Malakoplakia after renal transplantation in the current era of immunosuppressive therapy: case report and literature review

Malakoplakia is a rare chronic granulomatous disease of unknown cause. It is thought to be caused by an acquired bactericidal defect of macrophages. Malakoplakia is associated with chronic infections and immunosuppression. Although it occurs mainly in the urinary tract, it has already been reported in almost every organ system. The isolation of bacteria, especially Escherichia coli, is common in malakoplakia patients. Here, we present a case of primary cutaneous malakoplakia in a kidney transplant recipient who had been taking prednisone, tacrolimus, and mycophenolate. Culture of a lesion grew Burkholderia cepacia complex. Treatment with high doses of trimethoprim-sulfamethoxazole was successful. We also present a systematic review of the literature, identifying 4 previously reported cases of malakoplakia after renal transplantation under similar immunosuppressive therapy, most occurring in the urinary tract or perineum and following benign courses to cure. Data in the literature suggest that malakoplakia has become even rarer since changes were made in the immunosuppressive therapy employed after kidney transplantation.

Cyclopropane- and spirolimonoids and related compounds from Hortia oreadica

The dichloromethane extract from taproots of Hortia oreadica afforded six limonoids, these are 9,11-dehydro-12 alpha-acetoxyhortiolide A, hortiolide C, 11 alpha-acetoxy-15-deoxy-6-hydroxyhortiolide C, hortiolide D, hortiolide E, 12 beta-hydroxyhortiolide E, in addition to the known limonoid, guyanin. The dichloromethane extract from stems of H. oreadica also afforded two limonoids 9,11-dehydro12 alpha-hydroxyhortiolide A and 6-hydroxyhortiolide C. As a result of this study and literature data, Hortia has been shown to produce highly specialized limonoids that are similar to those from the Flindersia (Flindersioideae). The taxonomy of Hortia has been debatable, with most authors placing it in the Toddalioideae. Considering the complexity of the isolated limonoids, Hortia does not show any close affinity to the genera of Toddalioideae. That is, the limonoids appear to be of little value in resolving the taxonomic situation of Hortia. (C) 2012 Elsevier Ltd. All rights reserved.

A Simple Method to Evaluate, Correlate and Predict Boiling and Flash Points of Alkynes

Boiling points (T-B) of acyclic alkynes are predicted from their boiling point numbers (Y-BP) with the relationship T-B(K) = -16.802Y(BP)(2/3) + 337.377Y(BP)(1/3) - 437.883. In turn, Y-BP values are calculated from structure using the equation Y-BP = 1.726 + A(i) + 2.779C + 1.716M(3) + 1.564M + 4.204E(3) + 3.905E + 5.007P - 0.329D + 0.241G + 0.479V + 0.967T + 0.574S. Here A(i) depends on the substitution pattern of the alkyne and the remainder of the equation is the same as that reported earlier for alkanes. For a data set consisting of 76 acyclic alkynes, the correlation of predicted and literature T-B values had an average absolute deviation of 1.46 K, and the R-2 of the correlation was 0.999. In addition, the calculated Y-BP values can be used to predict the flash points of alkynes.

A simple method to evaluate, correlate and predict boiling and flash points of alkynes

Boiling points (T B) of acyclic alkynes are predicted from their boiling point numbers (Y BP) with the relationship T B(K) = -16.802Y BP2/3 + 337.377Y BP1/3 - 437.883. In turn, Y BP values are calculated from structure using the equation Y BP = 1.726 + Ai + 2.779C + 1.716M3 + 1.564M + 4.204E3 + 3.905E + 5.007P - 0.329D + 0.241G + 0.479V + 0.967T + 0.574S. Here Ai depends on the substitution pattern of the alkyne and the remainder of the equation is the same as that reported earlier for alkanes. For a data set consisting of 76 acyclic alkynes, the correlation of predicted and literature T B values had an average absolute deviation of 1.46 K, and the R² of the correlation was 0.999. In addition, the calculated Y BP values can be used to predict the flash points of alkynes.

Extra and intradural spinal Hemangioblastoma

Hemangioblastomas of the central nervous system (CNS) are low-grade highly vascularized tumors that may be sporadic or associated with Von Hippel-Lindau disease. Extradural hemangioblastomas are uncommon and those located extra and intradurally are even rarer. This study uses an illustrative case and literature review to discuss the difficulties to consider the correct diagnosis and to select the best surgical approach. A 57 years-old white male patient presented with myelopathy and right C5 radiculopathy. The images showed a lobulated, hourglass shaped, highly enhanced extra/intradural lesion that occupied the spinal canal and widened the C4-C5 right intervertebral foramen. Total resection of the intradural lesion was achieved through a posterior approach, but the extradural part could only be partially removed. Complete improvement was observed after four months of follow-up and the residual tumor has been followed up clinically and radiologically. Even though the preoperative impression was of a spinal schwannoma, the histopathological examination revealed grade I hemangioblastoma as per WHO. Despite their rarity, current complementary exams allow considering the diagnosis of hemangioblastoma preoperatively. That is essential to a better surgical planning in view of the particular surgical features of this lesion.

On the morphological differentiation between Libinia spinosa and L. ferreirae (Crustacea: Brachyura: Majoidea: Epialtidae)

Libinia spinosa H. Milne Edwards in Guérin, 1832 and L. ferreirae Brito Capello, 1871, inhabit very similar environments, and their geographic and bathymetric distributions overlap for about 3000 km along the southwestern Atlantic. Both species are commonly caught in the same haul and differentiating between them can often be difficult. Traditionally, morphological differentiation between L. spinosa and L. ferreirae has been based exclusively on the number of spines along the median, longitudinal line of the carapace and the development of a process at the anterolateral angle of the basal segment of the antenna. Because Libinia spinosa and L. ferreirae share similar numbers of median spines (7 and 6, respectively), and the number of median spines of the carapace and the process at the anterolateral angle of the basal antennal segment are variable, they are of little value in separating these species. It is shown herein that unequivocal identification can be easily achieved based on features of the male and female thoracic sternum, pereiopod dactyli, and infraorbital notch. A lectotype is designated for L. spinosa and its authorship and date are corrected. Libinia gibbosa A. Milne-Edwards, 1878, is demonstrated to be a junior synonym of L. ferreirae. The holotype of L. gibbosa is figured for the first time.