Coinfection of Invasive Pulmonary Aspergillosis and Pneumocystis Jiroveci Pneumonia in a Non-HIV Patient

Invasive pulmonary aspergillosis (IPA) and pneumocystis jiroveci pneumonia (PCP) are life-threatening opportunistic infections that occur in immunocompromised hosts. Early diagnosis and treatment of these opportunistic infections is essential to the survival of immunocompromised patients. We report a 60-year-old man undergoing short-term steroid therapy after surgical resection of a brain tumor infected with combined invasive pulmonary aspergillosis and pneumocystis jiroveci pneumonia diagnosed by bronchoscopy with bronchoalveolar lavage. Our case demonstrated that short-term systemic steroid therapy in non-HIV patients with underlying chronic lung conditions and malignancies was a risk factor for IPA and PCP, and for a combination of these infections

Isolation and Identification of Allelopathic Substances from <i>Forsythia suspensa</i> Leaves, and Their Metabolism and Activity

The fruit of Forsythia suspensa (Thunb.) Vahl has been used in traditional Chinese medicine as “Forsythiae fructus”. The species is also grown in parks and gardens, and on streets and building lots, as an ornamental plant, but it requires pruning. In this study, the allelopathic activity and allelopathic substances in the leaves of pruned branches of F. suspensa were investigated to determine any potential application. The leaf extracts of F. suspensa showed growth inhibitory activity against three weed species; Echinochloa crus-galli, Lolium multiflorum, and Vulpia myuros. Two allelopathic substances in the extracts were isolated through the bioassay-guided purification process, and identified as (-)-matairesinol and (-)-arctigenin. (-)-Matairesinol and (-)-arctigenin, which showed significant growth inhibitory activity at concentrations greater than 0.3 mM in vitro. The inhibitory activity of (-)-arctigenin was greater than that of (-)-matairesinol. However, both compounds were more active than (+)-pinolesinol which is their precursor in the biosynthetic pathway. The investigation suggests that F. suspensa leaves are allelopathic, and (-)-matairesinol and (-)-arctigenin may contribute to the growth inhibitory activities. Therefore, the leaves of the pruned branches can be applied as a weed management strategy in some agricultural practices such as using the leaf extracts in a foliar spray and the leaves in a soil mixture, thereby reducing the dependency on synthetic herbicides in the crop cultivation and contributing to developing eco-friendly agriculture

Simple and reliable enumeration of Escherichia coli concentrations in wastewater samples by measuring β-d-glucuronidase (GUS) activities via a microplate reader

Monitoring of Escherichia coli concentrations at wastewater treatment plants (WWTPs) is important to ensure process performance and protect public health. However, conventional E. coli enumeration methods are complicated and time- and labor-consuming. Here, we report a novel simple and reliable method based on β-D-glucuronidase (GUS) activity assay to enumerate E. coli concentrations in wastewater (WW) samples. An aliquot (20 μL) of the medium with fluorogenic enzyme substrate for E. coli and 180 μL of a WW sample were added to one well of a 96-well microplate. The microplate was placed in a microplate reader at 37°C. To this end, the fluorescence intensity of a fluorogenic enzyme substrate for E. coli was measured every 10 min over 3 h to determine GUS activity. The linear increase in the fluorescence intensity representing the GUS activities showed a positive correlation with E. coli concentrations in wastewater samples. However, the correlation equations were specific to WWTPs, which could be due to the difference in the E. coli population structures among WWTPs. We observed that the wastewater matrix is not a limitation to measure the GUS activity, and a WWTP-specific correlation equation can be used as a calibration curve to estimate the E. coli concentrations in the samples collected from that site. A comparison of the results with those of culture-dependent Colilert method proved that the current method is simple and useful for the enumeration of E. coli concentrations in wastewater samples reliably

Hepatocellular Carcinoma Mimicking Liver Abscesses in a Cirrhotic Patient with Severe Septic Shock as a Result of Salmonella O9 HG Infection

We describe a case of severe Salmonella O9 HG sepsis with a mass in the liver, which was diagnosed as hepatocellular carcinoma (HCC) by autopsy of the liver. The patient was a 67-year-old man with chronic high blood pressure. In addition, he was an alcoholic and had been drinking every day for many years. He had had a dinner of ‘sukiyaki’ with a raw egg two days before admission. The next morning, he had developed vomiting, diarrhea, and abdominal pain. Salmonella O9 HG was found in the blood and stool cultures. In the computed tomography (CT) finding of the liver, there was a 2 cm early-enhanced mass with a multilocular structure, with ringed enhancement and daughter nodes. Since we thought that the mass was a liver abscess, we performed needle aspiration from the liver mass and were able to withdraw blood. Despite adequate antibiotic treatment, the patient died as a result of complications on the 55th day after admission. After the patient’s death, we conducted an autopsy. There were two HCC masses, a moderately-differentiated and a well-differentiated mass, as a result of alcoholic cirrhosis of the liver. As the HCC had multilocular cyst-like structures, which were fiber- and necrosis-rich, CT images of the liver masses resembled abscesses

Usefulness of Multidetector Computed Tomography(M DCT) for the Initial Evaluation of Multiple Blunt Trauma of the Trunk

Background: Focused assessment with sonography for trauma (FAST) is useful for detecting hemoperitoneum (HE) in trauma patients in the emergency room (ER), but, patients’condition cannot be evaluated adequately by FAST alone. CT is useful for the diagnosis of multiple trauma, but has certain drawbacks. We evaluated the utility of mutidetector computed tomography(MDCT) as the initial tool for proper diagnosis and treatment planning of multiple trauma patients. Method: We retrospectively analyzed 128 cases treated in ER of Gunma University Hospital between April 1, 2005 and December 31, 2006, and they were hospital patients were hospitalized with blunt multiple trauma. We analyzed the sensitivity, specificity, and accuracy of FAST, compiled MDCT finding, lifesaving treatment, and outcome. Result: Eight patients were FAST positive, and 7 of the 8 were scanned by MDCT. There were 120 patients were FAST negative patients, 23 of the 120 were MDCT-negative, despite visceral injury, however 9 of the 120 had visceral injury by MDCT findings. Damage control surgery without MDCT was performed in one case, but the patient died after surgery. Six of the patients in the HE-positive group had really HE. One of the 6 died while a waiting surgery, transcatheter arterial embolization (TAE) was performed in three patients, and one person out of the 3 died. The course of the remaining 2 patients was monitored, and they are alive. A patient in the HE-negative group with bladder rupture required surgery. There were 120 patients in the FAST-negative group. One of the 6 patients in the HE-positive subgroup died while a waiting surgery. One patient required chest and pericardial drainage. TAE was performed in 2 patients, and the remaining 6 were monitored and are alive. There were 23 FAST-negative patients patients who had visceral injury. Five of them required chest drainage, one received TAE, 17 were monitored, and all of the 23 are alive. There were 14 cases of pelvic fracture alone, and all of them were FAST-negative. One patient required surgery for open femoral fracture, TAE was performed in three, 10 monitored, all 14 are alive. Only one patient developed shock during MDCT. The others underwent scanning safely. Conclusion: MDCT is a better tool for the diagnosis of blunt multiple trauma of the trunk than CT, because the scanning time is shorter

Echo Free Space in Morrison's Pouch in a Patient with Traumatic Bladder Rupture : A Case Report

Ultrasonography is a useful emergency room technique for detection of abdominal hemorrhage in trauma patients. In the JATEC course(Japan Advanced Trauma Evaluation and Care course), FAST (Focused Assessment of Sonography for Trauma) is advocated to determine the presence of a fluid pool, especially hemorrhage, in the pericardial, thoracic, and abdominal cavities. Most clinicians are initially likely to regard fluid as hemorrhage from the abdominal organs, but the fluid may also be derived from blood, ascites, urine, or other fluids. We report a 39-year-old man who suffered a bruise to his lower abdomen in a traffic accident. He underwent ultrasonography, and an echo free space was found in his Morison's pouch. Intraabdominal hemorrhage was suspected, but a CT scan did not show any multiple organ injury, but the bladder was ruptured. The fluid in the abdominal cavity was urine derived from this bladder rupture. The cause of FAST positivity, except for hemorrhage, is thought to be a blind spot for clinicians; however, causes other than hemorrhage need to be considered,especially in patients with trauma to the lower abdominal region