Three infantile cases of temporal lobe epilepsy presenting as apnea

We describe three cases of temporal lobe epilepsy in infancy presenting as repeated apneic attacks. In all cases, ictal electroencephalogram (EEG) showed unilateral focal high-voltage slow waves over the temporal or frontal areas. In two of the three cases, the epilepsy was due to mesial temporal tumors, and the apneic attacks disappeared following the removal of the tumor. Pathological examination identified ganglioglioma in both cases. In the remaining case, no focal lesions were found despite ictal EEG evidence of focal temporal abnormalities. Although intractable to several anti-convulsants, the addition of acetazolamide was dramatically effective in ceasing the apneic attacks. When assessing infants with apneic attacks, although causes such as obstructive apnea and gastroesophageal reflux need to be excluded, a diagnosis of epilepsy also needs to be considered as an important cause of apparent life-threatening events (ALTE). We would recommend EEG with video monitoring during apneic attacks in such cases.     

MR imaging of benign and malignant pleural disease

MR imaging serves as a problem-solving tool in the diagnosis of inflammatory and infectious pleural diseases and primary and secondary pleural malignancies. Knowledge of MR imaging appearance of pleural diseases, including pleural effusions and empyema, benign and malignant pleural tumors, and especially mesothelioma, helps guide treatment decisions and surgical planning.     

Diversity of the bacterial community found in samma-narezushi (saury narezushi) revealed by the 16S rRNA gene clone library

Narezushi is one of Japanese traditional foods and is made by fermenting salted fish meat and cooked rice together. In this study, the microbial diversity of samma-narezushi (narezushi using saury, Cobolabis saira) was analyzed by the 16S ribosomal RNA gene (rDNA) clone library. Randomly selected 89 clones were sequenced and phylogenetically analyzed. The sequences were classified into 12 operational taxonomy units (OTUs) at the 97% identity threshold. Most of the clones (89%) were lactic acid bacteria (LAB) and included Lactobacillus sakei, Leuconostoc gelidum, Lactococcus lactis subsp. lactis and L. pisium. The most predominant clone was L. sakei at 72% of the clones. The second most abundant clone was L. gelidum. These results suggest that L. sakei mainly contributes to the lactic acid fermentation process, taste and flavor of samma-narezushi. The present study showed that the culture independent method is useful for the microbial diversity analysis of narezushi.     

Construction of a consortium comprising ammonia-oxidizing bacteria and denitrifying bacteria isolated from marine sediment

A unique consortium of ammonia-oxidizing bacteria (AOB) and denitrifying bacteria was obtained via a long-term, 3-step cultivation of isolates from organically-enriched marine sediment. We developed this microbial consortium for possible applications in the remediation of degraded habitats in closed aquaculture or other aquatic environments via microbial degradation. Analysis of media components found definitive evidence of nitrogen removal via the coupling of ammonia-oxidation and denitrification. The phylogenetic diversity of the consortium was investigated by performing polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) that targeted the 16S rRNA gene, and the functional genes involved in ammonia-oxidation (amoA) and denitrification (nirS, nirK, norB and nosZ). Consequently, no significant divergence was observed, and thus it is suggested microbial populations were selected via a long-term, 3-step incubation process. All of the 16S rRNA clones fell into three phylogenetic groups, namely, gamma-proteobacteria, Actinobacteria and Flavobacteria. For almost half of the clones, the closest relatives in the database were identified as Alcanivorax spp. and these clones were present at all cultivation stages. The presence of these species as the dominant clones is significant since these bacterial species are known to reduce nitrate to nitrite. Accordingly, their abundance in our microbial consortium may have been responsible for the observed stepwise denitrification. All sequences of the amoA gene were identified to be Nitrosomonas lineage. Half of the nirS clones were identified to be from one major group of well-known denitrifying bacteria, Pseudomonas sp. Furthermore, 70% of the nirK clones were closely related to the nirK sequences of uncultured bacterial clones isolated from arable soil. The qnorB clones consisted of clusters exclusively, and formed a distinct cluster from the novel sequences of cultivated species. The nosZ clones also were not found in any of the closest relatives in the database including the uncultured bacterium from marine sediment. The unique clones obtained from the functional genes were related to each denitrification step.     

Subcutaneous gluteal metastasis from gastric cancer: case report and clinicopathologic analysis of 50 Japanese patients

Skin metastasis from gastric cancer is rare. We report a case of gluteal skin metastasis from gastric cancer. A 74-year-old woman underwent curative gastrectomy for advanced gastric cancer. Thirty-six months after surgery, follow-up abdominal computed tomography showed a subcutaneous gluteal tumor, and surgical extirpation was performed. Histopathologic examination of the resected tumor revealed poorly differentiated adenocarcinoma, coinciding with the histopathologic diagnosis of the resected gastric cancer. Further systemic evaluation revealed a lung metastasis and left supraclavicular lymph node metastasis. The patient was treated with chemotherapeutic reagents. However, she died of the disease 9 months after the diagnosis of skin metastasis. We reviewed the cases of 50 Japanese patients with skin metastasis from gastric cancer and analyzed the clinicopathologic features.     

Distinct expression of mast cell tryptase and protease activated receptor-2 in synovia of rheumatoid arthritis and osteoarthritis

The objective of this study is to examine the differential expression of mast cell tryptase and its receptor, protease-activated receptor-2 (PAR-2), in the synovium and synovial fluid of patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Biochemical and immunohistochemical analyses were performed to determine whether the trypsin-like protease in the synovium is identical to mast cell tryptase. The effects of mast cell tryptase on the proliferation of synovial fibroblast-like cells (SFCs) and the release of IL-8 thereof were evaluated by the [³H]-thymidine incorporation and ELISA, respectively. The trypsin-like protease in the synovium of RA patients was identical to human mast cell tryptase, which was composed of two subunits: 33 and 34 kDa. The 33- and 34-kDa proteins are different glycosylated forms of the 31-kDa protein, which was unglycosylated. Mast cell tryptase activity in RA synovial fluid was significantly higher than that in OA synovial fluid, while their activities and expression in the synovium were similar. Expression of PAR-2 mRNA in the synovium was higher in RA than in OA. Mast cell tryptase containing the unglycosylated 31-kDa subunit was the predominant form in synovial fluid. RA patients had higher amounts of this subunit in their synovial fluid than OA patients. Mast cell tryptase and PAR-2 activating peptide stimulated the proliferation of SFCs and release of IL-8 from these cells. Mast cell tryptase secretion into RA synovial fluid is higher than OA synovial fluid. Mast cell tryptase in synovial fluid stimulates the proliferation of SFCs and the release of pro-inflammatory cytokines via PAR-2, which may contribute to exacerbation of synovitis in RA.     

Intracisternal injection of orexin-A prevents ethanol-induced gastric mucosal damage in rats

Background Accumulating evidence indicates that orexin-A in the brain stimulates vagal flow projecting to the stomach. Since the vagal system plays an important role in gastric mucosal integrity, we hypothesized that orexin-A in the brain might have a gastroprotective action. Methods We examined the effect of centrally administered orexin-A on the development of gastric mucosal damage evoked by ethanol and its possible mechanism of action in rats. Results Intracisternal but not intraperitoneal injection of orexin-A significantly inhibited the severity of gastric mucosal damage by 70% ethanol in a dose-dependent manner, suggesting that orexin-A acts in the brain to prevent ethanol-induced gastric mucosal damage. The antiulcer action was observed in rats administered with orexin-A centrally but not orexin-B, indicating that the action is mediated through orexin 1 receptors. The gastroprotective action of centrally administered orexin-A was blocked by pretreatment with atropine, N ^ω-nitro-l-arginine methylester, or indomethacin. Conclusions These results suggest that orexin-A acts on orexin 1 receptors in the brain to exert a gastroprotective action against ethanol. The vagal muscarinic system, nitric oxide, and prostaglandins may mediate the cytoprotective action of centrally administered orexin-A.     

Elucidation of the relationship of BNIP3 expression to gemcitabine chemosensitivity and prognosis

AIM: To evaluate the significance of BNIP3 in the pathogenesis of pancreatic cancer, we analyzed the relationship between the expression of BNIP3 and survival rate of the patients with pancreatic cancer, or chemosensitivities in pancreatic cancer cell lines, particularly for gemcitabine, the first-line anti-tumor drug for pancreatic cancer. METHODS: To compare the expression level of BNIP3 with the resistance to gemcitabine, eight pancreatic cancer cell lines were subjected to gemcitabine treatment and the quantitative real-time RT-PCR method was used to evaluate BNIP3 expression. Immunohistochemical analysis was also performed using 22 pancreatic cancer specimens to study relationship between BNIP3 expression and survival rate. RESULTS: Although no significantly positive association between BNIP3 mRNA level and gemcitabine chemosensitivity was observed, pancreatic cancer cell lines that were sensitive to gemcitabine treatment tended to show high levels of BNIP3 expression. The converse, an absence of BNIP3 expression, was not correlated with gemcitabine resistance. We further compared the BNIP3 expression profiles of resected primary pancreaticcancer specimens with the prognosis of the patients, and found a tendency of favorable prognosis and low BNIP3 expression. CONCLUSION: High levels of BNIP3 expression cannot be used as one of the predicting factors for gemcitabine chemosensitivity, and some yet to be known factors will have to fill the gap for the accurate prediction of pancreatic cancer chemosensitivity to gemcitabine. However, BNIP3 expression may have an impact on prediction of prognosis of patients with pancreatic cancer.