Morvan Syndrome Converted from Isaacs' Syndrome after Thymectomy with Positivity for Both Anti-LGI1 and Anti-CASPR2 Antibodies

Anti-voltage-gated potassium channel complex antibodies-mediated disorder includes Isaacs'' syndrome, which is characterized by neuromyotonia, and Morvan syndrome, which is characterized by neuromyotonia, encephalopathy and autonomic dysfunction. We herein report a patient with Morvan syndrome that converted from Isaacs'' syndrome after thymectomy. The patient first presented with myospasm in all extremities and positivity for both anti-leucine-rich glioma inactivated 1 (LGI1) and anti-contactin-associated protein like 2 (CASPR2) antibodies and subsequently developed encephalopathy after thymectomy, which was successfully improved by immunotherapy. This is the first case of Morvan syndrome wherein thymectomy worsened Isaacs'' syndrome, suggesting that immunotherapy should be considered for Isaacs'' syndrome accompanied by positivity for both anti-LGI1 and anti-CASPR2 antibodies to prevent worsening to Morvan syndrome.     

人参全球产地生态适宜性分析及农田栽培选地规范

通过开展人参全球范围内产地生态适宜性分析及农田栽培选地规范制定,为农田栽参合理规划生产布局及规范化种植提供科学依据。采用中国中医科学院中药研究所自主研发的"药用植物全球产地生态适宜性区划信息系统"(global geographic information system for medicinal plant,GMPGIS),以本草文献记载的道地产区、野生分布区以及当前主产区271个样点的生态环境因子值为计算依据,经过生态相似性分析获得人参全球范围内的最佳生态适宜产区和潜在种植区,主要包括美国、加拿大、中国、俄罗斯、日本、朝鲜、法国、意大利、乌克兰、韩国等国家。其中,人参在中国的生态适宜产区主要包括黑龙江、吉林、辽宁、陕西、甘肃、湖北、四川、内蒙古、山东和山西等省区。另外,在产地生态适宜性分析结果和项目组多年农田栽参研究数据基础上,结合文献及对部分种植基地的调研结果,初步制订了农田栽参选地规范。该研究为人参农田规模化种植、引种栽培和保护抚育提供科学依据,农田栽参选地规范为高品质人参的科学生产奠定基础。     

Dimeric flavonol glycoside and galloylated C-glucosylchromones from Kunzea ambigua

A novel dimeric flavonol glycoside linked through a methylene group, kunzeagin A (1), and six new chromone C-glucosides, kunzeachromones A-F (2-7), were isolated along with seven known compounds from the leaf extract of Kunzea ambigua. The structures of these compounds were elucidated on the basis of spectroscopic analyses and chemical properties. Kunzeachromones A-F provided additional examples of galloylated C-glucosidic chromones occurring in the Myrtaceae. Kunzeagin A (1) and major constituents of this plant (6-C- and 8-C-glucosylchromones and their monogallates) exhibited potent inhibitory effects on activation of Epstein-Barr virus early antigen induced by 12-O-tetradecanoylphorbol 13-acetate in Raji cells.     

Analysis of Differences in Preterm Birth Rates According to Household Occupation in Japan From 2007 to 2019

ObjectivesNo studies have examined the association between preterm birth rates and socioeconomic factors in Japan using nationwide statistical data. We analyzed the association between preterm birth rates and household occupation using Vital Statistics data.MethodsAggregated Vital Statistics data from Japan from 2007 to 2019 were obtained from the Ministry of Health, Labour and Welfare. From the data, the number of births according to year, age group, gestational period, number of pregnancies, and household occupation were used in this study. Crude preterm birth rates and preterm birth rates adjusted by maternal age according to household occupation were calculated for each year. Poisson regression analysis was conducted to evaluate the association between household occupation and preterm births.ResultsUnemployed households had the highest preterm birth rate, and households with an occupation classification of “full-time worker 2” (an employee at a large company, civil servant, or board member) had the lowest preterm birth rate throughout each period. Poisson regression analysis revealed that unemployed households were statistically significantly associated with a high preterm birth risk. In contrast, the preterm birth rate adjusted by maternal age remained stable throughout each period regardless of household occupation, and preterm birth rates were found not to have increased in recent years in Japan.ConclusionsUnemployed households had higher preterm birth rates than other household occupations. Further studies investigating the characteristics of unemployed households are needed to identify the reasons for this disparity.     

Ultrasound-guided local injection of methotrexate to treat an invasive hydatidiform mole

A 28-year-old Japanese woman had an invasive hydatidiform mole which was diagnosed by means of transvaginal ultrasonography. After the two initial courses of systemic methotrexate (MTX) therapy given over a period of weeks, the tumor was 14 mm in diameter and the surrounding blood supply remained rich. In addition to the two initial courses of systemic MTX therapy, local ultrasound-guided injection of MTX therapy was given three times, once per week. After the local MTX treatment, the betahCG level, which had been as high as 240 ng/mL, dropped to less than 0.1 ng/mL. We then gave two additional courses of systemic MTX therapy (once per week). More than 3 years have passed since the final systemic MTX therapy, and the patient's serum betahCG levels continue to be less than 0.1 ng/mL. An invasive mole can be treated with an ultrasound-guided local injection of MTX in addition to the established systemic MTX treatment.     

Involvement of catalase in the endometrium of patients with endometriosis and adenomyosis

OBJECTIVE: To determine the distribution of catalase in eutopic and ectopic endometria in patients with endometriosis or adenomyosis. DESIGN: Retrospective randomized study. SETTING: Department of obstetrics and gynecology in a university hospital. PATIENT(S): Thirty-three patients with endometriosis, 36 with adenomyosis, and 47 fertile controls (total, 116 women). MAIN OUTCOME MEASURE(S): Semiquantitative immunostaining of endometrial cells obtained by biopsy sampling, followed by calculation of an evaluation nomogram score. RESULT(S): The score of catalase in the glandular epithelium of controls group fluctuated during the menstrual cycle; it was lowest in the early proliferative phase and peaked in the late secretory phase. In patients with endometriosis, catalase scores did not fluctuate during the cycle, and scores were high compared with controls throughout the menstrual cycle. Catalase scores did not vary in patients with adenomyosis, and scores in this group were consistently higher than those in patients with endometriosis throughout the cycle. CONCLUSION(S): Abnormal expression of catalase in the eutopic and ectopic endometrium strongly suggests pathologic involvement of free radicals in endometriosis and adenomyosis.     

基于GMPGIS全球变暖情景下人参未来生态适宜产区变化

目的:通过开展未来时期人参全球潜在生态适宜产区分析,为其合理规划生产布局提供科学依据。方法:采用"药用植物全球产地生态适宜性区划信息系统"(Global Geographic Information System for Medicinal Plant,GMPGIS),以人参本草文献记载的道地产区、野生分布区以及当前主产区人参生态因子数值为依据,对其在全球范围内的潜在生态分布区进行分析。结果:亚洲东部、北美洲中部及东部、欧洲中南部及大洋洲东部地区是当前人参全球范围内的主要适生区域。随着全球气候变暖,在温室气体排放相对较少的A1b模型和排放较多的A2a模型下,2050年人参潜在生态适宜产区面积约为9 500×10~3km~2,比当前产区适宜面积增加了7.05%~7.12%,增长区域主要分布在亚洲东北部和欧洲北部地区;2100年人参适宜产区面积约为10 800×10~3km~2,比当前产区适宜面积增加了22.89%~27.41%,增长区域主要分布在欧洲北部及亚洲中部及东部地区。结论:气温升高有助于人参适宜产区增加,本研究结果可为人参生产布局规划、引种栽培、规模化种植提供科学依据。     

Differentiating Dementia with Lewy Bodies from Alzheimer's Disease Using the Fall Risk Evaluation Questionnaire

Objective Dementia with Lewy bodies (DLB) is the second-most common form of neurodegenerative dementia after Alzheimer''s disease (AD). Falls are a vital prognostic factor in patients with dementia and are a characteristic feature of DLB. This study investigated the screening potential of the fall risk evaluation for DLB and compared it with that of AD to facilitate an accurate diagnosis. Methods We enrolled patients diagnosed with DLB (n=410) and AD (n=2,683) and categorized the participants into 3 groups depending on their physical ability, age, cognitive function, and fall events. Using the Fall Risk Index-21 (FRI-21) questionnaire, we evaluated and comparatively analyzed the fall risk between DLB and AD patients in three defined groups of participants. Results The FRI-21 score was significantly higher in DLB patients than in AD patients in every group. Using this score, we were able to distinguish between DLB and AD patients in each group. Among the three groups, the group with a young age, relatively mild cognitive dysfunction, and no fall events exhibited the best specificity for DLB (0.895). Conclusions The FRI-21 is a useful tool for screening for DLB and differentiating it from AD. This questionnaire can be used at a relatively early stage of the disease in young patients with mild cognitive dysfunction and no history of falling. These preliminary results need to be validated in an interventional study to evaluate the effectiveness of rehabilitative measures and daily environmental changes carried out to prevent falls using this tool.     

Coupling of acceptor-substituted diazo compounds and tertiary thioamides: synthesis of enamino carbonyl compounds and their pharmacological evaluation

This paper describes the synthesis of enamino carbonyl compounds by the copper(i)-catalyzed coupling of acceptor-substituted diazo compounds and tertiary thioamides. We plan to use this method to synthesize indolizidine (−)-237D analogs to find α6-selective antismoking agents. Therefore, we also performed in silico α6-nAchRs binding studies of selected products. Compounds with low root-mean-square deviation values showed more favorable binding free energies. We also report preliminary pharmacokinetic data on indolizidine (−)-237D and found it to have weak activity at CYP3A4. In addition, as enamino carbonyl compounds are also known for antimicrobial properties, we screened previously reported and new enamino carbonyl compounds for antibacterial, antimicrobial, and antifungal properties. Eleven compounds showed significant antimicrobial activities.

This paper describes the synthesis of enamino carbonyl compounds by the copper(i)-catalyzed coupling of acceptor-substituted diazo compounds and tertiary thioamides.     

Successful bronchial artery embolization using hydrogel coils for hemoptysis during extracorporeal membrane oxygenation

A 58-year-old woman with bronchiectasis presented with massive hemoptysis and severe respiratory failure, which required long-term extracorporeal membrane oxygenation with continuous heparin infusion. Bronchial artery embolization using hydrogel coils, which provide a greater volume occlusion than bare platinum coils, was performed; hemoptysis stopped and she fully recovered. No recanalization was observed on follow-up computed tomography angiography 2 months postbronchial artery embolization, and there had been no recurrence of bleeding at the time of this report (at least 6 months). Although continuous anticoagulation during extracorporeal membrane oxygenation might hinder complete vessel occlusion by metallic coils or induce early recanalization (because the homeostatic mechanism of coils depends on the patient''s coagulability), our experience showed that bronchial artery embolization using hydrogel coils was effective and safe. Additionally, this case presents a successful example of anticoagulation management for patients with hemoptysis on extracorporeal membrane oxygenation who undergo bronchial artery embolization using coils.