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Eitan Israeli
the sarcoplasmic reticulum, are larger in SMCs from a mouse
“Inaction saps the vigor of the mind”
that clusters of ryanodine receptors, which release Ca 2+ from
PERFECTOR
and co-authors used superresolution microscopy to show
determines ICC outgrowth from oncogenically transformed
causes damage to both skeletal and cardiac muscle. pritchard
necroptosis-associated hepatic cytokine microenvironment
muscle cells (SMCs). A lack of dystrophin during disease
dystrophin. Dystrophin is also expressed in vascular smooth
in mosaic mouse models of liver tumorigenesis. Although a
caused by mutations in the gene that encodes the protein
microenvironment epigenetically shapes lineage commitment
unknown. Seehawer and colleagues showed that the hepatic
Duchenne muscular dystrophy (DMD) is a hereditary disease
commit transformed hepatic cells toward HCC or ICC are largely
Impaired constriction in Duchenne muscular dystrophy
However, the regulatory molecules and tissue context that
their morphology, metastatic potential, and responses to therapy.
cholangiocarcinoma (ICC), which differ markedly with regards to
comprises hepatocellular carcinoma (HCC) and intrahepatic
Primary liver cancer represents a major health problem. It
Eitan Israeli
by affecting the splicing of some transcripts and delaying
necroptosis microenvironment directs lineage commitment in liver cancer
active genes. This process down-regulates gene expression
through the transcription termination site of almost all
of transcription. After IAV infection, RNA polymerase II runs
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that influenza A virus (IAV) infection led to global deregulation
subvert stress responses for its own gain. zhao et al. found
Studying two independent populations of pregnant black
host’s advantage to curb infection; however, the virus can also
to confer a high risk of kidney disease in black Americans.
Viral infection leads to cellular stress, which can act to the
apolipoprotein L1 (APOL1), which was previously shown
Stressed out by influenza virus
and colleagues investigated a variant of the gene encoding
African ancestry, most likely because of genetic factors. Reidy
The disorder is more prevalent and severe in women with
often presents as an increase in maternal blood pressure.
Preeclampsia is a serious complication of pregnancy that
gene for preeclampsia
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In our patient, we opted for a cautious
showed that the same set of oncogenic factors transforms both
through the same mechanism has been unclear. park et al.
Whether distinct cancer types accomplish this “reprogramming”
cancer called small cell neuroendocrine carcinoma (SCNC).
by undergoing phenotypic conversion to a highly aggressive
in a number of different ways. Several cancer types do so
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#131118-COHANIM - 131118-COHANIM | 2 - A | 18-11-13 | 11:24:13 | SR:-- | Black
Epithelial cancers develop resistance to targeted therapies
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Some (re)programming notes on cancer
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mediastinoscopy. J Thorac Oncol 2008; 3 (6): 577-82.
adenopathy-real-time endobronchial ultrasound guided needle aspiration versus
18. Ernst A, Anantham D, Eberhardt R, Krasnik M, Herth FJ. Diagnosis of mediastinal
diagnostic difficulties. Am J Clin Pathol 2008; 130 (3): 434-43.
Minnesota experience, with emphasis on usefulness, adequacy assessment, and
ultrasound-guided transbronchial fine-needle aspiration: the University of
17. Alsharif M, Andrade RS, Groth SS, Stelow EB, Pambuccian SE. Endobronchial
mediastinal lymph nodes. Acta Gastroenterol Belg 2008; 71 (2): 219-29.
FNA and FDG-PET are complementary procedures in the diagnosis of enlarged
16. Bataille L, Lonneux M, Weynand B, Schoonbroodt D, Collard P, Deprez PH. EUS-
#
Case CommuniCations Case CommuniCations Nat Struct Mol Biol 2018; 25: 885 Proc Natl Acad Sci USA 2018; 115: E9745 J Clin Endocrinol Metab 2017; 102: 3775-82. to thyroid hormone and its clinical implications. Weiss RE, Refetoff S. Prenatal diagnosis of resistance 102: 3234-40. humans and mice. J Clin Endocrinol Metab 2017; causes central resistance to thyroid hormone in adult exposure to high maternal thyroid hormone levels Thyroid 2014; 24: 1656-61.
Moreover, the serial scans demonstrated The mortality rate for invasive aspergillosis endured. They were forced to move forward. Many busied them- viduals who were divided into four categories: participants
the appearance of new hepatic and splenic COMMEnT is even higher than for invasive candidiasis. selves with work and family responsibilities, trying to make their diagnosed with both OCD and hoarding, OCD only, hording
hypermetabolic lesions, some of which In the past few decades, there has been a Therefore, such infections must be diag- lives have meaning out of a sense of obligation to those who only, and a control group without pathological diagnoses of
were not apparent on the corresponding considerable increase in both the frequency nosed as early as possible and appropriate did not survive [3]. Consequently, there is rationale to connect any of the three disorders. Individuals with hoarding reported
CT images [Figure 1B, Figure 1C]. The and importance of IFIs. This increase is treatment should be initiated immediately. PTSD and hoarding in Jewish Holocaust survivors. The pur- significantly higher numbers of stressful and harmful events
results of the scans provided evidence for directly related to the growing population of Diagnosis of disseminated fungal infection pose of our research was to evaluate the potential associations of early in life prior to diagnosis compared to the groups without
the progression of the disease indicating immunocompromised individuals, resulting can be only established via biopsy since CT, PTSD and hoarding among Jewish Holocaust survivors. hoarding. Furthermore, controlling for age, gender, education
that the antifungal therapy was unsatisfac- from advances in medical practice such as ultrasonography, and magnetic resonance level, depression, and OCD symptoms did not impact results.
tory; therefore, the antifungal therapy was the use of intensive chemotherapy, immu- imaging (MRI) yield non-specific results. Neziroglu and colleagues [7] compared distress reactions
switched and enhanced with the addition nosuppressive drugs, and growing stem In recent years, the use of FDG PET/CT PATIENTS AND METHODS and behavioral dysfunction activities via responses to a ques-
of voriconazole. However, the results of cell transplantation possibilities. Human in inflammatory and infectious diseases is A systematic search of the literature was conducted from tionnaire among 148 participants, who were divided into three
the follow-up FDG PET/CT scans clearly immunodeficiency virus and other diseases rapidly increasing and is already the gold 1 March 2017 to 15 July 2018, using PubMed, Google Scholar, research groups: participants with OCD without hoarding, par-
showed that the hypermetabolic lesions that cause immunosuppression have also standard for some indications. However, NCBI, Psych Info, and EBSCO Host search engines. The follow- ticipants with hoarding only, and participants with OCD and
still persisted, thus indicating that the contributed to this problem. In the clinical the application of FDG PET/CT in fungal ing search terms were used: hoarding, hoarding disorder, obses- hoarding. Researchers observed that hoarders demonstrated
chronic Aspergillus infection was not well- practice, IFI mostly affects patients with infection has not yet been well defined in sive compulsive disorder, OCD, compulsive hoarding, Jewish behavioral difficulties rather than emotional stress or depres-
controlled yet and necessitated long-term hematologic malignancies, such as leukemia the literature or by the guidelines [2]. The Holocaust survivors, Shoa, post-traumatic stress disorder, and sion. Gordon and co-authors [8] evaluated beliefs associated
antifungal treatment. Although repeated or lymphoma. Fungal infections in such indications are rapidly evolving and these PTSD. Inclusion criteria were peer-reviewed research of adults with possessions among individuals with OCD and hoarding
bone marrow biopsies revealed hemato- patients continue to have a high mortality guidelines cannot be seen as definitive. published after 1990 and written in the English language. compared to participants who hoard without an OCD diagno-
logical remission, stem cell transplantation rate [1]. Despite recent improvement, the In our case, CT helped in the initial Exclusion criteria included pediatric research, case-studies, sis. Consistent with the previously cited articles, Gordon’s team
was postponed due to the persistent IFI, therapy for treating IFIs is still disappoint- identification of some of the lesions. and articles published before 1990. Due to the scant literature found those with OCD and hoarding experienced significantly
which markedly increases the patient’s risk ing, with high failure rates in both invasive However, it lacked both sensitivity and linking hoarding, PTSD, and Jewish Holocaust survivors, refer- greater personal distress and emotional harm than did those
for failure in this condition. candidiasis and invasive aspergillosis [1]. specificity. Metabolic changes precede ana- ences mentioned in the retained papers were manually searched with hoarding but without OCD.
for additional published work. Those papers deemed most Focusing on traumatic events related to hoarding, Przeworski
Figure 1. 18 F-fluorodeoxyglucose A B relevant to potential connections were retained for this article. et al. [9] examined and compared the number and type of trau-
positron-emission tomography/ In addition, the number of scientific publications in a specific matic events among individuals with OCD symptoms, hoarding
computed tomography ( 18F-FDG year (1990–2018), using the keywords Holocaust and hoarding symptoms, or both. They found those diagnosed with hoarding
PET/CT) images. [A] Whole body as well as the combination of both terms, were conducted. All experienced significantly greater traumatic events prior to diag-
maximum intensity projection data were derived from the PubMed database.
image shows multifocal lesions in
the liver and spleen with intensely figure 1. Number of scientific publications on hoarding and Holocaust survivors: 1990–2018
increased FDG uptake. In addition,
numerous hypermetabolic lesions RESULTS 110
were seen in the muscles of Seven research articles combining PTSD and hoarding were 100 Holocaust
the lower extremities (arrows). identified according to our research criteria. However, when Hoarding
[B] Serial follow-up scans 90 Holocaust and hoarding
(chronologically performed from the search was modified to link together Jewish Holocaust
left to right) revealed that the Survivors, PTSD, and hoarding, no published papers were 80
uptake of the lesions in the liver found. Results of the number of scientific publications from 70
and spleen increased despite 1990 to 2018 are presented in Figure 1.
enhancement of antifungal therapy C 60
with appearance of multiple new Publication count
hypermetabolic lesions, many DISCUSSION 50
of them were unrecognized on
CT components of the study, pTSD AnD HOARDIng 40
indicating progression of the Over the last decade, several researchers have demonstrated 30
disease and unsuccessful therapy. links between traumatic events and hoarding behavior, suggest-
[C] Serial axial fusion PET/CT scans ing that the former may cause the latter. Tolin and colleagues 20
(chronologically from left to right) [5] conducted an online survey of 751 participants with self-
showed the appearance of new D E 10
lesions. [D] Left kidney involvement reported hoarding symptoms. The goal of their research was to 0
is demonstrated (arrow). investigate the severity of hoarding symptoms and relate onset 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
[E] One of the intramuscular of those symptoms to traumatic events. The survey clearly dem-
lesions is demonstrated in the left onstrated traumatic events experienced early in life can cause Years
leg (arrow). Many of the lesions hoarding later in life. Furthermore, the more intense the trauma,
were initially unapparent on the CT The following databases were searched: PubMed, Google Scholar, NCBI, Psych Info, and EBSCO Host
component of the study the more severe the hoarding behaviors. Landau and co-authors Search terms used: hoarding, hoarding disorder, obsessive compulsive disorder, OCD, compulsive
hoarding, Jewish Holocaust survivors, Shoa, post-traumatic stress disorder, and PTSD
[6] made similar observations in personal interviews of indi-
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