Mucoepidermoid carcinoma is the most common primary malignancy of the salivary gland. We and others showed that CRTC1-MAML2 gene fusion was associated with favorable clinicopathological tumor features. Recently, a novel gene fusion, CRTC3-MAML2, was reported as a rare gene alteration in a case of mucoepidermoid carcinoma. However, its frequency and clinicopathological significance remains unclear. In all, 101 cases of mucoepidermoid carcinoma and 89 cases of non-mucoepidermoid carcinoma of the salivary gland were analyzed, and RNA was extracted from formalin-fixed, paraffin-embedded specimens. In the CRTC family, there have been three genes, CRTC1, CRTC2, and CRTC3. We developed reverse transcriptionpolymerase chain reaction (RT-PCR) assays for CRTC1-MAML2, CRTC2-MAML2, and CRTC3-MAML2 fusions. Clinicopathological data of the patients were obtained from their clinical records. Of 101 cases of mucoepidermoid carcinoma, 34 (34%) and 6 (6%) were positive for CRTC1-MAML2 and CRTC3-MAML2 fusion transcripts. However, in the 89 cases of non-mucoepidermoid carcinoma, neither transcript was noted. In the former cases, CRTC1-MAML2 and CRTC3-MAML2 fusions were mutually exclusive. The other fusion, CRTC2-MAML2, was not detected. We confirmed that the clinicopathological features of CRTC1-MAML2-positive mucoepidermoid carcinomas indicated an indolent course. CRTC3-MAML2-positive mucoepidermoid carcinomas also had clinicopathologically favorable features; all cases showed a less advanced clinical stage, negative nodal metastasis, no high-grade tumor histology, and no recurrence or tumor-related death after surgical resection of the tumor. It is interesting to note that patients with CRTC3-MAML2-positive tumors (mean 36 years of age) were significantly younger that those with the CRTC1-MAML2 fusion (55 years) and those with fusionnegative tumors (58 years). In conclusion, CRTC3-MAML2 fusion, which is mutually exclusive with CRTC1-MAML2 fusion and specific to mucoepidermoid carcinoma, may be detected more frequently than previously expected. Mucoepidermoid carcinomas possessing CRTC3-MAML2 fusion may be associated with favorable clinicopathological features and patients may be younger than those with CRTC1-MAML2 fusion or those with no detectable gene fusion. Keywords: mucoepidermoid carcinoma; CRTC3-MAML2 fusion; clinicopathological study; prognosis Mucoepidermoid carcinoma, representing 5% of all salivary gland tumors and 20% of the malignant forms, is the most frequent primary malignancy of the salivary gland in both adults and children.

[1] A new process-based distributed model, the National Institute for Environmental Studies (NIES) integrated catchment-based ecohydrology (NICE) model, was developed. The model includes surface-unsaturated-saturated water processes and assimilates land-surface processes describing the variation in phenology with Moderate Resolution Imaging Spectroradiometer (MODIS) satellite data. The model was applied to the Kushiro River catchment (northern Japan, area of 2204.7 km 2 ) with a resolution of 500 m and 8 days averaged vegetation changes. Excellent agreement between simulated and measured values was obtained for soil temperature, soil moisture, groundwater level, and river flow discharge during the 6 month snow-free period, achieved by taking into account vegetation phenology, soil properties, and geological structure. The model explains water cycle change and drying phenomena in the Kushiro Mire associated with vegetation change caused by the increased sediment load due to river channelization and consequently the invasion of alder (Alnus japonica) into the mire.

Abstract:We simulated the effects of irrigation on groundwater flow dynamics in the North China Plain by coupling the NIES Integrated Catchment-based Ecohydrology (NICE) model with DSSAT-wheat and DSSAT-maize, two agricultural models. This combined model (NICE-AGR) was applied to the Hai River catchment and the lower reach of the Yellow River (530 km wide by 840 km long) at a resolution of 5 km. It reproduced excellently the soil moisture, evapotranspiration and crop production of summer maize and winter wheat, correctly estimating crop water use. So, the spatial distribution of crop water use was reasonably estimated at daily steps in the simulation area. In particular, NICE-AGR reproduced groundwater levels better than the use of statistical water use data. This indicates that NICE-AGR does not need detailed statistical data on water use, making it very powerful for evaluating and estimating the water dynamics of catchments with little statistical data on seasonal water use. Furthermore, the simulation reproduced the spatial distribution of groundwater level in 1987 and 1988 in the Hebei Plain, showing a major reduction of groundwater level due mainly to overpumping for irrigation.

Obturator hernia is a rare type of hernia, but it is a significant cause of intestinal obstruction due to the associated anatomy. Correct diagnosis and treatment of obturator hernia is important, be cause delay can lead to high mortality. Twelve patients with obturator hernia were managed during a 11-year period, including 11 women and 1 man with a mean age of 82 years. We compared our expe rience with the previously published data to establish standards for the diagnosis and treatment of this hernia. All 12 patients presented with intestinal obstruction. The median interval from admission to operation was 2 days. The Howship-Romberg sign was positive in 5 patients. A correct diagnosis was made in all 8 patients who underwent pelvic CT scanning. Surgery was performed via an abdominal approach (n=7) or an inguinal approach (n=5). The hernial orifice was closed using the uterine fundus (n=6), a patch (n=5), and direct suture (n=1). Mean follow-up time was 33 months, and no recurrence has been detected. The poor physical condition of patients might have led to a delay in di agnosis and treatment. In troubled patients with nonspecific intestinal obstruction, CT scanning is useful for the early diagnosis of obturator hernia. Correct CT diagnosis of obturator hernia allows us to select the inguinal approach combined with patch repair, which is minimally invasive surgery.