[Comparison of transabdominal ultrasound with quantitative power Doppler and colonoscopic findings for the evaluation of colonic inflammation in active ulcerative colitis].

BACKGROUND: Transabdominal ultrasound is a promising technique to evaluate inflammatory bowel disease. Several studies have demonstrated a relationship between ultrasound findings and colonic inflammation. However, the applicability of transabdominal ultrasound in patients with ulcerative colitis (UC) has not been elucidated. The aim of this study was to clarify the relationship between the transabdominal ultrasound findings and endoscopic activity in patients with UC. METHODS: Patients with active and underwent transabdominal ultrasound and colonoscopy were enrolled in this retrospective single-center analysis. Blood flow in the bowel wall was evaluated by power Doppler ultrasound. Both the thickness and stratification of the bowel wall were assessed by B-mode ultrasound imaging. The endpoints were the correlations between the ultrasound appearances (i.e., blood flow, thickness, and stratification of the bowel wall) and endoscopic activity (endoscopic Mayo Score). RESULTS: There were 34 lesions in 26 patients evaluated. Blood flow and thickness of the bowel wall were positively significantly correlated with the endoscopic Mayo Scores (r=0.43, p=0.011 and r=0.503, p=0.002, respectively). According to the bowel stratification, the endoscopic Mayo Scores were significantly higher in unclear and diminished bowel wall stratifications than in the clear bowel wall stratifications (p<0.001 and p<0.001, respectively). When focusing on the endoscopic Mayo Scores of three lesions, blood flow was lower in ulcer lesions with a diameter of ≥10mm than in those with a diameter of <10mm. CONCLUSION: All transabdominal ultrasound findings of bowel blood flow, wall thickness, and wall stratification reflected colonic inflammation.

Period-3 dominant phase synchronisation of Zelkova serrata: border-collision bifurcation observed in a plant population.

The population synchrony of tree seed production has attracted widespread attention in agriculture, forestry and ecosystem management. Oaks usually show synchronisation of irregular or intermittent sequences of acorn production, which is termed 'masting'. Tree crops such as citrus and pistachio show a clear two-year cycle (period-2) termed 'alternate bearing'. We identified period-3 dominant phase synchronisation in a population of Zelkova serrata. As 'period-3' is known to provide evidence to imply chaos in nonlinear science, the observed period-3 phase synchronisation of Zelkova serrata is an attractive real-world phenomenon that warrants investigation in terms of nonlinear dynamics. Using the Hilbert transform, we proposed a procedure to determine the fractions of periods underlying the survey data and distinguished the on-year (high yield year) and the off-year (low yield year) of the masting. We quantified the effects of pollen coupling, common environmental noise and individual variability on the phase synchronisation and demonstrated how the period-3 synchronisation emerges through a border-collision bifurcation process. In this paper, we propose a model that can describe diverse behaviours of seed production observed in many different tree species by changing its parameters.

Dispersal of allergenic pollen from Cryptomeria japonica and Chamaecyparis obtusa: characteristic annual fluctuation patterns caused by intermittent phase synchronisations.

Trees produce pollen during specific times of the year. Pollen can induce pollinosis, a type of allergic rhinitis, in humans. In Japan, allergenic pollen is mainly dispersed from February to May. Using data collected at 120 observation sites managed by the Japanese Ministry of the Environment, we studied the annual patterns of airborne allergenic pollen. The allergenic pollen showed an alternating ON-OFF cycle, but the length of the cycle differed among regions. We used an in-phase/out-of-phase analysis to quantify two characteristic features of the synchronisation. The degrees of phase synchronisation were strong in eastern and weak in western Japan. The pattern of allergenic pollen dispersal throughout Japan is typical intermittent synchronisation. This is the first study to evaluate allergenic pollen's distribution from a phase synchronisation viewpoint.

Changes in Treatment with Granulocyte and Monocyte Adsorptive Apheresis from the Past to Future in Patients with Inflammatory Bowel Disease.

BACKGROUND: Idiopathic acute-on-chronic inflammation in the gastrointestinal tract is an etiology of inflammatory bowel disease (IBD). Granulocyte and monocyte adsorptive apheresis (GMA) is a nonpharmacological treatment tool for patients with IBD. Here, we present a review of the positioning and possibilities of GMA for patients with IBD. SUMMARY: GMA decreases inflammatory cytokines and upregulates regulatory T cells. Intensive GMA is significantly more effective than weekly GMA in patients with IBD. The frequency of GMA sessions per week positively correlates with treatment effects. GMA can be safely used in pregnant women and children because of its low adverse event rates. Maintenance therapy and rescue therapy for loss of response of anti-tumor necrosis factor (TNF)-α antibodies are effective. Optimal patients who responded to combination therapy with infliximab and GMA showed aggravation characteristics against infliximab treatment at week 4. Key Message: Prospective randomized blinded studies using a sham column should be performed for the loss of response against anti-TNF-α antibodies.

Optimized Management of Ulcerative Proctitis: When and How to Use Mesalazine Suppository.

BACKGROUND: Ulcerative proctitis, one of the disease types of ulcerative colitis, is considered one of the initial manifestations of ulcerative colitis. Prevention of aggravation of ulcerative proctitis is important for improving the prognosis of ulcerative colitis. Here we reviewed the epidemiology, diagnosis, and management of ulcerative proctitis. SUMMARY: The number of patients with ulcerative proctitis is increasing. Disease extension occurs in many patients with ulcerative proctitis. Differential diagnosis from other chronic proctitis is important and should be performed based on the clinical history and endoscopical and histological features. Mesalazine suppository has been the first-line therapy for patients with ulcerative proctitis because of its high effectiveness and safety. Topical treatment of ulcerative proctitis, particularly using mesalazine suppository has been underused in clinical practice. Key Messages: Mesalazine suppositories are more effective than dose intensification of oral mesalazine for relapsed patients with maintenance dose of oral mesalazine. However, low adherence to rectal mesalazine has hindered remission in patients with ulcerative proctitis.

Investigation of effect of edaravone on ischemic stroke.

A novel free radical scavenger, edaravone, has been demonstrated to exert a neuroprotective effect and improve outcomes in acute ischemic stroke, but there have been few clinical studies. Therefore, we investigated retrospectively whether the administration of edaravone at the acute stage of ischemic stroke can improve outcomes of the disease at the time of discharge. Between January 1998 and December 2011, 625 consecutive patients (331 males and 294 females: mean age 77.0 years, range 36-101 years) with acute ischemic stroke who were admitted to our institution within 48 hours after stroke onset were enrolled. Subtypes of strokes were lacunar infarction (LI) in 188 (30.0%), atherothrombotic infarction (ATCI) in 268 (42.0%), and cardioembolic infarction (CEI) in 169 (27.0%). Of the 625 patients, 237 (37.0%) received both edaravone and conventional treatment, while the other 388 (62.0%) patients underwent conventional treatment only. As a conventional treatment, 422 (67.0%) of 625 patients were treated with ozagrel sodium, and 37 patients received argatroban. The overall outcomes at discharge were favorable (modified Rankin Scale score 0-2) in 296 (47.4%) and death occurred (mRS score 6) in 86 (13.8%). In a univariate analysis, the administration of edaravone did not have a significant effect on total death from all types of cerebral infarction. However, treatment with edaravone showed a favorable tendency (p=0.099) compared to conventional treatment after adjustments for age and gender. Further investigation is required before a definite conclusion can be made.

A comparative study of treatments for chronic subdural hematoma: burr hole drainage versus burr hole drainage with irrigation.

Although chronic subdural hematoma (CSDH) is one of the most common entities encountered in neurosurgical practice, optimal surgical treatment for CSDH remains controversial. This study retrospectively compared results for CSDH between burr hole drainage alone and burr hole drainage with irrigation. Ninety-two patients with CSDH underwent surgery at our institution from January 1998 through December 2009. Fifty-eight patients received burr hole drainage alone (Group A), while 34 patients were treated using burr hole drainage with irrigation (Group B). Outcomes, recurrence rates, and death rates for the two groups were analyzed. Age, sex ratio, consciousness level on admission, radiodensity of hematoma on computed tomography before surgery, and duration of hospitalization were nearly the same in both groups. No significant differences were seen in good outcomes or death rates between groups, but poor outcomes were significantly more frequent in Group A (p=0.009). The recurrence rate was higher in Group A compared to Group B (10.3% vs. 2.9%). The authors used logistic regression analysis to identify factors associated with the outcome of CSDH, and found that duration of hospital stay, anti-coagulant therapy, presence of dementia and burr hole drainage alone were significantly associated with poor outcome of CSDH. These results indicate that burr hole drainage with irrigation has a significantly stronger association with good outcomes compared to drainage alone, and could be a reliable and effective operative method for the treatment of CSDH with a lower recurrence rate.

The fabrication of Ni quantum cross devices with a 17 nm junction and their current-voltage characteristics.

Quantum cross (QC) devices which consist of two Ni thin films deposited on polyethylene naphthalate substrates with their edges crossing have been fabricated and their current-voltage characteristics have been investigated. The cross-sectional area between the two Ni electrodes, which was obtained without the use of electron-beam or optical lithography, can be as small as 17 nm x 17 nm. We have successfully obtained ohmic current-voltage characteristics, which show good agreement with calculation results within the framework of the modified Anderson model. The calculated results also predict a high switching ratio in excess of 100,000:1 for QC devices having the molecule sandwiched between the Ni electrodes. This indicates that QC devices having the molecule can be expected to have potential application in novel switching devices.

5-Aryl-imidazolin-2-ones as a scaffold for potent antioxidant and memory-improving activity.

A series of 5-phenyl-substituted-N-alkyl-imidazolin-2-ones with potent radical-scavenging activity and lipid peroxidation inhibitory activity was synthesized. Many of the compounds showed memory-improving effect in animal models independent of the inhibitory activity on lipid peroxidation.

Is antiplatelet therapy for the prevention of ischemic stroke associated with the prognosis of intracerebral hemorrhage?

To examine whether antiplatelet therapy contributes to the unfavorable prognosis of intracerebral hemorrhage, we enrolled 253 consecutive patients (120 men and 133 women; 72.9+/-11.7 years) hospitalized in our institution within 24 hrs after onset of intracerebral hemorrhage. The location and size of intracerebral hemorrhage were determined from computed tomography (CT). Hematoma enlargement was identified on the basis of a second computed tomography scan performed on the day after admission. An unfavorable prognosis was defined as an outcome of worsening or death using the modified Rankin Scale (mRS). Locations of intracerebral hemorrhage (ICH) determined from CT were the thalamus in 92 patients (36.3%), putamen in 79 (31.2%), subcortex in 35 (13.8%), cerebellum in 20 (7.9%), brainstem in 18 (7.1%), and caudate nucleus in 9 (3.5%). Sizes of ICH were small and moderate in 153 patients (60%) and large in 100 (40%). Seventeen patients (6.7%) received antiplatelet therapy for stroke prevention. Hematoma enlargement was identified in 39 patients (15.4%). Overall outcomes at the time of discharge were unfavorable (modified Rankin Scale score 5-6) in 64 patients (25.2%) and favorable mRS score (0-1 approximately 4) in 189 (74.8%). Univariate analysis demonstrated that age >or=75 years (odds ratio: 2.78; 95%CI: 1.54-5.04) and presence of a large hematoma (odds ratio: 19.28; 95%CI: 8.84-42.1) were significantly related to the unfavorable prognosis. Using multiple logistic regression analysis after adjustments for age and sex, the presence of a large hematoma was still judged unfavorable; however, antiplatelet therapy was not related to unfavorable prognosis. Antiplatelet therapy may be unrelated to the unfavorable prognosis of ICH.

Effect of E6060 [4-{5-[7-fluoro-4-(trifluoromethyl)benzo[b]furan-2-yl]-1H-2-pyrrolyl}benzoic acid], a novel subtype-selective retinoid, on lupus-like nephritis in female (NZBxNZW)F1 mice.

Disease amelioration by retinoids in various nephritic models has been reported from either immunological or pathophysiologic viewpoints. It has also been reported that retinoids exert immunosuppressive effects in a retinoic acid receptor (RAR)-alpha-dependent manner. In particular, synthetic retinoid agonists with selectivity to RAR-alpha have been reported to have a remarkable disease-ameliorating effect in some immune disease models via their potent immunosuppressive activities; however, there has been no report in which the effect of RAR-alpha-selective agonists in the nephritic models was examined. In this report, we investigated the effect of a newly synthesized RAR-alpha-selective retinoid agonist, E6060 [4-{5-[7-fluoro-4-(trifluoromethyl)benzo[b]furan-2-yl]-1H-2-pyrrolyl}benzoic acid], on the disease progression in a murine lupus nephritis model. Female (NZBxNZW)F1 mice were prophylactically treated with E6060 from 5 months of age, and their nephritic (proteinuria, blood urea nitrogen) and immunological parameters (serum anti-DNA autoantibodies and total serum immunoglobulins) were monitored with age up to 10 months old. E6060 at 0.03 and 0.1 mg/kg (once daily, p.o.) significantly improved survival rate and prevented the development of proteinuria in (NZBxNZW)F1 mice. Anti-DNA autoantibodies and total serum IgG were also significantly reduced in the E6060-treated mice. Among IgG isotypes, IgG2a was substantially reduced by E6060 treatment, indicating reduced T helper 1 responses in E6060-treated mice. In accordance with this possibility, elevation of serum interleukin-12 (p40) in old female (NZBxNZW)F1 mice was significantly inhibited by E6060 treatment. Our data suggest that the RAR-alpha-selective retinoid E6060 is a promising candidate of new remedy for lupus nephritis in systemic lupus erythematosus patients.

Surface activity and redox behavior of a non-ionic surfactant containing a phenothiazine group.

A novel non-ionic surfactant, alpha-(phenothiazinylhexyl)-omega-hydroxy-oligo(ethylene oxide) (PCPEG) containing phenothiazine as an electro-active group has been synthesized. Fundamental interfacial behavior of the surfactant at the air/water interface has been investigated by means of surface tensiometry to provide an insight into the relationship between the structure of the hydrophobic moiety and the surfactant properties. A comparison of diffusivity of PCPEG in the aqueous phase with that in the acetonitrile solution at high PCPEG concentrations shows that micellization has a pronounced effect on the redox behavior of PCPEG. The electrochemical responses for PCPEG aqueous solutions at the interface of a glassy carbon electrode are fairly dependent on the concentration of PCPEG. Above CMC, PCPEG molecules self-associate to form micellar aggregates and the formation and disruption of micelles can be reversibly controlled by change in the redox state of the phenothiazine group. The cyclic voltammetric responses for PCPEG aqueous solutions have been correlated with the dissolved states to explain the distinctive feature of the surfactant.

Linear hyperpigmentation with extensive epidermal apoptosis: a variant of linear lichen planus pigmentosus?

We report 3 female patients who rapidly developed pigmented patches in a linear arrangement. Histologically there was minimum epidermal basal cell damage and bandlike lymphocyte infiltration in the dermis, but focal massive apoptotic materials positively stained with antikeratin antibody were prominently seen in the papillary and subpapillary dermis. We considered these cases as a variant of linear lichen planus pigmentosus with unique histologic change of severe epidermal apoptosis. These histologic features may represent a severe apoptotic change in the end stage of lichenoid tissue reaction.

Massive cerebral infarctions in main cerebral arteries.

This study was designed to investigate the outcomes in patients with massive cerebral infarction, and to determine the risk factors associated with worse outcomes in the patients with massive cerebral infarction. Twenty-seven patients with acute massive cerebral infarction were hospitalized in our institution. These 10 men and 17 women had an average age of 77.8 years (range, 42 to 97 years). Some patients had multiple infarctions. Thirteen patients had infarctions of the middle cerebral artery, 12 patients had internal carotid artery infarctions, 6 patients had anterior cerebral artery infarctions, and 3 patients had vertebro-basilar artery infarctions. The causes of the main cerebral arterial infarctions were cardiac embolism in 22 patients, atherothrombosis in 4 patients, and unknown in one patient. Fifteen (55%) of the 27 patients died from transtentorial herniation caused by massive cerebral infarction or from general complications. Of the 12 patients (45%) who survived, 8 patients were moderately disabled, 1 patient was severely disabled, and 3 patients existed in a vegetative state. Worse outcomes were more frequent in younger patients with internal carotid artery infarctions related to cardiogenic embolism.

Amyloid deposition of systemic myeloma-associated amyloidosis excludes actinic elastotic material.

We report a 65-year-old Japanese man presenting with myeloma-associated systemic amyloidosis. A biopsy specimen taken from the purpuric papules on the periorbital area showed the presence of both amyloid and elastotic materials (actinic elastosis) in the upper dermis. Amyloid deposition and altered elastotic fibers were clearly bordered and never colocalized, and amyloid materials appeared to exclude elastotic materials. The mechanism of this phenomenon is discussed.

Coexistence of pseudoxanthoma elasticum-like papillary dermal elastolysis and linear focal dermal elastosis.

An 89-year-old Japanese woman had pseudoxanthoma elasticum-like papillary dermal elastolysis on the neck and linear focal elastosis on the flexor aspects of the legs and thighs. The lesions of both diseases had similar histologic patterns-loss of elastic fibers in the papillary dermis and accumulation of normal-appearing elastic fibers in the subpapillary or mid dermis. Immunohistochemical analysis showed elastin, and microfibril-associated proteins (fibrillin 1 and 2 and microfibril associated glycoprotein 1 and 4) were absent or decreased in the papillary dermis and present in the accumulated elastic fibers in both lesions. The association of 2 diseases on different areas of the same patient and histologic and immunohistologic similarities between the diseases suggest that, despite the clinical differences, both diseases are closely related.

A library construction of 2,5-disubstituted pyrrole compounds by using solid/solution-phase syntheses.

Using solid- and solution-phase synthesis, a library of 2,5-disubstituted pyrrole compounds was constructed. This is the first report that Stetter reaction was applied to the solid-phase synthesis for C-C bond formation. Some of 2,5-disubstituted pyrrole compounds showed the inhibitory activity of LPS-induced mouse B-lymphocyte proliferation.

A variant of acrokeratoelastoidosis in systemic scleroderma: report of 7 cases.

We describe acrokeratoelastoidosis-like lesions on the palms of the patients with systemic scleroderma. Histology showed a focal hyperkeratosis with or without epidermal concavity, regular acanthosis, and hyalinization of collagen fibers and, in some cases, fragmentation and diminution of elastic fibers in the deep dermis. A slight degree of fibrotic change of collagen in the uninvolved neighboring skin was found in one case. The lesions were found in 7 of 26 patients with systemic scleroderma who were analyzed here, and were not found in the unrelated connective tissue disorders (n = 32) and normal controls (n = 27). The cause of the unique skin lesions may be related to the altered connective tissue metabolism similar to that of systemic scleroderma.

Expression of 36-kDa microfibril-associated glycoprotein (MAGP-36) in human keratinocytes and its localization in skin.

Microfibril-associated glycoprotein-36 (MAGP-36) is a recently isolated elastin-binding protein and considered to be a member of microfibril-associated glycoproteins (MAGPs). We studied the expression of MAGP-36 in cultured normal human keratinocytes and its localization in the skin. MAGP-36 was found to be expressed in cultured human keratinocytes by Western blot and RT-PCR assays. The levels of MAGP-36 (polypeptide and mRNA) and the number of MAGP-36-producing keratinocytes were greatly increased during Ca(2+)-induced differentiation of keratinocytes. Immunohistochemical studies demonstrated that MAGP-36 colocalized with elastic fibers and formed candelabra like-fibers in the superficial dermis of normal skin. In the elderly skin of sun-exposed region, immunoreactivity of MAGP-36 in the superficial dermis disappeared. In the lesional skin of pseudoxanthoma elasticum which is an elastin-related disorder, immunoreactivity of MAGP-36 was found in the accumulation of disintegrated elastic fibers. The results show that MAGP-36 is a component of elastic fibers in the dermis and co-operates with elastin in normal and diseased conditions.

Advanced glycation end product-modified beta2-microglobulin is a component of amyloid fibrils of primary localized cutaneous nodular amyloidosis.

Primary localized cutaneous nodular amyloidosis is a rare form of cutaneous amyloidosis. Amyloid fibrils in primary localized cutaneous nodular amyloidosis have been reported to be originated from immunoglobulin light chains. Immunohistochemical studies on the lesional skins of four patients with primary localized cutaneous nodular amyloidosis demonstrated that amyloid deposits of all cases showed a positive reaction with the antibodies for beta2-microglobulin and advanced glycation end products as well as immunoglobulin light chain (kappa or lambda). No beta2-microglobulin and advanced glycation end product immunoreactivity was found in the amyloid deposits of other primary localized cutaneous amyloidosis (lichen amyloidosis and macular amyloidosis). Double immunofluorescence study of the lesional skin of primary localized cutaneous nodular amyloidosis showed that anti-kappa light chain, anti-beta2-microglobulin and anti-advanced glycation end product antibodies mostly reacted with the same area of amyloid deposit. Amyloid proteins were sequentially extracted with distilled water from one case of primary localized cutaneous nodular amyloidosis and recovered in the five water-soluble fractions (fractions I-V). Immunoblot assay of amyloid fibril proteins demonstrated that immunoreactive polypeptides with anti-kappa light chain antibody (29 kDa) and with anti-beta2-microglobulin antibody (12 kDa) were detected in fractions I-V, whereas immunoreactive polypeptide with anti-advanced glycation end product antibody (12 kDa) was detected exclusively in fractions III-V but not in fractions I and II. Two-dimensional polyacrylamide gel electrophoresis revealed that 12 kDa polypeptide in fractions I and II was electrophoretically identical with authentic beta2-microglobulin and that beta2-microglobulin in fractions III-V was advanced glycation end product-modified beta2-microglobulin with more acidic pI value. These results indicate that beta2-microglobulin is another major component of amyloid fibrils in primary localized cutaneous nodular amyloidosis and that beta2-microglobulin in primary localized cutaneous nodular amyloidosis is partly subjected to the modification of advanced glycation end product.