaphthalane 6 gave 1,4-etheno-1,2,3,4-tetrahydronaphtho[b]-furan 21. The different behaviour of these endoperoxides 11 and 20 is discussed in terms of ring strain and the degree of the pyramidalization of the C=C bon