A case of localized amyloidosis in the mediastinum,CT, MRI,and 18F-FDG-PET/CT findings

Amyloidosis is a heterogeneous group of diseases characterized by the presence of extracellular deposition of amyloid. We present a case of localized amyloidosis of the middle mediastinum, that was diagnosed by trans-esophageal endoscopic ultrasound (EUS)-guided biopsy, focusing on imaging features of contrast-enhanced CT, MRI including dynamic contrast-enhanced study and DWI, and integrated fluorine-18 fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/CT.     

Action spectra for phytochrome A- and B-specific photoinduction of seed germination in Arabidopsis thaliana.

We have examined the seed germination in Arabidopsis thaliana of wild type (wt), and phytochrome A (PhyA)- and B (PhyB)-mutants in terms of incubation time and environmental light effects. Seed germination of the wt and PhyA-null mutant (phyA) was photoreversibly regulated by red and far-red lights of 10-1,000 micromol m-2 when incubated in darkness for 1-14 hr, but no germination occurred in PhyB-null mutant (phyB). When wt seeds and the phyB mutant seeds were incubated in darkness for 48 hr, they synthesized PhyA during dark incubation and germinated upon exposure to red light of 1-100 nmol m-2 and far-red light of 0.5-10 micromol m-2, whereas the phyA mutant showed no such response. The results indicate that the seed germination is regulated by PhyA and PhyB but not by other phytochromes, and the effects of PhyA and PhyB are separable in this assay. We determined action spectra separately for PhyA- and PhyB-specific induction of seed germination at Okazaki large spectrograph. Action spectra for the PhyA response show that monochromatic 300-780 nm lights of very low fluence induced the germination, and this induction was not photoreversible in the range examined. Action spectra for the PhyB response show that germination was photoreversibly regulated by alternate irradiations with light of 0.01-1 mmol m-2 at wavelengths of 540-690 nm and 695-780 nm. The present work clearly demonstrated that PhyA photoirreversibly triggers the germination upon irradiations with ultraviolet, visible and far-red light of very low fluence, while PhyB controls the photoreversible effects of low fluence.     

Detection of xenogeneic anti-idiotypic antibodies specific to murine monoclonal antibody 17-1A in patients with gastrointestinal cancer.

Murine monoclonal antibody (MoAb) 17-1A, which reacts with an adenocarcinoma-associated antigen, has recently been utilized in a phase I clinical trial for patients with gastrointestinal tract cancers in Japan. In order to analyze anti-idiotypic (Id) antibodies to murine MoAb 17-1A in the sera of these cancer patients, we established a simple and specific assay. In a modified sandwich assay, normal mouse sera were utilized for neutralization of rat antimouse immunoglobulin (Ig) antibodies and reduction of their nonspecific effects. When the modified sandwich assay was applied to the sera of patients who had been treated with MoAb 17-1A, anti-Id antibodies were induced in 53% of 13 cancer patients with gastrointestinal cancers at 3-4 weeks after infusion of MoAb.     

Head region of unconventional myosin I family members is responsible for the organ‐specificity of their roles in left–right polarity in Drosophila

In Drosophila, Myosin31DF (Myo31DF), encoding a Myosin ID protein, has crucial roles in left–right (LR) asymmetric development. Loss of Myo31DF function leads to laterality inversion for many organs, including the embryonic gut. Here, we found that Myo31DF was required before LR asymmetric morphogenesis in the hindgut, suggesting it functions in LR patterning instead of directly in hindgut morphological changes. Myosin61F (Myo61F) encodes another Myosin I, and Myo31DF or Myo61F overexpression reverses the laterality of different organs. Myo31DF and Myo61F have domains conserved in Myosin proteins, particularly in the proteins' head regions. We studied the roles of these domains in LR patterning using overexpression analysis. The Actin‐binding and ATP‐binding domains were essential for both proteins, but the IQ domains, binding sites for Myosin light chains, were required only by Myo31DF. Our results also suggest that the organ specificities of the Myo31DF and Myo61F activities depended on their head regions. Developmental Dynamics 237:3528–3537, 2008. © 2008 Wiley‐Liss, Inc.     

Effect of early enteral nutrition on critical care outcomes in patients with acute ischemic stroke

ObjectiveStroke-associated pneumonia (SAP) is a comorbidity of ischemic stroke related to clinical outcomes. Early enteral nutrition (EEN; within 48 hours) reduces the incidence of infection and length of intensive care unit (ICU)/hospital stay. The relationship between EEN and critical care outcomes, including SAP, in patients with ischemic stroke has been insufficiently studied.MethodsWe recruited 499 patients in this retrospective observational study. We evaluated SAP incidence within 14 days from admission. Patients were divided into an EEN group and a late EN group (LEN; start later than EEN). We compared groups regarding background and length of ICU/hospital stay.ResultsEN was started within 48 hours in 236 patients. SAP was diagnosed in 94 patients (18.8%), with most in the LEN group (28.1% vs. 8.5%). Median [interquartile range] lengths of hospitalization (22 [12–30] days vs. 35 [20–45] days) and ICU stay (4 [2–5] days vs. 6 [3–8] days) were longer in the LEN group. EEN reduced the incidence of SAP. By contrast, consciousness disturbance and worsening consciousness level increased the SAP incidence. Increased age and National Institutes of Health Stroke Scale score were associated with start of prolonged EN.ConclusionsWe found that EEN may reduce SAP risk.     

Induction of secondary metabolite production by fungal co-culture of Talaromyces pinophilus and Paraphaeosphaeria sp.

Fungal co-culture is a strategy to induce the production of secondary metabolites by activating cryptic genes. We discovered the production of a new compound, talarodone A (1), along with five known compounds 2–6 in co-culture of Talaromyces pinophilus and Paraphaeosphaeria sp. isolated from soil collected in Miyazaki Prefecture, Japan. Among them, the productions of penicidones C (2) and D (3) were enhanced 27- and sixfold, respectively, by the co-culture. The structure of 3 should be represented as a γ-pyridol form with the reported chemical shifts, but not as a γ-pyridone form, based on DFT calculation.     

A new manometry device for evaluating the sphincter of Oddi using a fiber-optic pressure sensor

Introduction: Although measuring the pressure of the sphincter of Oddi and the bile duct is considered to be an important examination, called Sphincter of Oddi manometry (SOM), some complications related to the SOM device remain unsolved.

Material and methods: To decrease adverse complications, we developed a 0.46?mm manometry and we performed some in vitro studies.

Results: We successfully developed a 0.46?mm SOM. The diameter is the thinnest size used in endoscopic examinations. The results of in vitro studies show the suitability as SOM.

Conclusion: This device will decrease the risks related to SOM examination. To confirm the safety and feasibility, further studies including in vivo studies will be needed.     

Estimating an EQ-5D population value set: the case of Japan

Quality adjustment weights for quality-adjusted life years (QALYs) are available with the EQ-5D Instrument, which are based on a survey that quantified the preferences of the British public. However, the extent to which this British value set is applicable to other, especially non-European, countries is yet unclear. The objectives of this study are (a) to compare the valuations obtained in Japan and Britain, and (b) to explore a local Japanese value set. A diminished study design is employed, where 17 hypothetical EQ-5D health states are evaluated as opposed to 42 in the British study. The official Japanese version of the instrument and the Time Trade-Off method are used to interview 543 members of the public. The results are: firstly, the evaluations obtained in Japan and those from Britain differ by 0.24 on average on a [-1, +1] scale, and mean absolute error (MAE) in predicting the Japanese preferences with the British value set is 0.23. Secondly, comparable regressions suggest that the two peoples have systematically different preference structures (p<0.001 for 8 of 12 coefficients; F-test). Thirdly, using alternative models, the predictions are improved so that the local Japanese value set achieves MAE in the order of 0.01.     

Effect of the active adult learning/patient oriented clerkship on affective reaction of students ∼ from the results of student survey

We have previously reported the efficacy of the Patient Oriented Clerkship (POC) in the clinical clerkship in Showa University Hospitals, by a trial with old four-year pharmacy program students. In the unique clerkship, each student has a patient in charge, and follows his/her clinical conditions throughout the rotation. The aim of the POC is that having the students learn spontaneously (Active Learning) and actively (Adult Learning) promoted by student's commitment and responsibility by communicating with patients and health professionals in a team. As the POC requires students both Active Learning and Adult Learning, we define the POC as Active Adult Learning (AAL). Having a patient in charge for each student gives them many opportunities to participate in the medical team and foster their problem solving skills. Our previous study eventually showed positive results of the POC in the one-month short clerkship in the four-year program. On the other hand, the effect of the unique hospital clerkship in the new six-year program is not known. We conducted a student survey to clarify the learning effect in the new six-year education system which was revised and 2.5 month clinical clerkship was scheduled according to the model core clerkship curriculum. This report is the first report to show a challenge of the AAL/POC clerkship in the new six-year pharmacy education program.