Clinical manifestations of a sporadic maturity-onset diabetes of the young (MODY) 5 with a whole deletion of HNF1B based on 17q12 microdeletion.

We report a sporadic case of maturity-onset diabetes of the young type 5 (MODY5) with a whole-gene deletion of the hepatocyte nuclear factor-1beta (HNF1B) gene. A 44-year-old Japanese man who had been diagnosed with early-onset non-autoimmune diabetes mellitus at the age of 23 was examined. He showed multi-systemic symptoms, including a solitary congenital kidney, pancreatic hypoplasia, pancreatic exocrine dysfunction, elevation of the serum levels of liver enzymes, hypomagnesemia, and hyperuricemia. These clinical characteristics, in spite of the absence of a family history of diabetes, prompted us to make the diagnosis of maturity-onset diabetes of the young 5 (MODY 5). One allele deletion of the entire HNF1B gene revealed by multiplex ligation-dependent probe amplification (MLPA) led us to the diagnoses of 17q12 microdeletion syndrome even though there were negative chromosomal analyses with array comparative genomic hybridization (CGH). 17q12 microdeletion syndrome, which is not rare especially in sporadic cases since 17q12 is a typical hot spot for chromosomal deletion, could have complicated the clinical heterogeneity of MODY5.

Rituximab-induced Acute Thrombocytopenia in a Patient with Follicular Lymphoma: A Case Report and Review of the Literature.

Rituximab is a highly effective agent that is used in the treatment of B-cell lymphoma. Rituximab-induced acute thrombocytopenia is a rare side effect that has previously been reported in a small number of patients with malignant lymphoma; its mechanism is still unknown. We herein report the case of a 74-year old man who was diagnosed with follicular lymphoma and who developed severe acute thrombocytopenia the day after the administration of rituximab. Coagulation abnormality, which mimicked disseminated intravascular coagulation, also appeared. When physicians use rituximab to treat high-risk patients, the platelet count should be closely monitored to avoid possible adverse events.

A Lognormal Recurrent Network Model for Burst Generation during Hippocampal Sharp Waves.

The strength of cortical synapses distributes lognormally, with a long tail of strong synapses. Various properties of neuronal activity, such as the average firing rates of neurons, the rate and magnitude of spike bursts, the magnitude of population synchrony, and the correlations between presynaptic and postsynaptic spikes, also obey lognormal-like distributions reported in the rodent hippocampal CA1 and CA3 areas. Theoretical models have demonstrated how such a firing rate distribution emerges from neural network dynamics. However, how the other properties also display lognormal patterns remain unknown. Because these features are likely to originate from neural dynamics in CA3, we model a recurrent neural network with the weights of recurrent excitatory connections distributed lognormally to explore the underlying mechanisms and their functional implications. Using multi-timescale adaptive threshold neurons, we construct a low-frequency spontaneous firing state of bursty neurons. This state well replicates the observed statistical properties of population synchrony in hippocampal pyramidal cells. Our results show that the lognormal distribution of synaptic weights consistently accounts for the observed long-tailed features of hippocampal activity. Furthermore, our model demonstrates that bursts spread over the lognormal network much more effectively than single spikes, implying an advantage of spike bursts in information transfer. This efficiency in burst propagation is not found in neural network models with Gaussian-weighted recurrent excitatory synapses. Our model proposes a potential network mechanism to generate sharp waves in CA3 and associated ripples in CA1 because bursts occur in CA3 pyramidal neurons most frequently during sharp waves.