Pink nodule accompanied with multiple yellow globules at the periphery

ArticleJAAD case reports. 3(4): 351-353. (2017)journal articl

Juvenile Granulosa Cell Tumor with Elevated Peripheral Interleukin-6 Level Shows Prolonged Fever and Delayed Puberty

Juvenile granulosa cell tumor (JGCT), classified as a sex cord-stromal tumor, is a rare neoplasm. This is an instructive case report of JGCT accompanied by augmented interleukin (IL)-6 secretion. A 13-year-old girl with prolonged fever and delayed puberty was diagnosed with JGCT of the left ovary based on an imaging study and pathological investigation. Although it was not clear whether IL-6 was secreted from the tumor cells, her serum level of IL-6 was very high. After tumorectomy, the patient’s symptoms immediately disappeared, her IL-6 level decreased, and she entered puberty. Therefore, augmented IL-6 secretion production induced by tumors should be considered a potential cause of prolonged fever and/or delayed puberty

Short-Interval Self-Learning to Improve Retention of Resuscitation Skills: A Randomized Controlled Trial

The optimal interval and methods for cardiopulmonary resuscitation (CPR) retraining remain unclear. We evaluated the difference in CPR skills one year after a 45-minute chest compression-only CPR training among participants receiving short self-learning refresher training at 3-month intervals, those receiving this training at 6-month intervals, and those without the refresher training. Participants were randomly assigned to the 3-month group, 6-month group, or control group. Resuscitation skills were assessed immediately after the initial training, and at 1 year after the training. The primary endpoint was the number of chest compressions performed with appropriate depth one year after the training. Among 129 participants that were selected, 112 were fully evaluated. Although no significant differences were found in the baseline characteristics among the three groups, the self-training groups demonstrated a tendency to perform fewer chest compressions with appropriate depth (p = .122). No significant differences were observed between the three groups in terms of the number of chest compressions with appropriate depth one year after the training (p = .895). However, the appropriate number of chest compressions, the number of chest compressions with appropriate depth, and chest compression depth in the short-interval self-retraining groups one year later were better than those observed immediately after training. Short self-retraining every 3 or 6 months after the chest compression-only CPR training could not be attributed to the retention of chest compression skills with appropriate depth. However, short, frequent self-retraining in persons with poor skills might be useful in acquiring chest compression skills

Melanocytic Naevus Shows Parallel Ridge Pattern due to the Melanin Columns Under the Ridges

ArticleACTA DERMATO-VENEREOLOGICA.95(1):95-96(2015)journal articl

Consideration of Intestinal Failure in Cases of De-Adaptation of Short Bowel Syndrome: A Case Report and Descriptive Review

Short bowel syndrome (SBS) causes malabsorption due to extensive intestinal resection. While intestinal function declines with age, little is known about the relationship between intestinal failure and ageing. For the first time in Japan, we report a case of de-adaptation of SBS thought to be due to ageing, in a 93-year-old woman who presented with electrolyte imbalance and malnutrition. She had undergone five surgical resections of the small intestine over the past 20 years. She had developed SBS once due to multiple surgeries, but due to compensatory function, the symptoms had abated. However, due to decreased intestinal function caused by ageing, it worsened and symptoms reappeared. A literature search for the period January 1990 to May 2021 in Ichushi a major journal in Japan, found that de-adaptation of SBS occurred in 23 previous cases, of which we were able to confirm the details in 17 cases, with no case reports on “de-adaptation of SBS”, demonstrating that the concept of “intestinal failure” has only recently begun to be used in routine practice. Therefore, we stress the importance of re-emphasizing the concept of ”intestinal failure” in everyday practice, as well as other organ-related conditions such as cardiac or renal failure, as this may lead to a better understanding of the pathogenesis of malnutrition and diarrhoea in elderly patients

Plasmid-Encoded asp Operon Confers a Proton Motive Metabolic Cycle Catalyzed by an Aspartate-Alanine Exchange Reaction

Tetragenococcus halophila D10 catalyzes the decarboxylation of l-aspartate with nearly stoichiometric release of l-alanine and CO(2). This trait is encoded on a 25-kb plasmid, pD1. We found in this plasmid a putative asp operon consisting of two genes, which we designated aspD and aspT, encoding an l-aspartate-β-decarboxylase (AspD) and an aspartate-alanine antiporter (AspT), respectively, and determined the nucleotide sequences. The sequence analysis revealed that the genes of the asp operon in pD1 were in the following order: promoter → aspD → aspT. The deduced amino acid sequence of AspD showed similarity to the sequences of two known l-aspartate-β-decarboxylases from Pseudomonas dacunhae and Alcaligenes faecalis. Hydropathy analyses suggested that the aspT gene product encodes a hydrophobic protein with multiple membrane-spanning regions. The operon was subcloned into the Escherichia coli expression vector pTrc99A, and the two genes were cotranscribed in the resulting plasmid, pTrcAsp. Expression of the asp operon in E. coli coincided with appearance of the capacity to catalyze the decarboxylation of aspartate to alanine. Histidine-tagged AspD (AspDHis) was also expressed in E. coli and purified from cell extracts. The purified AspDHis clearly exhibited activity of l-aspartate-β-decarboxylase. Recombinant AspT was solubilized from E. coli membranes and reconstituted in proteoliposomes. The reconstituted AspT catalyzed self-exchange of aspartate and electrogenic heterologous exchange of aspartate with alanine. Thus, the asp operon confers a proton motive metabolic cycle consisting of the electrogenic aspartate-alanine antiporter and the aspartate decarboxylase, which keeps intracellular levels of alanine, the countersubstrate for aspartate, high