Fructobacillus fructosus OS-1010 strain stimulates intestinal cells to secrete exosomes that activate muscle cells.

Fructobacillus is a lactic-acid bacterium recently identified in fructose-rich environments. Fructobacillus is also known to exhibit unusual growth characteristics due to an incomplete gene encoding alcohol/acetaldehyde hydrogenase, which results in an imbalance in the nicotinamide adenine mononucleotide (NAD+)/NADN levels. Recently, the addition of d-fructose to the culture medium of Fructobacillus strains increased the intracellular nicotinamide mononucleotide (NMN) content. In the present study, we evaluated the functionality of Fructobacillus that produces high levels of NMN, using one substrain (Fructobacillus fructosus OS-1010). Therefore, in this study, we examined its functionality in the interaction between intestinal cells and muscle cells. The results showed that supernatant derived from intestinal epithelial cells (Caco-2 cells) treated with F. fructosus OS-1010 activated muscle cells (C2C12 cells). Further analysis revealed that Caco-2 cells treated with F. fructosus OS-1010 secreted exosomes known as extracellular vesicles, which activated the muscle cells. Furthermore, pathway analysis of the target genes of miRNA in exosomes revealed that pathways involved in muscle cell activation, including insulin signaling and cardiac muscle regulation, neurotrophic factors, longevity, and anti-aging, can be activated by exosomes. In other words, F. fructosus OS-1010 could activate various cells such as the skin and muscle cells, by secreting functional exosomes from the intestinal tract.

A case of repeated Kounis syndrome after anaphylactic shock: A note for disease management.

Background: Kounis syndrome (KS) is an underdiagnosed disease. The management of the disease remains elusive because of its infrequency. Case Presentation: A 78-year-old man with anaphylactic shock was admitted to our hospital 2 h after multiple bee stings. After recovering from an anaphylactic reaction, he presented with chest pain with ST elevation. We diagnosed him with KS. After a continuous intravenous infusion of vasodilators, his chest pain and ST elevation improved. However, chest pain with ST-segment elevation recurred the next day. Coronary angiography revealed severe stenosis in the middle left anterior descending coronary artery, and drug-eluting stents were implanted. The patient was discharged on foot after treatment for heart failure. Conclusion: KS, in which anaphylaxis and acute coronary syndrome occur simultaneously, can recur repeatedly after an initial anaphylactic reaction; however, it could be delayed or it could present simultaneously with the anaphylactic reaction. Therefore, long-term observation is important.

Uncommon etiology of Cullen's sign and Grey Turner sign.

This case report describes a patient with acute appendicitis presenting with Cullen's sign and Grey Turner sign. This case highlights the importance of the recognition of Cullen's sign and Grey Turner sign in patients with acute appendicitis to prevent life-threatening complications such as perforation and sepsis.

Urinary Actinomyces infection with a urachal remnant.

Urinary Gram staining is helpful in patients with complicated urinary retention, such as prolonged urinary retention and coexisting ureteral retention disease. If gram-positive rods are observed on urine Gram staining in a patient with urinary tract infection, an anaerobic culture of the urine may be helpful for early diagnosis and treatment of Actinomyces infection.