Primary Signet Ring Cell Carcinoma of Rectum Diagnosed by Boring Biopsy in Combination with Endoscopic Mucosal Resection

A 46-year-old man with severe back pain visited our hospital. Magnetic resonance imaging revealed extensive bone metastasis and rectal wall thickness. Colonoscopy revealed circumferential stenosis with edematous mucosa, suggesting colon cancer. However, histological findings of biopsy specimens revealed inflammatory cells but no malignant cells. The patient underwent endoscopic ultrasound, which demonstrated edematous wall thickness without destruction of the normal layer structure. After unsuccessful detection of neoplastic cells by boring biopsies, we performed endoscopic mucosal resection followed by boring biopsies that finally revealed signet ring cell carcinoma. Herein, we present a case and provide a review of the literature.

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Phototoxic drug reaction with the novel agent rovalpituzumab tesirine

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Rhinoplasty: lessons from “errors”

Abstract

Background

Reshaping the nose can be achieved following 3 main concepts: preservation and reshaping of normal anatomy, resection of nasal deformities, reconstruction of nasal framework. Time, experience and nasal anatomic knowledge are keys to understand nasal biomechanics.

Objectives

To describe how experience and morphodynamic anatomy lead to a new concept of sequential primary rhinoplasty, resulting in reducing revision rhinoplasties.

Methods

Through 36 years' experience in different rhinoplasty procedures, 25 years in personal anatomic studies of the nose and reviewing the last 15 years including 600 patients who underwent new concepts in primary rhinoplasty out of 1200 patients operated during this period, the author analyzes how nasal anatomic layers, surgical approaches, and morphological effect of the time interact to modify the aesthetic results according to current rhinoplasty concepts.

Results

Nasal bony cartilaginous vaults biomechanics understanding leads to consider the K‑area as a flexible joint which can be reshaped without resection of the nasal vaults. The role of the subdorsal septum is highlighted as the main anatomic structure which can be safely resected in rhinoplasty, and which allows to respect the natural anatomy, the nasal valves and the dorsal aesthetic lines. Description of nasal compartments divided by the "T" ligament leads to rethink the incisions and approaches of the nose: the interseptal-columellar and extended infracartilaginous incisions allow to protect nasal ligaments and to perform a deep plane undermining. Protection of the anatomic layers allows quick recovery, nasal function improvement and long-lasting results.

Conclusion

The goal to reduce the rate of revision rhinoplasty and to improve the natural results can be achieved, considering the concept of sequential primary rhinoplasty. Nasal soft tissues are protected as far as possible. The current rhinoplasty concepts are not antagonist but appear as an intraoperative succession of alternative techniques from anatomy and function preservation to reconstruction of the nasal framework.

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Submucosal gland mucus strand velocity is decreased in chronic rhinosinusitis

Background

Chronic rhinosinusitis (CRS) may be initiated by innately impaired host defense mechanisms that predispose the upper airways to infection. Recent evidence suggests tethering of submucosal gland mucus strands represents an inciting event within cystic fibrosis (CF) airways, occurring prior to onset of chronic infection. Submucosal gland hypertrophy and defective mucociliary clearance (MCC) are present in actively inflamed sinuses, but mucus strand velocity may also be affected as a secondary event, further contributing to chronic disease. The objective of this study is to assess whether mucus strand velocity is decreased in patients with CRS.

Methods

Mucosal explants from patients with and without CRS were submerged in Ringer's solution mixed with fluorescent nanospheres. Methacholine was then added, and videos demonstrating strand growth and detachment were generated from a time-lapse of Z-stack images using a multiphoton confocal microscope. Dynamic mucus strands were identified and individual velocities quantified with the MTrackJ plug-in of ImageJ.

Results

Fifteen patients met criteria for ex vivo analysis of mucus strand velocities (CRS, n = 9 vs controls, n = 6). Mucus strands were recorded (pixels/second) streaming from the submucosal gland openings. Average mucus strand velocities were significantly decreased in patients with CRS (1.53 ± 0.67 vs controls, 4.86 ± 1.68 pixels/second; p < 0.001).

Conclusion

This study is the first to report evidence of abnormal mucus strand velocity from submucosal glands in diseased sinonasal mucosa. Future pharmacologic studies targeting this critical component of MCC are warranted.

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Immunization of mice with egG1Y162-1/2 provides protection against Echinococcus granulosus infection in BALB/c mice

Publication date: February 2018
Source:Molecular Immunology, Volume 94
Author(s): Fengbo Zhang, Shaoyu Li, Yuejie Zhu, Chuntao Zhang, Yujiao Li, Haimei Ma, Nannan Pang, Mengting An, Hongying Wang, Jianbing Ding
AimsThis study is to predict and purify the T-B combined epitopes of egG1Y162 antigen in Echinococcus granulosus, and to evaluate their immunogenicity in mice.MethodsThe bioinformatics software was used to predict the T-B combined epitopes of egG1Y162 antigen. Recombinant egG1Y161/2 peptides were constructed, expressed and purified. Mice were immunized with egG1Y161/2 peptides. The serum and spleen cells were isolated. The isolated spleen cells were stimulated with egG1Y161/2 peptides in vitro and the culture supernatant was collected. The levels of IgG in serum and levels of IL-4 and IFN-γ in the culture supernatant were measured by ELISA. The weight and number of the fresh hydatid cysts were evaluated. The serum ptotoscolicidal activity was measured by the complement dependent cytotoxicity assay.ResultsPeptides of 6–19aa, 64–82aa, 106–119aa were predicted as T-B combined epitopes of egG1Y162 antigen. And, recombinant protein egG1Y162-1 or egG1Y162-2, which contained T-B combined epitope(s) of the 6–19aa, or the 64–82aa and the 106–119aa in egG1Y162 antigen, respectively, was successfully expressed and purified. Serum IgG levels of mice immunized with egG1Y162-1/2 were significantly increased during the immune response to Echinococcus granulosus. The levels of IFN-γ, IL-4 and the ratio of IFN-γ/IL-4 after egG1Y162-1/2 immunization were significantly higher. Weight and number of the fresh hydatid cysts in egG1Y162-1/2 immunized mice was significantly decreased. And, the serum protoscolicidal activity after egG1Y162-1/2 immunization was enhanced.ConclusionsThe egG1Y162-1/2 induces production of serum IgG levels and Th1 cell immune response, which enhances the protective immunity in Echinococcus granulosus challenged mice and thus may be used as a potential vaccine candidate.



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The science behind skin care: Moisturizers

Summary

Moisturizers provide functional skin benefits, such as making the skin smooth and soft, increasing skin hydration, and improving skin optical characteristics; however, moisturizers also function as vehicles to deliver ingredients to the skin. These ingredients may be vitamins, botanical antioxidants, peptides, skin-lightening agents, botanical anti-inflammatories, or exfoliants. This discussion covers the science of moisturizers.

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The Global Encyclopaedia of Informality, Volume 2

Ledeneva, AV (Ed). (2018) The Global Encyclopaedia of Informality, Volume 2. [Book]. Fringe: Vol.2. UCL Press: London, UK. Green open access

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