Brainstem cavernous hemangioma with improvement of Holmes tremor on excision.

An 8-year-old boy presenting with left-angle paralysis, tremor in upper and lower extremities, and diplopia was diagnosed with hemorrhage from a mesencephalic cavernous hemangioma. He underwent hemangiomectomy through the occipital transtentorial approach 4 weeks post-hemorrhage, after which Holmes tremor (HT) markedly reduced. A year later, hemangioma has not recurred; he is now independent in his daily activities. Early intervention in the subacute stage allows for the complete removal of brainstem cavernomas (BSCs), with minimal risk of complications or sequelae. Proper timing and surgical approach for BSCs can prevent re-bleeding and improve HT after an initial hemorrhage, without any lasting negative consequences.

Aneurysm appearing at the anastomosis site 11 years after superficial temporal artery-middle cerebral artery bypass surgery: moyamoya disease with a rapidly growing aneurysm. Illustrative case.

BACKGROUND: Superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery is performed to prevent ischemia and hemorrhage in patients with moyamoya disease. Only a few reports have described aneurysms appearing around the anastomosis site after bypass surgery, and the underlying mechanism remains unknown. OBSERVATIONS: The present case involved a 62-year-old woman who underwent STA-MCA bypass surgery for ischemic quasi-moyamoya disease at 46 years of age. Postoperatively, she underwent annual magnetic resonance imaging examinations. At 11 years after STA-MCA bypass surgery, a 3-mm aneurysm appeared at the anastomosis site. Four years later, headache developed and the aneurysm had grown to 5 mm. Craniotomy clipping was performed to prevent rupture. The patient was discharged home 2 weeks after surgery without any apparent complications. LESSONS: Long-term observation is crucial after direct bypass surgery for moyamoya disease. Measures to prevent rupture should be considered for cases involving aneurysm complications.

[A case of sarcomatoid intrahepatic cholangiocarcinoma that was difficult to diagnose].

A 70-year-old man presented to our hospital with fever and abdominal pain. A mass was found in the left lobe of his liver. Three months later, disseminated peritoneal nodules and ascites appeared. Liver biopsy and review laparoscopy did not lead to a diagnosis. Approximately five months later, a pathological autopsy was performed, and a final diagnosis of sarcomatoid intrahepatic cholangiocarcinoma was made. Differentiating sarcomatoid cholangiocarcinoma from sarcomatoid malignant peritoneal mesothelioma was difficult due to the similarity of clinical and pathological findings. Because the two diseases are treated differently, being able to differentiate them is a challenge in the future.

Formulation of resonant optical force based on the microscopic structure of chiral molecules.

Optical manipulation, exemplified by Ashkin's optical tweezers, is a promising technique in the fields of bioscience and chemistry, as it enables the non-destructive and non-contact selective transport or manipulation of small particles. To realize the separation of chiral molecules, several researchers have reported on the use of light and discussed feasibility of selection. Although the separation of micrometer-sized chiral molecules has been experimentally demonstrated, the separation of nanometer-sized chiral molecules, which are considerably smaller than the wavelength of light, remains challenging. Therefore, we formulated an optical force under electronic resonance to enhance the optical force and enable selective manipulation. In particular, we incorporated the microscopic structures of molecular dipoles into the nonlocal optical response theory. The analytical expression of optical force could clarify the mechanism of selection exertion of the resonant optical force on chiral molecules. Furthermore, we quantitatively evaluated the light intensity and light exposure time required to separate a single molecule in a solvent. The results can facilitate the design of future schemes for the selective optical manipulation of chiral molecules.

[A case of pustular psoriasis preceded by liver dysfunction].

The patient is a female in her thirties. The patient was diagnosed with pustular psoriasis during the treatment course for pneumonia with the appearance of small pustules of the skin and with an increase of serum total bilirubin level. Pustular psoriasis is a designated intractable disease with extremely low prevalence in which the skin of the whole body is flushed with high fever and many sterile pustules occur. This disease has been reported to be accompanied by liver dysfunction. Liver dysfunction appeared 1-2 weeks after the eruption appears in most cases, but this is the rare case in which the liver disorder precedes.

Granulocyte and Monocyte Adsorptive Apheresis for Ulcerative Colitis in a Patient with Low Bone Mineral Density Due to Fanconi-Bickel Syndrome.

Systemic steroid is required for the exacerbation of ulcerative colitis (UC), although its administration should be avoided in patients with a low bone mineral density (BMD) exacerbated by side effects of steroids. We herein report the successful induction of remission in an UC case with a low BMD due to Fanconi-Bickel syndrome-or glycogen storage disease type XI-using granulocyte and monocyte adsorptive apheresis (GMA). For a 43-year-old woman with a BMD of 50% the young adult mean, GMA was performed 2 times a week for a total of 10 times. GMA might be a steroid-free treatment option for UC patients with a low BMD.

Chemotherapy-induced neutropenia as a prognostic factor in patients with pancreatic cancer treated with gemcitabine plus nab-paclitaxel: a retrospective cohort study.

OBJECTIVES: Chemotherapy-induced neutropenia (CIN) is a common adverse event of chemotherapy. Several reports have suggested that CIN could be an important prognostic factor in chemotherapy of various cancers. However, whether CIN is a prognostic factor in unresectable pancreatic cancer (PC) treated with gemcitabine plus nab-paclitaxel (GnP) is unknown. The primary endpoint of this study was to compare overall survival (OS) between patients with severe CIN (grade ≥ 3) and those with absent/mild CIN (grade ≤ 2) in unresectable PC cases treated with GnP as first-line chemotherapy. METHODS: A retrospective, cohort study was conducted using data from a computerized database. A total of 290 patients with pathologically confirmed PC treated with GnP as first-line chemotherapy were analyzed (severe CIN: ≥ grade 3, n = 174; absent/mild CIN: ≤ grade 2, n = 116). RESULTS: The median OS was longer in the severe CIN group than in the absent/mild CIN group (19.2 months vs 11.3 months, respectively; P < 0.001). After adjustment, severe CIN was an independent predictive factor for OS (hazard ratio [HR], 0.53; 95% confidence interval [CI], 0.38-0.74; P < 0.001). After adjustment by time-varying covariates, severe CIN was still a significant prognostic factor for OS (HR, 0.79; 95% CI 0.69-0.91, P = 0.001). CONCLUSION: The present results show that severe CIN is an independent and useful prognostic factor in PC patients treated with GnP.

Immunoglobulin G4-related sclerosing cholangitis diagnosed by liver biopsy: a case report.

Patients with immunoglobulin (Ig) G4-related sclerosing cholangitis typically have a high serum IgG4 level. However, here we describe our experience of a patient with a normal serum IgG4 level for whom the cholangitis was diagnosed by liver biopsy. A 61-year-old male presented with elevated liver enzymes and a normal serum IgG4 level. The hilar, intrahepatic, and upper extrahepatic bile ducts were stenotic, with no evidence of a pancreatic lesion. We therefore performed a liver biopsy to differentiate between cholangiocarcinoma and primary sclerosing cholangitis. Pathological examination revealed lymphoplasmacytic infiltrates around the bile ducts with a storiform fibrosis. IgG4-positive plasma cells were also observed. These results fulfilled the Japanese diagnostic criteria for IgG4-related sclerosing cholangitis. When this condition is suspected, liver biopsy should be performed even when serum IgG4 levels are normal.

Analysis of Water State and Gelation of Methylcellulose Thermo-reversible Hydrogels by Thermal Analysis and NMR.

The gelation of aqueous methylcellulose (MC) solutions containing polyethylene glycol (PEG) was studied by the combination of differential scanning calorimetry (DSC) and Raman spectrometry. The gelation of MC hydrogels containing PEG occurred in two-steps. First, the gel network was formed by the hydrophobic interaction between MC and PEG at 310 - 313 K, and then, the gel network was formed between MC chains at 323 K. On the other hand, in the MC hydrogels containing PEG and NaCl, sodium ion assumed to be enclosed by PEG, forming a helix with the hydrophobic groups outward. The sodium ion in the gel was expected to be surrounded by the ether oxygen of PEG as crown ether.

Cell-sized spherical confinement induces the spontaneous formation of contractile actomyosin rings in vitro.

During cell division, many animal cells transform into a spherical shape and assemble a contractile ring composed of actin filaments and myosin motors at the equator to separate the cell body into two. Although actomyosin regulatory proteins are spatio-temporally controlled during cytokinesis, the direct contribution of cell shape and actomyosin activity to the contractile ring assembly remains unclear. Here, we demonstrated in vitro that actin polymerization inside cell-sized spherical droplets induced the spontaneous formation of single ring-shaped actin bundles in the presence of bundling factors. Despite a lack of spatial regulatory signals, the rings always assembled at the equator to minimize the elastic energy of the bundles. Myosin promoted ring formation by the dynamic remodelling of actin networks, and an increase in the effective concentration of myosin triggered ring contraction. These results will help us understand how animal cells coordinate cell shape and actomyosin activities to direct cytokinesis.

Acyl-chain remodeling of dioctanoyl-phosphatidylcholine in Saccharomyces cerevisiae mutant defective in de novo and salvage phosphatidylcholine synthesis.

A yeast strain, in which endogenous phosphatidylcholine (PC) synthesis is controllable, was constructed by the replacement of the promoter of PCT1, encoding CTP:phosphocholine cytidylyltransferase, with GAL1 promoter in a double deletion mutant of PEM1 and PEM2, encoding phosphatidylethanolamine methyltransferase and phospholipid methyltransferase, respectively. This mutant did not grow in the glucose-containing medium, but the addition of dioctanoyl-phosphatidylcholine (diC8PC) supported its growth. Analyses of the metabolism of (13)C-labeled diC8PC ((methyl-(13)C)3-diC8PC) in this strain using electrospray ionization tandem mass spectrometry revealed that it was converted to PC species containing acyl residues of 16 or 18 carbons at both sn-1 and sn-2 positions. In addition, both acyl residues of (methyl-(13)C)3-diC8PC were replaced with 16:1 acyl chains in the in vitro reaction using the yeast cell extract in the presence of palmitoleoyl-CoA. These results indicate that PC containing short acyl residues was remodeled to those with acyl chains of physiological length in yeast.

Incorporation and remodeling of extracellular phosphatidylcholine with short acyl residues in Saccharomyces cerevisiae.

The pem1/cho2 pem2/opi3 double mutant of Saccharomyces cerevisiae, which is auxotrophic for choline because of the deficiency in methylation activities of phosphatidylethanolamine, grew in the presence of 0.1 mM dioctanoyl-phosphatidylcholine (diC(8)PC). Analysis of the metabolism of methyl-(13)C-labeled diC(8)PC ((methyl-(13)C)(3)-diC(8)PC) by electrospray ionization tandem mass spectrometry (ESI-MS/MS) revealed that it was rapidly converted to (methyl-(13)C)(3)-PCs containing C16 or C18 acyl chains. (Methyl-(13)C)(3)-8:0-lyso-PC, (methyl-(13)C)(3)-8:0-16:0-PC and (methyl-(13)C)(3)-8:0-16:1-PC, which are the probable intermediate molecular species of acyl chain remodeling, appeared immediately after 5 min of pulse-labeling and decreased during the subsequent chase period. These results indicate that diC(8)PC was taken up by the pem1 pem2 double mutant and that the acyl chains of diC(8)PC were exchanged with longer yeast fatty acids. The temporary appearance of (methyl-(13)C)(3)-8:0-lyso-PC suggests that the remodeling reaction may consist of deacylation and reacylation by phospholipase activities and acyltransferase activities, respectively. The detailed analyses of the structures of (methyl-(13)C)(3)-8:0-16:0-PC and (methyl-(13)C)(3)-8:0-16:1-PC by MS/MS and MS(3) strongly suggest that most (methyl-(13)C)(3)-8:0-16:0-PCs have a C16:0 acyl chain at sn-1 position, whereas (methyl-(13)C)(3)-8:0-16:1-PCs have a C16:1 acyl chain at either sn-1 or sn-2 position in a similar frequency, implying that the initial C16:0 acyl chain substitution prefers the sn-1 position; however, the C16:1 acyl chain substitution starts at both sn-1 and sn-2 positions. The current study provides a pivotal insight into the acyl chain remodeling of phospholipids in yeast.

[Comparison of semitransparent colored labels with opaque colored labels for prevention of adverse drug administration].

BACKGROUND: We made a semitransparent color label to supplement a demerit of an opaque color label for prevention of adverse drug administration, and evaluated whether a semitransparent color label is superior to an opaque color label. METHODS: We prepared a total of 16 syringes (8 colors; two syriges of each color) in the opaque (NC) group and in the semitransparent (CL) group. Each ten subjects were asked to pick up the same drug label alternately in each group, and we measured the time and the number of syringes until the examinee can pick up the five correct syringes. We also examined the adhesiveness of the label to the syringe for six hours in each group. RESULTS: The time and syringe number until the examinee could pick up five correct syringes were 24.6+/-4.6 seconds and 16.2+/-2.7 in NC group (P= 0.0004) and 10.9+/-3.7 seconds and 6.5+/-1.7 in CL group, respectively (n-10, each, P <0.0001). In CL group the label adhered to the syringes tightly for six hours, whereas all the labels in NC group were detached (P<0.0001). CONCLUSIONS: The semitransparent color label is superior to the opaque color label in discrimination and adhesion.