Case report of a young male, with recurrent pneumothorax, hemoptysis and intrapulmonary cavitary lesions

RATIONALE

Primary spontaneous pneumothorax (PSP) is a manifestation of Vascular Ehlers-Danlos syndrome (vEDS) caused by heterozygous mutations in the COL3A1 gene. vEDS is a rare inherited disorder with an prevalence of one in 150,000. It can causes PSP and severe fragility of connective tissues with arterial but it remains poorly defined on clinical grounds and diagnose. Through this report, we hoped to help clinicians further understand the characteristics of vEDS.

PATIENT CONCERNS

A 22-year-old man presented with recurrent pneumothorax, hemoptysis, and chest pain. Physical examination revealed remarkable hypermobility of the small joints and translucent skin with visible veins. Chest computed tomography (CT) showed pneumothorax and multiple pulmonary cavities.

INTERVENTION AND OUTCOME

Genomic deoxyribonucleic acid (DNA) was extracted from patients. Heterozygosity was observed in all 3 novel variants. The main variant is COL3A1, c.3256-43T > G(NM_000090.3), which represents a missense mutation in collagen type III alpha 1 that can lead to vEDS. The other 2 mutations were FLNB c.4814G > A(NM_001457.3) and TSC2 c.3145G > A (NM_000548.3). These variants were validated by Sanger sequencing of their parents. COL3A1was not detected in either of the parent strains. FLNB and TSC2 were detected in his mother.

DIAGNOSES

Vascular Ehlers-Danlos syndrome.

LESSONS

Both COL3A1 and TSC2 gene mutations can cause PSP; however, to the best of our knowledge, there are no reports on these 2 gene mutations in 1 patient at the same time.

Tracheobronchial schwannoma: a case report and literature review

Primary tracheobronchial schwannoma is extremely rare. A woman in her early 60 s was admitted to our department with a 2-month history of cough and expectoration. Chest computed tomography (CT) revealed a high-density nodule at the opening of the right main bronchus, accompanied by atelectasis in the middle and lower lobes. Flexible bronchoscopy revealed a tumor at the opening of the bronchus of the right middle lung lobe, which protruded into the main bronchus. A high-frequency electrosurgical snare, endobronchial cryosurgery, and argon plasma coagulation (APC) were used under rigid bronchoscopy. Histopathological examination diagnosed the tumor as schwannoma. The patient's symptoms resolved after the operation. Follow-up chest CT showed that the right main bronchus was unobstructed, and the bronchus of the lower lobe was open. Bronchoscopic interventional therapy is an alternative treatment for tracheobronchial schwannoma.

Cold atmospheric plasma treatment improves the γ-aminobutyric acid content of buckwheat seeds providing a new anti-hypertensive functional ingredient

Buckwheat (BW) is rich in γ-aminobutyric acid (GABA), which has great potential as a functional anti-hypertensive food ingredient. This study utilized cold atmospheric plasma (CAP) to promote GABA accumulation in BW during germination. The effect of this approach on GABA enrichment and anti-hypertensive activity of BW along with its processing properties were investigated. The results indicated that CAP stress treatment (50 W for 40 s) of BW seeds followed by germination at 30 °C for 60 h resulted in a GABA content of 2.22 ± 0.06 mg/g, which was a 2.64-fold greater than that of pristine BW. Cracking of the seed coat, faster germination, and the activation of glutamate decarboxylase might be responsible for the GABA enrichment. Compared with pristine BW, the GABA-enriched BW powder showed a greater inhibitory effect on the angiotensin-converting enzyme, an increased degree of pre-gelatinization and elasticity when it was formed into a dough.

Genome-Wide analysis of aluminum-activated malate transporter family genes in six rosaceae species, and expression analysis and functional characterization on malate accumulation in Chinese white pear

Aluminum-activated malate transporters (ALMTs) exhibit a variety of physiological roles in plants to regulate fruit quality, but the evolutionary history of the ALMT family in the Rosaceae species remains unknown. In this study, a total of 113 ALMT homologous genes were identified from six Rosaceae species (Pyrus bretschneideri, Malus × domestica, Prunus persica, Fragaria vesca, Prunus mume, and Pyrus communis), and 27 of these sequences came from Chinese white pear, designated PbrALMT. Based on the phylogenetic analysis, we divided these ALMT genes into three main clusters (A-C). Conserved domain analysis indicated that all PbrALMT proteins contained the ALMT domain and the FUSC_2 domain, and fewer proteins included the FUSC domain. The results of subcellular localization experiments showed that parts of PbrALMT proteins containing the FUSC domain were located in the membrane. Collinearity analysis revealed that segmental and dispersed duplications were the primary forces underlying ALMT gene family expansion in the Rosaceae. Calculation of Ka/Ks between the paralogous pairs indicated that all of the genes in the PbrALMT family have evolved under negative selection. Combining the changes of malate content and transcriptome data analysis, five genes belonging to Cluster B were chosen for qRT-PCR, and the results revealed that Pbr020270.1, as a candidate gene, may play important roles in malate accumulation during pear fruit development. Further transgenic assay confirmed the above conclusion. The present study provides a foundation to better understand the molecular evolution of ALMT genes in pear and the functional characterization of these genes in the future.