Mucinous adenocarcinoma of the bladder associated with long term suprapubic tube: A case report

BACKGROUND: Chronic indwelling catheters may induce histologic changes within the bladder, and these changes are sometimes pre-malignant. There are many documented cases of squamous cell carcinoma associated with indwelling catheters, but only three cases of catheter-associated adenocarcinoma have been reported. In this case report, we present radiographic findings of a case of mucinous adenocarcinoma of the bladder and suprapubic (SP) tract in a quadriplegic patient. CASE PRESENTATION: A 71-year-old male with a history of spinal cord injury presented with hematuria and SP discharge after SP catheterization for 51 years. CT urography was performed and revealed an irregular, infiltrative, and heterogeneous mass arising from the anterior bladder at the level of the suprapubic catheter and extending along the SP tube tract. Cystoscopy and biopsy revealed an adenocarcinoma of the anterior bladder and stoma with extensive associated mucin production and a background of acute and chronic inflammation. Surgical therapy included cystoprostatectomy, abdominal wall resection, ileal conduit creation, and abdominal wall reconstruction. The final diagnosis was a high-grade, T2a/N0/M0 (Stage II) mucinous adenocarcinoma of the bladder. There has been no evidence of tumor recurrence over the previous 5 years. CONCLUSION: Few cases of adenocarcinoma associated with long term indwelling catheter have been reported in the literature, and due to the rarity of this disease process, the prognosis with surgical therapy is not well known. The patient described herein has been free of recurrence for the previous five years, suggesting that surgery is a viable management option for these patients

A communal catalogue reveals Earth’s multiscale microbial diversity

Our growing awareness of the microbial world’s importance and diversity contrasts starkly with our limited understanding of its fundamental structure. Despite recent advances in DNA sequencing, a lack of standardized protocols and common analytical frameworks impedes comparisons among studies, hindering the development of global inferences about microbial life on Earth. Here we present a meta-analysis of microbial community samples collected by hundreds of researchers for the Earth Microbiome Project. Coordinated protocols and new analytical methods, particularly the use of exact sequences instead of clustered operational taxonomic units, enable bacterial and archaeal ribosomal RNA gene sequences to be followed across multiple studies and allow us to explore patterns of diversity at an unprecedented scale. The result is both a reference database giving global context to DNA sequence data and a framework for incorporating data from future studies, fostering increasingly complete characterization of Earth’s microbial diversity

A communal catalogue reveals Earth's multiscale microbial diversity

Our growing awareness of the microbial world's importance and diversity contrasts starkly with our limited understanding of its fundamental structure. Despite recent advances in DNA sequencing, a lack of standardized protocols and common analytical frameworks impedes comparisons among studies, hindering the development of global inferences about microbial life on Earth. Here we present a meta-analysis of microbial community samples collected by hundreds of researchers for the Earth Microbiome Project. Coordinated protocols and new analytical methods, particularly the use of exact sequences instead of clustered operational taxonomic units, enable bacterial and archaeal ribosomal RNA gene sequences to be followed across multiple studies and allow us to explore patterns of diversity at an unprecedented scale. The result is both a reference database giving global context to DNA sequence data and a framework for incorporating data from future studies, fostering increasingly complete characterization of Earth's microbial diversity.Peer reviewe

A quantum Cherry theorem for perturbations of the plane rotator

{We consider on L^2(\T^2) the \Sc\ operator family L_\ep: \ep\in\R with domain and action defined as \ds D(L_\ep)=H^2(\T^2),\; L_\ep u=-\frac12\hbar^2(\alpha_1\partial_{\phi_1}^2+\alpha_2\partial_{\phi_2}^2)u-i\hbar(\gamma_1\partial_{\phi_1}+\gamma_2\partial_{\phi_2})u+\ep Vu. Here \ep\in\R, $\alpha=(\alpha_1,\alpha_2)$, $\gamma=(\gamma_1,\gamma_2)$ are vectors of complex non-real frequencies, and $V$ a pseudodifferential operator of order zero. L_\ep represents the Weyl quantization of the Hamiltonian family \L_\ep(\xi,x)=\frac12(\alpha_1\xi_1^2+\alpha_2\xi_2^2)+\gamma_1\xi_1+\gamma_2\xi_2+\ep \V(\xi,x) defined on the phase space \R^2\times\T^2, where \V(\xi,x)\in C^2(\R^2\times \T^2;\R). We prove the uniform convergence with respect to $\hbar\in [0,1]$ of the quantum normal form, which reduces to the classical one for $\hbar=0$. This result simultaneously entails an exact quantization formula for the quantum spectrum as well as a convergence criterion for the classical Birkhoff normal form generalizing a well known theorem of Cherry to a class of perturbations of a non self-adoint quantum plane rotator.