Hereditary Hemorrhagic Telangiectasia in a Patient Undergoing Hemodialysis with Anticoagulants and Antiplatelets: A Case Report.

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder that causes abnormal blood vessel formation and bleeding. We herein report a 61-year-old woman with aggravated HHT symptoms after hemodialysis initiation. She was diagnosed with HHT based on her recurrent bleeding, abnormal blood vessel formation, and family history. Despite bleeding complications, the patient required anticoagulants and antiplatelet agents to treat cardiovascular complications. Eventually, the patient died of extensive cerebral hemorrhaging. Our experience suggests that special attention should be paid to bleeding complications in high-risk patients.

Task-dependent engagements of the primary visual cortex during kinesthetic and visual motor imagery.

Motor imagery can be divided into kinesthetic and visual aspects. In the present study, we investigated excitability in the corticospinal tract and primary visual cortex (V1) during kinesthetic and visual motor imagery. To accomplish this, we measured motor evoked potentials (MEPs) and probability of phosphene occurrence during the two types of motor imageries of finger tapping. The MEPs and phosphenes were induced by transcranial magnetic stimulation to the primary motor cortex and V1, respectively. The amplitudes of MEPs and probability of phosphene occurrence during motor imagery were normalized based on the values obtained at rest. Corticospinal excitability increased during both kinesthetic and visual motor imagery, while excitability in V1 was increased only during visual motor imagery. These results imply that modulation of cortical excitability during kinesthetic and visual motor imagery is task dependent. The present finding aids in the understanding of the neural mechanisms underlying motor imagery and provides useful information for the use of motor imagery in rehabilitation or motor imagery training.

Covalent anthocyanin-flavonol complexes from the violet-blue flowers of Allium 'Blue Perfume'.

Three covalent anthocyanin-flavonol complexes (pigments 1-3) were extracted from the violet-blue flower of Allium 'Blue Perfume' with 5% acetic acid-MeOH solution, in which pigment 1 was the dominant pigment. These three pigments are based on delphinidin 3-glucoside as their deacylanthocyanin and were acylated with malonyl kaempferol 3-sophoroside-7-glucosiduronic acid or malonyl-kaempferol 3-p-coumaroyl-tetraglycoside-7-glucosiduronic acid in addition to acylation with acetic acid. By spectroscopic and chemical methods, the structures of these three pigments 1-3 were determined to be: pigment 1, (6(I)-O-(delphinidin 3-O-(3(I)-O-(acetyl)-ß-glucopyranoside(I))))(2(VI)-O-(kaempferol 3-O-(2(II)-O-(3(III)-O-(ß-glucopyranosyl(V))-ß-glucopyranosyl(III))-4(II)-O-(trans-p-coumaroyl)-6(II)-O-(ß-glucopyranosyl(IV))-ß-glucopyranoside(II))-7-O-(ß-glucosiduronic acid(VI)))) malonate; pigment 2, (6(I)-O-(delphinidin 3-O-(3(I)-O-(acetyl)-ß-glucopyranoside(I))))(2(VI)-O-(kaempferol 3-O-(2(II)-O-ß-glucopyranosyl(III))-ß-glucopyranoside(II))-7-O-(ß-glucosiduronic acid(VI)))); and pigment 3, (6(I)-O-(delphinidin 3-O-(3(I)-O-(acetyl)-ß-glucopyranoside(I))))(2(VI)-O-(kaempferol 3-O-(2(II)-O-(3(III)-O-(ß-glucopyranosyl(V))-ß-glucopyranosyl(III))-4(II)-O-(cis-p-coumaroyl)-6(II)-O-(ß-glucopyranosyl(IV))-ß-glucopyranoside(II))-7-O-(ß-glucosiduronic acid(VI)))) malonate. The structure of pigment 2 was analogous to that of a covalent anthocyanin-flavonol complex isolated from Allium schoenoprasum where delphinidin was observed in place of cyanidin. The three covalent anthocyanin-flavonol complexes (pigment 1-3) had a stable violet-blue color with three characteristic absorption maxima at 540, 547 and 618nm in pH 5-6 buffer solution. From circular dichroism measurement of pigment 1 in the pH 6.0 buffer solution, cotton effects were observed at 533 (+), 604 (-) and 638 (-) nm. Based on these results, these covalent anthocyanin-flavonol complexes were presumed to maintain a stable intramolecular association between delphinidin and kaempferol units closely related to that observed between anthocyanin and hydroxycinnamic acid residues in polyacylated anthocyanins. Additionally, an acylated kaempferol glycoside (pigment 4) was isolated from the same flower extract, and its structure was determined to be kaempferol 3-O-sophoroside-7-O-(3-O-(malonyl)-ß-glucopyranosiduronic acid).

A case of severe acalculous cholecystitis associated with sorafenib treatment for advanced hepatocellular carcinoma.

Sorafenib, a multikinase inhibitor, is the first and only drug, which improves significantly the overall survival in patients with advanced hepatocellular carcinoma (HCC). However, many patients experience diverse side effects, some of them severe and unexpected. To date, acute acalculous cholecystitis has not been documented in association with a HCC patient treated with sorafenib. Here, we report the case of a 43-year-old woman with hepatitis C virus-related advanced HCC. She received sorafenib, and later complained of a sudden onset of severe right hypocondrial pain with rebound tenderness and muscle defense. Laboratory examination showed mild elevation of transaminases, biliary enzymes, bilirubin, inflammation markers, and a marked peripheral eosinophilia. Abdominal computed tomography (CT) revealed a swollen gallbladder with exudate associated with severe inflammation without stones or debris. Consequently, sorafenib treatment was stopped immediately, and steroid-pulse therapy was performed. Steroid therapy drastically improved all clinical manifestations along with normalization of CT findings, eosinophilia, and liver functions. In summary, we herein report a rare case of acute severe acalculous cholecystitis associated with sorafenib in the patient with advanced HCC.

Interhemispheric difference for upright and inverted face perception in humans: an event-related potential study.

We recorded event-related potentials (ERPs) to investigate the interhemispheric difference of the N170 component for upright and inverted face perception in detail in fifteen healthy subjects. This is the first ERP study focusing on interhemispheric differences for face perception by showing faces in the hemifield. The face inversion effect, the prolonged latency and enhanced amplitude were found in both hemispheres. We found that the peak latency of the N170 following both upright and inverted face stimulation showed no significant difference between each hemisphere, though the N170 latency for the inverted face in the left hemisphere was shorter than that in the right hemisphere. The N170 recorded from the hemisphere ipsilateral to the stimulated hemifield showed unique findings. The interhemispheric time difference of the N170 between the right and the left hemispheres when the inverted face was presented in the left hemifield was significantly shorter than in the other three conditions. This unique finding may indicate that the conduction time from the right to the left for inverted face perception is faster than the other conditions, or that the left hemisphere specifically processed the inverted face very rapidly after receiving signals from the right hemisphere. If the N170 was generated by some, at least two, temporally overlapping activities, the different style of a summation of these activities may cause the unique findings found in this study. In conclusion, by presenting face stimuli in the hemifields, we could identify several new findings regarding the N170 component related to the face inversion effect.

Effects of face contour and features on early occipitotemporal activity when viewing eye movement.

We investigated whether early activity in the occipitotemporal region, corresponding to human MT/V5, is influenced by a face contour and/or features such as the mouth using magnetoencephalography (MEG). We used apparent motion as visual stimuli and compared four conditions as follows: (1) CDL: A schematic face consisting of a face Contour, two Dots and a horizontal Line (2) CD: The Contour and two Dots (3) DL: Two Dots and a horizontal Line and (4) D: Two Dots only. Subjects described a simple movement of dots for D, but eye movement for CDL, DL and CD, though movement modalities were the same through all conditions. We used a single equivalent current dipole (ECD) model within 145-220 ms after stimulus onset and estimated the location, dipole moment (strength) and peak latency. There were no significant differences in the peak latency of the estimated dipoles between each condition, but the activity was significantly stronger for CDL than for CD (p<0.05), DL (p<0.01), and D (p<0.01) in the right hemisphere, and DL and D (p<0.01) in the left. These results indicated that there is specific information processing for eye movements in the occipitotemporal region, the human MT/V5 homologue, and this activity was significantly influenced by whether movements appeared with the face contour and/or features, in other words, whether the eyes moved or not, even if the movement itself was the same.

Early gastric cancer and early colon cancer detected simultaneously by PET cancer screening incidentally.

We report a case of early gastric cancer and early colon cancer detected by positron emission tomography (PET) cancer screening. A 64-year-old male patient with an unremarkable past history except for hypertension and cerebrovascular disease underwent 18F-FDG PET for cancer screening. Images revealed increased uptake in the gastric antrum and sigmoid colon. Both areas appeared suspicious for neoplasm on subsequent fluoroscopy and endoscopy, and biopsies were positive for neoplasia at both sites. The gastric lesion was treated by distal gastrectomy and D2 lymphadenectomy and the colon cancer by endoscopic mucosal resection (EMR). Both surgical specimens were positive for cancer.

Over-expressed Bcl-2 cannot suppress apoptosis via the mitochondria in buprenorphine hydrochloride-treated NG108-15 cells.

We previously reported that the morphine alkaloid derivative buprenorphine hydrochloride (Bph) induces rapid apoptosis in NG108-15 nerve cells accompanied by the activation of caspase-3. Here, we found this kind of apoptosis was also accompanied by rapid loss of the mitochondrial membrane potential, followed by the efflux of cytochrome c from the mitochondria to the cytosol and the activation of caspases-9 and -3. Together, these results strongly suggested the Bph death signal was routed through the mitochondrial pathway in NG108-15 cells. In these cells, serum-starvation induces a different apoptosis, which we exploited to investigate Bcl-2's role as an apoptosis inhibitor. We made an NG108-15 transfectant, Bcl-2(P2), that stably expressed human Bcl-2, and used it to test Bcl-2's effect on the serum-starvation-induced apoptosis in NG108-15 cells. Cell viability, DNA-ladder formation, and efflux of cytochrome c from the mitochondria were all detected, showing that the human Bcl-2 functioned normally in the Bcl-2(P2) cells. Although the apoptotic events tested were identical in the parental cells and transformants, Bcl-2 expression completely failed to inhibit Bph-induced apoptosis in the Bcl-2(P2) cells.

Isolation and characterization of Bacillus sp. INT005 accumulating polyhydroxyalkanoate (PHA) from gas field soil.

A gram-positive bacterium (designated strain INT005) that accumulated polyhydroxyalkanoate (PHA) was isolated from gas field soil. From its morphological and physiological properties and the partial nucleotide sequence (about 500 bp) of its 16S rDNA, it was suggested that strain INT005 was similar to several species of the genus Bacillus. We confirmed that strain INT005 is a Bacillus sp. The PHA productivities of strain INT005 were higher than those of Bacillus megaterium and Ralstonia eutropha at 37-45 degrees C reported to date, and it was suggested that the PHA synthase of INT005 may exhibit moderate thermostability. The bacterium had the ability to produce poly(3-hydroxybutyrate), poly(3-hydroxybutyrate-co-3-hydroxyvalerate), poly(3-hydroxybutyrate-co-3-hydroxyhexanoate), poly(3-hydroxybutyrate-co-4-hydroxybutyrate-co-3-hydroxyhexanoate), and poly(3-hydroxybutyrate-co-6-hydroxyhexanoate-co-3-hydroxyhexanoate) from the appropriate carbon sources. The PHA synthase from INT005 showed similar substrate specificity to those of class I and III PHA synthases and strain INT005 produced PHAs with various monomer compositions. From the analysis of monomer composition and PHA accumulation in the presence of acrylic acid, it was suggested that de novo fatty acid synthesis and beta-oxidation are involved in the PHA synthesis of Bacillus sp. INT005. Since Bacillus sp. INT005 could synthesize PHA even at 45 degrees C and PHAs with various monomer compositions, and only one report on the cloning of the synthesis-related genes from a Bacillus species (B. megaterium) has been published;Bacillus sp. INT005 is thought to be very valuable source of PHA synthesis-related genes.

[Relationship between anxiety and physical traits of facial expressions].

The purpose of this study is to investigate correlations between anxiety and physical traits of facial expressions. In this study, subjects were divided into two groups on the basis of MAS (manifest anxiety scale), and were taken pictures under three different conditions. In Analysis I, we examined how facial expressions differ between high-anxiety and low-anxiety groups. The results showed that facial expressions differed between two groups especially in mouth, left half of the face, and asymmetry of the face. In Experiment I and II, we investigated whether human beings could identify one's anxiety trait and apparent anxiety in facial expressions only on the basis of its facial expressions. The results showed that one's anxiety trait and apparent anxiety could be detected through the mouth. From these results, human beings can recognize one's anxiety through its facial expressions.