Search

Objective: To describe local recurrence rates and patient-reported outcomes when Mohs micrographic surgery with cytokeratin-7 immunostains (MMS-CK7) is included in the interdisciplinary management of extramammary Paget's disease (EMPD) METHODS: A retrospective study was conducted of EMPD treated with MMS-CK7 as part of an interdisciplinary team at an academic medical center between 2009 and 2016. Local recurrence rates and patient-reported outcomes were determined by record review and patient surveys., Results: Twenty tumors in 19 patients were treated using MMS-CK7. After MMS-CK7 defined clear microscopic margins, 75% (15/20) of tumors underwent excision or reconstruction by a surgical colleague. Internal malignancy screening was performed by multiple specialties in 17 patients, with 1 associated malignancy of prostate cancer detected. No local recurrence was detected with a mean follow-up of 75.2 months. Most patients were satisfied with appearance (18/19, 95%) and function (16/19, 84%) after surgery., Conclusion: Interdisciplinary teams that include MMS-CK7 can treat EMPD with low local recurrence rates, high patient satisfaction, and thorough internal malignancy screening., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Lamin is an intermediate protein underlying the nuclear envelope and it plays a key role in maintaining the integrity of the nucleus. A defect in the processing of its precursor by a metalloprotease, ZMPSTE24, results in the accumulation of farnesylated prelamin in the nucleus and causes various diseases, including Hutchinson-Gilford progeria syndrome (HGPS). However, the role of lamin processing is unclear in fish species. Here, we generated zmpste24-deficient medaka and evaluated their phenotype. Unlike humans and mice, homozygous mutants did not show growth defects or lifespan shortening, despite lamin precursor accumulation. Gonadosomatic indices, blood glucose levels, and regenerative capacity of fins were similar in 1-year-old mutants and their wild-type (WT) siblings. Histological examination showed that the muscles, subcutaneous fat tissues, and gonads were normal in the mutants at the age of 1 year. However, the mutants showed hypersensitivity to X-ray irradiation, although p53target genes, p21 and mdm2, were induced 6 h after irradiation. Immunostaining of primary cultured cells from caudal fins and visualization of nuclei using H2B-GFP fusion proteins revealed an abnormal nuclear shape in the mutants both in vitro and in vivo. The telomere lengths were significantly shorter in the mutants compared to WT. Taken together, these results suggest that zmpste24-deficient medaka phenocopied HGPS only partially and that abnormal nuclear morphology and lifespan shortening are two independent events in vertebrates., (Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.)

Piggery-associated methicillin-resistant Staphylococcus aureus (MRSA) is a potential zoonotic pathogen. We constructed the population structure and dynamics of staphylococcal chromosome cassette mec (SCCmec) in MRSA ST9 isolates from different geographical areas of Taiwan. A total of 140 MRSA (135 piggery and 5 human clinical) isolates from three populations located in western Taiwan (n=96 including the 5 clinical isolates), central eastern Taiwan (n=22), and Penghu Island (n=22) were collected and characterized by analysis of the mec-associated direct repeat unit (dru). Twenty-eight dru types (with 24 novel) and 15 dru-Clonal Complexes (CCs) were identified. The predominant novel dt12w type (48.6%) was widespread in all populations and may have a superior ability to transmit among populations. The minimum spanning network showed that at least two ancestral dru types (dt11a and dt12w) were identified, and the genetics between different populations could be differentiated. Temporal distributions of clone population dynamics estimated through the Bayesian skyline plot indicated a stable population with a long evolutionary history for MRSA ST9 in Taiwan. Findings indicating that some dru types are shared between piggery-associated and human-clinical MRSA ST9 suggest the occurrence of cross-species horizontal transmission of SCCmec., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Most enteroviruses excreted in human feces and urine are present in environmental water. In order to clarify the infection route of enterovirus, the detection of viruses in both clinical and environmental samples may contribute to understanding the mode of transmission of strains responsible for human infection. Thus, 21 epidemic enterovirus 71 strains from environmental water or stool samples were collected from HFMD children during 2005. Enterovirus genomic RNA was first amplified directly from clinical and environmental samples and then characterized by DNA sequencing and phylogenetic analysis. Results showed that these clinical strains share similar sequence identity (86.4-86.8%) to prototype BrCr based on the 5'-nontranslated region (NTR). However, environmental strains, except HME 77, share similar sequence identity (86.2-87.2%) to prototype BrCr. HME 77 showed higher sequence identity (90.1%). Results from phylogenetic analysis revealed that five environmental isolates were clustered as genogroup 3, which was closely related to a Taiwan outbreak in 1998 (AY055133). HME 77 was more closely related to a China epidemic isolate (AY895144), which belonged to genogroup 4. In contrast, all strains from clinical samples tested belonged to genogroup 3, which clustered with AY055133. In conclusion, there are two major epidemic clones (genogroups 3 and 4) prevalent in Taiwan since 2004 either in water or clinical patients.