Collision tumors are extremely rare, and currently, no therapeutic protocols are established. A 64-year-old man presented to his physician with complaints of right chest and abdominal pain. The contrast-enhanced CT scan showed a mass measuring 3.6 cm around the gastric fundus. Esophagogastroduodenoscopy was performed and a semicircular longitudinal ulcerative mass was found at the distal esophagus. A mass measuring about 4 cm with central ulceration was noted at the cardia. The esophageal biopsy revealed positivity for a component of neuroendocrine carcinoma adjacent to a squamous cell carcinoma. PET-CT revealed a mass in the esophagus and cardia and several tumors in the whole liver, pancreas, and bone. The patient was finally diagnosed with a collision tumor of the esophagus with multiple metastases. In conclusion, patients with collision tumors must undergo active multidisciplinary management that will include pathologists and oncologists, who will decide on proper treatment strategies.

OBJECTIVE: The microRNA (miR)-10b is the T helper (Th) 17 cell specific in patients with ankylosing spondylitis (AS). The interleukin (IL)-22, which is closely related to Th17 cells, has been implicated in the regulation of new bone formation in experimental models. Therefore, the aim of this study was to evaluate whether miR-10b affects bone formation via the IL-22 pathway in AS. METHODS: Primary CD4+ T cells from AS were purified and transfected with miR-10b, anti-miR-10b, or scramble. Cell-surface markers and cytokine expression were analyzed by flow cytometry and enzyme-linked immunosorbent assay. Primary bone-derived cells (BdCs) from the facet joints of the spine were isolated, then osteogenic differentiation of primary BdCs was performed. We assessed alkaline phosphatase (ALP) activity and staining of BdCs at early time points. Alizarin red S staining of BdCs was performed at late time points. RESULTS: Overexpression of miR-10b reduced both IL-22 producing cell frequencies and cytokine production in T cells from the patients with AS. The IL-22 significantly increased ALP staining and bone mineralization. The ALP promotor activity of AS-BdCs was notably higher for the IL-22 concentration. The supernatants of the miR-10b overexpression group suppressed ALP activity on osteogenic progenitor cells from the facet joints of the spine in patients with AS. CONCLUSION Our data suggest that miR-10b suppresses IL-22 production, which was involved in osteogenic proliferation in AS. Therefore, miR-10b might be a potential therapeutic candidate for regulation of new bone formation in patients with AS.

PURPOSE: This study aimed to determine the appropriate stimulus strength that could result in a positive effect on the ankle joint spasticity when patients with chronic stroke performed whole body vibration (WBV) exercise. METHODS: Among 72 patients who were diagnosed with stroke at least 6 months ago, those able to perform a half squat pose with ambulation issues due to ankle joint spasticity (modified Ashworth scale, MAS≥2) were included for analysis. Individuals participated in four different frequencies of vertical WBV exercise; 0 Hz, 10 Hz, 20 Hz, and 30 Hz. Vibration amplitude was 3-4 mm and 5 minutes WBV exercise was performed at each frequency, followed by a measurement after 2-minute rest. We assigned 18 individuals to each frequency and asked them to participate in the WBV exercise once every 3 weeks. The level of spasticity was evaluated by visual analogue scale (VAS) for self-assessment. The myoton PRO was utilized to objectively evaluate the level of spasticity and check the muscle tone and stiffness. RESULTS: Participants showed 0 Hz VAS was a significant difference between 20 Hz application conditions (p < 0.05). Muscle tone was significantly different at 0 Hz between 20 Hz, and 30 Hz (p < 0.05), significantly difference at 10 Hz between 30 Hz (p < 0.05). Muscle stiffness significantly difference at 0 Hz between 20 Hz, and 30 Hz (p < 0.05), significantly difference at 10 Hz between 20 Hz, and 30 Hz (p < 0.05). CONCLUSION: Findings of this study show that the frequency of more than 20 Hz was effective in improving the ambulatory ability in patients with chronic stroke. Currently, the effective WBV protocol is limited. Hence, this study was designed to suggest an effective WBV protocol to improve neuromodulation ability for chronic stroke patients.
Ankle Joint* ; Ankle* ; Humans ; Muscle Spasticity* ; Self-Assessment ; Stroke* ; Vibration* ; Walking

PURPOSE: The objective of the study was to investigate the effects of xylobiose-sugar mixture intake on defecation frequency and constipation symptoms in 31 young women with constipation. METHODS: Thirty-one subjects were assigned to two groups, and subjects in each group were administered 10 g of a 7% xylobiose-sugar mixture (Experiment 1: XBS, n = 15) or 10 g of a 7% xylobiose-sugar mixture containing coffee mix (Experiment 2: XBS coffee mix, n = 16) twice per day for 6 weeks. During the study, clinical efficacy was assessed by a daily diary record. The subjects recorded their defecation frequency and fecal characteristics. RESULTS: During pretreatment week, mean defecation frequency of XBS subjects was 2.13 times/week, whereas that of XBS coffee mix subjects was 1.56 times/week. The mean defecation frequencies of XBS and XBS coffee mix subjects increased significantly to 3.73 times/week (p < 0.05) and 3.56 times/week by week 6 (p < 0.05), respectively. After treatment with either XBS or XBS coffee mix, patients presented significant improvements in their amounts of stool, feelings of residual stool leftness, and abdominal pain symptoms (p < 0.05). The total constipation scoring system (CSS) for diagnosing constipation symptoms significantly decreased in the XBS group (10.53 score vs 7.22 score) and in the XBS coffee mix group (10.75 score vs 6.51 score) after 6 weeks. Improvement due to intake of 7% xylobiose-containing sugar seemed to last during the experimental period. CONCLUSION: The addition of approximately 7% xylobiose to commercially available sweeteners has been shown to improve constipation.
Abdominal Pain ; Coffee ; Constipation* ; Defecation* ; Female ; Humans ; Sweetening Agents ; Treatment Outcome

PURPOSE: The purpose of this study is to evaluate the results and the advantages of the operative treatment of metastatic pathologic fractures in long bones using locking compression plates. MATERIALS AND METHODS: Twenty-five patients (28 cases) who underwent open reduction and internal fixation with a locking compression plate with or without cement augmentation for pathologic fractures in long bones resulting from metastatic cancer between 2004 and 2013 were reviewed retrospectively. Mean age at the time of surgery was 62.8 years. Pathologic fractures occurred in 11 cases in the humerus, 11 cases in the femur, and 6 cases in the tibia. Functional analysis of Musculoskeletal Tumor Society (MSTS) scores, functional restoration condition of patients with upper extremity involvements, and interval to wheelchair ambulation in patients with lower extremity involvements was performed. Pain relief (visual analogue scale, VAS) and operation time, postoperative satisfaction with individuals, and complications were evaluated. RESULTS: Mean operation time was 81.3 minutes and mean MSTS scores were 19.8. Mean time from operation to wheelchair ambulation was 3.3 days. Mean VAS improved from 8.1 preoperatively to 2.9 at 1 week postoperatively. Most patients reported that they were more than 'satisfied' One transient radial nerve palsy and one late complication of screw breakage and reduction loss had occurred at postoperative 3 months. CONCLUSION: Internal fixation with a locking compression plate in metastatic pathologic fractures can be an effective treatment option in the meta or diaphyseal area of long bones.
Femur ; Fractures, Spontaneous* ; Humans ; Humerus ; Lower Extremity ; Paralysis ; Radial Nerve ; Retrospective Studies ; Tibia ; Upper Extremity ; Walking ; Wheelchairs

A new L-isoascorbic acid derivative epi-leptosphaerin (1) and two known compounds leptosphaerin (2), and verongamine (3) were isolated from sponges of the orders Verongida and Thorectidae. Compounds 1 and 2 are most likely of sponge-associated fungal origin. In the present study, isolated compounds were investigated for their inhibition of soluble epoxide hydrolase (sEH), which is considered a promising target for the management of pain, inflammation, and comorbidities associated with diabetes. Compound 3, verongamine, displayed weak inhibitory activity against sEH with an IC50 value 51.5 +/- 1.0 microM.
Comorbidity ; Inflammation ; Inhibitory Concentration 50 ; Porifera*

BACKGROUND: Thyroid incidentalomas detected by 2-deoxy-2-18F-fluoro-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) have been reported in 1% to 4% of the population, with a risk of malignancy of 27.8% to 74%. We performed a retrospective review of FDG-avid thyroid incidentalomas in cancer screening subjects and patients with nonthyroid cancer. The risk of malignancy in thyroid incidentaloma and its association with the maximal standardized uptake value (SUVmax) in 18F-FDG PET/CT were evaluated to define the predictor variables in assessing risk of malignancy. METHODS: A total of 2,584 subjects underwent 18F-FDG PET/CT for metastatic evaluation or cancer screening from January 2005 to January 2010. Among them, 36 subjects with FDG-avid thyroid incidentalomas underwent further diagnostic evaluation (thyroid ultrasonography-guided fine needle aspiration cytology [FNAC] or surgical resection). We retrospectively reviewed the database of these subjects. RESULTS: Of the 2,584 subjects who underwent 18F-FDG PET/CT (319 for cancer screening and 2,265 for metastatic evaluation), 52 (2.0%) were identified as having FDG-avid thyroid incidentaloma and cytologic diagnosis was obtained by FNAC in 36 subjects. Of the subjects, 15 were proven to have malignant disease: 13 by FNAC and two by surgical resection. The positive predictive value of malignancy in FDG-avid thyroid incidentaloma was 41.7%. Median SUVmax was higher in malignancy than in benign lesions (4.7 [interquartile range (IQR), 3.4 to 6.0] vs. 2.8 [IQR, 2.6 to 4.0], P=0.001). CONCLUSION: Thyroid incidentalomas found on 18F-FDG PET/CT have a high risk of malignancy, with a positive predictive value of 41.7%. FDG-avid thyroid incidentalomas with higher SUVmax tended to be malignant.
Biopsy, Fine-Needle ; Diagnosis ; Early Detection of Cancer ; Electrons ; Fluorodeoxyglucose F18 ; Humans ; Incidental Findings ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Prevalence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms

Squamous cell carcinoma of the rectum is extremely rare, with an incidence between 0.25 and 1 case per 1,000 cases of colorectal carcinoma. In familial adenomatous polyposis (FAP), characterized by the progressive development of hundreds to thousands of adenomatous colonic polyps, unscreened patients and those who are not treated at an early stage of the disease have an extremely high risk of developing colorectal adenocarcinoma. A few reports of squamous cell carcinoma of the rectum have been published but none of the patients had FAP. Here, we report the case of a 17-year-old male with FAP who developed rectal squamous cell carcinoma.
Adenocarcinoma ; Adenomatous Polyposis Coli* ; Adolescent ; Carcinoma, Squamous Cell* ; Colonic Polyps ; Colorectal Neoplasms ; Humans ; Incidence ; Male ; Rectal Neoplasms ; Rectum

When evaluating the underlying causes of tall stature, it is important to differentiate pathologic tall stature from familial tall stature. Various pathologic conditions leading to adult tall stature include excess growth hormone secretion, Marfan syndrome, androgen or estrogen deficiency, testicular feminization, and sex chromosome anomaly, such as Klinefelter syndrome and XYY syndrome. Men with 47,XYY syndrome can exhibit multiple phenotypes. A 13-year-old boy visited the hospital for evaluation of tall stature. The boy had no other physical abnormalities except tall stature. All biochemical and imaging studies were within the normal ranges. He was diagnosed with XYY syndrome in this chromosome study. When evaluating men with tall stature, XYY syndrome should be ruled out.
Adolescent* ; Adult ; Androgen-Insensitivity Syndrome ; Estrogens ; Growth Disorders ; Growth Hormone ; Humans ; Klinefelter Syndrome ; Male* ; Marfan Syndrome ; Phenotype ; Reference Values ; Sex Chromosome Disorders ; Sex Chromosomes

beta-Glucosidase, which hydrolyzes cellobiose into two glucoses, plays an important role in the process of saccharification of the lignocellulosic biomass. In this study, we optimized the activity of beta-glucosidase of brown-rot fungus Fomitopsis pinicola KCTC 6208 using the response surface methodology (RSM) with various concentrations of glucose, yeast extract and ascorbic acid, which are the most significant nutrients for activity of beta-glucosidase. The highest activity of beta-glucosidase was achieved 3.02% of glucose, 4.35% of yeast extract, and 7.41% ascorbic acid where ascorbic acid was most effective. The maximum activity of beta-glucosidase predicted by the RSM was 15.34 U/mg, which was similar to the experimental value 14.90 U/mg at the 16th day of incubation. This optimized activity of beta-glucosidase was 23.6 times higher than the preliminary activity value, 0.63 U/mg, and was also much higher than previous values reported in other fungi strains. Therefore, a simplified medium supplemented with a cheap vitamin source, such as ascorbic acid, could be a cost effective mean of increasing beta-glucosidase activity.
Ascorbic Acid ; beta-Glucosidase* ; Biomass ; Cellobiose ; Coriolaceae* ; Fungi* ; Glucose ; Vitamins ; Yeasts