Association between Daily Life Difficulties and Acceptance of Disability in Cancer Survivors after Total Laryngectomy: a Cross-Sectional Survey

Objective: This study aimed to clarify the relationships between the acceptance of disability and daily life difficulties in patients after total laryngectomy. Methods: An anonymous questionnaire was mailed to 135 patients who were participating in a self-help group after laryngectomy. The questionnaire included items on personal attributes, daily life difficulties, and acceptance of disability according to the Nottingham Adjustment Scale – Japanese Laryngectomy version (NAS-J-L). Multiple regression analysis was conducted using the NAS-J-L acceptance of disability subscale score as the dependent variable and daily life difficulties as the independent variables. Results: Among the 57 respondents, 43 who provided valid answers were included in the analysis (41 men and 2 women; mean age = 67.5 ± 10.6 years). Acceptance of disability was significantly associated with difficulties in defecation (β = −0.409, P < 0.01) and breathing (β = −0.356, P < 0.05). Conclusions: Our findings suggested that difficulties in defecation and breathing due to airway alterations influence acceptance of disability after laryngectomy. Therefore, nurses should carefully assess daily life difficulties and patient's ability to perform self-care activities such as defecating and breathing to promote acceptance of disability and facilitate adaptation to daily life after total laryngectomy

Sarcoidosis of mediastinal lymph nodes mimicking distant metastasis of oral squamous cell carcinoma : a case report and review of literature

Sarcoidosis is a systemic, chronic inflammatory disease with unknown cause and is characterized by formation of epithelioid granulomas in various organs, mainly the lungs and lymphatic system as mediastinal lymph nodes (LNs). Lymphadenopathy is common in sarcoidosis. Subsequent cancer also tends to occur in patients with the disease, and the most frequent is lymphoma and cancer of the lung. Head and neck cancer is uncommon but possible. We report a 70-year-old woman with squamous cell carcinoma (SCC) of the mandibular gingiva concomitant with mediastinal multiple lymphadenopathy, and a medical history of chronic sarcoidosis. Mediastinal LNs showed increased uptake of 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) with positron emission tomography (PET). Subsequent to lymphadenectomy, the histological diagnosis was lymphadenopathy caused by sarcoidosis. Next, we performed wide local excision of the gingival tumor. During follow-up, a pulmonary lesion was detected by computed tomography at 3 years and 11 months after surgery, and diagnosed as pulmonary sarcoidosis, which had been stable without treatment until now. After follow-up of 5 years, the patient was alive without signs of local recurrence or metastasis. The combination of oral SCC and sarcoidosis of the mediastinal LNs in a sarcoidosis patient has not been previously reported. FDG-PET was not able to distinguish LN metastasis from lymphadenopathy caused by sarcoidosis. In our case, her chronic inflammatory condition with sarcoidosis as well as ill-fitting dentures could have increased the risk of oral cancer. We suggest that clinicians should carefully check for the development of subsequent oral cancer in patients with a past history of sarcoidosis. To avoid inaccurate staging and incorrect therapy, LN biopsy should be promptly performed following a diagnosis of cancer and multiple lymphadenopathies in patients with a history of sarcoidosis. Lymphadenopathy with sarcoidosis patients have malignant potential, especially those who develop subsequent cancer. Misdiagnosis of LN malignancy and sarcoidosis may lead to unnecessary adjuvant therapy or worse prognosis

Laparoscopic resection of a metastatic myxoid liposarcoma in the mesentery of the small intestine: a case report

Abstract Background Myxoid liposarcoma (MLS), with its risk factors, tends to spread to the lungs and extraperitoneally, with intraperitoneal metastases occurring rarely. We present an unusual case of a myxoid liposarcoma that metastasized to the abdominal organs. Case presentation A 60-year-old female patient was referred to our hospital for the evaluation of a right upper limb tumor that had been growing for 7 years. The patient refused surgery, and during follow-up, tumor hemorrhage resulted in hemorrhagic shock. The patient’s right upper limb was immediately amputated. MLS was diagnosed histopathologically. Subsequently, the patient underwent adjuvant chemotherapy. Computed tomography (CT) revealed a right buttock mass, a pelvic mass, and left cardiophrenic angle lymph nodes 3 years after the initial surgery. Contrast-enhanced abdominal CT revealed a relatively low-density, lobulated pelvic tumor. Contrast-enhanced pelvic magnetic resonance imaging (MRI) revealed a low-intensity, lobulated mass on T1-weighted images and a high-intensity mass on T2-weighted images. The pelvic mass showed no significant fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET)-CT. On clinical examination, gynecological malignancies were ruled out as the origin of the pelvic lesions. After resection of the right buttock mass, pelvic mass, and left cardiophrenic angle lymph nodes, the patient underwent laparoscopic surgery for a preoperative diagnosis of small intestinal mesenteric metastasis of MLS. A tumor was found in the mesentery of the small intestine and removed with a margin of 5 cm on both the proximal and distal sides. The specimen measured 10 × 8 × 5 cm and contained a multifocal mass. The tumor was found in the mesentery of the small intestine, with no mucosal or submucosal invasion. The patient was diagnosed with MLS with small mesenteric intestinal metastases. On postoperative day 8, the patient was discharged after an uneventful postoperative course. Twelve months after the surgery, there was no evidence of local or distant recurrence. Conclusions Small intestinal mesenteric metastases of MLSs are rare. Moreover, there are few reports on laparoscopic resection. In this case, the laparoscopic approach was useful in detecting the tumor location and determining the range of resection

The genomes of intracellur symbionts in deep-sea Calyptogena clams are still in an early phase of reductive genome evolution.

http://www.godac.jamstec.go.jp/darwin/cruise/yokosuka/yk09-12/ehttp://www.godac.jamstec.go.jp/darwin/cruise/yokosuka/yk11-04/ehttp://www.godac.jamstec.go.jp/darwin/cruise/natsushima/nt10-08/

doi:10.1093/nar/gkr575 Diverse substrate recognition and hydrolysis mechanisms of human NUDT5

Human NUDT5 (hNUDT5) hydrolyzes various modified nucleoside diphosphates including 8-oxo-dGDP, 8-oxo-dADP and ADP-ribose (ADPR). However, the structural basis of the broad substrate specificity remains unknown. Here, we report the crystal structures of hNUDT5 complexed with 8-oxo-dGDP and 8-oxo-dADP. These structures reveal an unusually different substrate-binding mode. In particular, the positions of two phosphates (a and b phosphates) of substrate in the 8-oxo-dGDP and 8-oxo-dADP complexes are completely inverted compared with those in the previously reported hNUDT5–ADPR complex structure. This result suggests that the nucleophilic substitution sites of the substrates involved in hydrolysis reactions differ despite the similarities in the chemical structures of the substrates and products. To clarify this hypothesis, we employed the isotope-labeling method and revealed that 8-oxo-dGDP is attacked by nucleophilic water at Pb, whereas ADPR is attacked at Pa. This observation reveals that the broad substrate specificity of hNUDT5 is achieved by a diversity of not only substrate recognition, but also hydrolysis mechanisms and leads to a novel aspect that enzymes do not always catalyze the reaction of substrates with similar chemical structures by using the chemically equivalent reaction site