Laparoscopic management of a giant adrenal cyst

AbstractAdrenal cysts, a rare entity, are usually nonfunctional and asymptomatic. Here, we report a 32-year-old woman who presented with mild breathlessness and vague abdominal fullness and discomfort that had lasted 6 months. Chest radiography showed elevation of the left side of the diaphragm. Abdominal sonography showed an anechoic lesion of >15cm, without a septum, that was situated over the left abdominal area. Abdominal computed tomography (CT) showed a 20cm suprarenal cyst located between the pancreas, spleen, and left kidney, causing anterior displacement of the pancreas and inferior displacement of the left kidney. Magnetic resonance imaging confirmed the CT and sonographic findings, and revealed that the cystic mass was originating from the left adrenal gland. Fluid analysis of the cystic lesion showed no evidence of infection or malignancy. A laparoscopic adrenalectomy was performed. Histopathologically, the adrenal tissue showed no evidence of adenoma or malignancy, and the cystic component showed a flattened endothelial lining with fibrotic tissue, consistent with an endothelial cyst. The postoperative course was uneventful and the patient had no evidence of recurrence during a 6-year follow-up. We discuss the diagnosis and management of adrenal cysts

Fabrication of Semiconductor with Modified Microstructure for Efficient Photocatalytic Hydrogen Evolution Under Visible Light

Since sustainable energy and environment emerging as one of the top issues and challenges for humanity, the photocatalytic hydrogen evolution under visible light has attracted increasing attention. Basically the separation and transmission of photogenerated charge carriers are the two main steps of a photocatalytic reaction. They should be key aspects in the design of efficient photocatalysts for solar energy conversion

Single crystalline beta-SiAlON nanowhiskers: preparation and enhanced properties at high temperature

Single crystalline β-SiAlON (z = 1.0) nanowhiskers with uniform morphology were prepared using a reaction sintering method at 1773 K for 6 h under flowing nitrogen atmosphere. The as-synthesized whiskers were well-crystallized with about 100-200 nm in diameter and a few hundred microns in length. According to the thermodynamic calculation, Al(g) and SiO(g) are important intermediate reactants to synthesize β-SiAlON whiskers. In the experiment, the two phases was controlled by changing the flow rate of nitrogen to make β-SiAlON whiskers grow in a stable way. The formation of β-SiAlON whiskers occurred through a vapor-solid (VS) mechanism. SiAlON was found to grow as a single crystal whisker from the (1010) plane of the granule. Furthermore, an enhanced oxidation resistance for β-SiAlON whiskers at high temperature was also observed using the thermogravimetry method (TG), demonstrating that β-SiAlON whiskers with uniform morphology is a promising candidate as a reinforcing agent in composite

Effect of rehabilitation on a patient suffering from a tuberculous brain abscess with Gerstmann’s syndrome: case report

There are few reports in the literature of tuberculous brain abscess. Tuberculous brain abscess usually occurs in an immunocompromised host. Almost all previously documented cases have involved acquired immune deficiency syndrome. We encountered a 53-year-old right-handed immunocompetent male who was initially suspected of having a cerebrovascular accident due to acute-onset right hemiparesis and paresthesia. A tentative diagnosis of brain tumor versus brain abscess was made on imaging studies. The patient was finally diagnosed with a tuberculous brain abscess based upon deterioration on imaging and a positive tuberculosis culture. The tuberculous brain abscess was located in the left parietal lobe, which resulted in Gerstmann’s syndrome and right-sided apraxia. Stereotactic surgery was performed. He was also given antituberculosis chemotherapy and comprehensive rehabilitation. Considerable improvement was noted after rehabilitation. The patient even returned to a normal life and work. Our case demonstrates that an aggressive intensive inpatient rehabilitation program combined with stereotactic surgery and effective antituberculosis therapy play an important role in improving the outcome for patients with tuberculous brain abscess, Gerstmann’s syndrome, and right-sided apraxia

High Altitude Pulmonary Edema in a Patient with Previous Pneumonectomy

High altitude pulmonary edema (HAPE) is a life-threatening illness that can occur in individuals ascending to altitudes exceeding 2400 m. The risk factors are rapid ascent, physical exertion and a previous history of HAPE. This work presents a case study of a 74-year-old man who underwent left side pneumonectomy 40 years ago and subsequently experienced several instances of HAPE. The well-known risk factors for HAPE were excluded in this patient. We suspect that the post-pneumonectomy condition may be a risk factor for HAPE based on this case. [J Formos Med Assoc 2007;106(4):320-322

Measurements of Natural Carbonate Rare Earth Elements in Femtogram Quantities by Inductive Coupled Plasma Sector Field Mass Spectrometry

A rapid and precise standard-bracketing method has been developed for measuring femtogram quantity rare earth element (REE) levels in natural carbonate samples by inductively coupled plasma sector field mass spectrometry that does not require chemical separation steps. A desolvation nebulization system was used to effectively reduce polyatomic interference and enhance sensitivity. REE/Ca ratios are calculated directly from the intensities of the ion beams of 46Ca, 139La, 140Ce, 141Pr, 146Nd, 147Sm, 153Eu, 160Gd, 159Tb, 163Dy, 165Ho, 166Er, 169Tm, 172Yb, and 175Lu using external matrix-matched synthetic standards to correct for instrumental ratio drifting and mass discrimination. A routine measurement time of 3 min is typical for one sample containing 20-40 ppm Ca. Replicate measurements made on natural coral and foraminiferal samples with REE/Ca ratios of 2-242 nmol/mol show that external precisions of 1.9-6.5% (2 RSD) can be achieved with only 10-1000 fg of REEs in 10-20 μg of carbonate. We show that different sources for monthly resolved coral ultratrace REE variability can be distinguished using this method. For natural slow growth-rate carbonate materials, such as sclerosponges, tufa, and speleothems, the high sample throughput, high precision, and high temporal resolution REE records that can be produced with this procedure have the potential to provide valuable time-series records to advance our understanding of paleoclimatic and paleoenvironmental dynamics on different time scales

Genetic analysis of fish iridoviruses isolated in Taiwan during 2001–2009

To investigate the genetic relationships between field strains of iridoviruses gathered from various fish species in Taiwan, viruses that were collected from 2001 to 2009 were analyzed. Open reading frames encoding the viral major capsid protein (MCP) and adenosine triphosphatase (ATPase) were sequenced for phylogenetic analysis. Our results indicated that iridoviruses from Taiwan aquaculture fishes could be classified into two groups: prior to 2005, the viruses were closely related to members of the genus Ranavirus; and after 2005, they were similar to members of the genus Megalocytivirus. Based on the analysis of MCP amino acid sequences, virus isolates were divided into 4 major genotypes that were related to ISKNV, RSIV, FLIV, and GIV, respectively. Pairwise comparisons of MCP genes showed that the ranavirus was an epidemic pathogen for economically important species in the major production regions and cultured marine fish, while the megalocytivirus isolates were sensitive to host range. In addition, the distribution of synonymous and non-synonymous changes in the MCP gene revealed that the iridoviruses were evolving slowly, and most of the variations were synonymous mutations. The Ka/Ks values were lower than one, and hence, the viruses were under negative selection

The role of cytochrome c oxidase subunit Va in non-small cell lung carcinoma cells: association with migration, invasion and prediction of distant metastasis

BACKGROUND: Lung cancer is one of the most lethal malignancies worldwide, but useful biomarkers of lung cancer are still insufficient. The aim of this study is to identify some membrane-bound protein(s) associated with migration and invasion in human non-small cell lung cancer (NSCLC) cells. METHODS: We classified four NSCLC cell lines into high and low migration/invasion groups by Transwell and Matrigel assays. Using two-dimensional gel electrophoresis and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), we identified 10 membrane-associated proteins being significantly overexpressed in the high migration/invasion group. The expression of the target protein in the four NSCLC cell lines was then confirmed by reverse transcription polymerase chain reaction (RT-PCR), western blot and immunostaining. RNA interference technique was applied to observe the influence of the target protein on migration and invasion. Gelatin zymography was also performed to evaluate the activities of matrix metalloproteinase (MMP)-2 and MMP-9. Expression condition of the target protein on surgical specimens was further examined by immunohistochemical staining and the clinicopathologic data were analyzed. RESULTS: We identified a mitochondria-bound protein cytochrome c oxidase subunit Va (COX Va) because of its abundant presence found exclusively in tumorous areas. We also demonstrated that migration and invasion of NSCLC cells decreased substantially after knocking down COX Va by siRNA. Meanwhile, we found a positive correlation between COX Va expression, Bcl-2 expression and activities of MMP-2 and MMP-9 in NSCLC cells. Immunohistochemical staining of surgically resected lung adenocarcinomas in 250 consecutive patients revealed that strong COX Va expression was found in 54.8% (137/250) of patients and correlated positively with the status of lymph node metastasis (P = 0.032). Furthermore, strong COX Va expression was associated with the presence of distant metastasis (P = 0.033). CONCLUSIONS: Our current study showed that COX Va may play a role in migration and invasion of NSCLC cells and can be used as a biomarker to predict aggressiveness of NSCLC