Opsoclonus-myoclonus syndrome following long-term use of cyclosporine

Background: Cyclosporine A (CsA) is a widely used immunosuppressive agent that may provoke unexpected neurologic complications. The mechanism is unclear and variable intervals have been reported between CsA administration and onset of the related side effects. Here, we describe a case of delayed-onset CsA neurotoxicity presenting as opsoclonus-myoclonus syndrome (OMS).

Case details: A 37-year-old woman with a two-week period of opsoclonus and upper extremity myoclonus was admitted to our hospital. The patient had been taking CsA for 17 years after receiving a kidney transplant. Further evaluation did not reveal any other abnormalities. Seven days after switching from CsA to tacrolimus, in the absence of additional immune-modulating therapy, her neurologic symptoms improved considerably.

Conclusion: This is the case of delayed, long-term complications of CsA presenting as OMS. Symptoms resolved by substituting CsA with another immunomodulating drug. The etiology of the neurologic complications may involve paradoxically-enhanced delayed-type hypersensitivity.     

Genoprotection and Cytotoxicity of Cassia surattensis Seed Extract on Vero Cell Evaluated by Comet and Cytotoxicity Assays

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - Cassia (C.) surattensis Burm. f. (Leguminosae) is a flowering plant that has been traditionally used in many...     

Lifespan and reproduction in Drosophila: New insights from nutritional geometry

Modest dietary restriction (DR) prolongs life in a wide range of organisms, spanning single-celled yeast to mammals. Here, we report the use of recent techniques in nutrition research to quantify the detailed relationship between diet, nutrient intake, lifespan, and reproduction in Drosophila melanogaster. Caloric restriction (CR) was not responsible for extending lifespan in our experimental flies. Response surfaces for lifespan and fecundity were maximized at different protein-carbohydrate intakes, with longevity highest at a protein-to-carbohydrate ratio of 1:16 and egg-laying rate maximized at 1:2. Lifetime egg production, the measure closest to fitness, was maximized at an intermediate P:C ratio of 1:4. Flies offered a choice of complementary foods regulated intake to maximize lifetime egg production. The results indicate a role for both direct costs of reproduction and other deleterious consequences of ingesting high levels of protein. We unite a body of apparently conflicting work within a common framework and provide a platform for studying aging in all organisms.     

A case of colon obstruction developed during the recovery period of acute pancreatitis]

Complications of acute pancreatitis usually occur in pancreas and its contiguous organs. The prevalence of colonic invasion is rare, however, the consequence is fatal, with mortality above 50%. The initial symptoms and onset times are variable and major affected sites are transverse colon and splenic flexure. The spread of inflammatory exudates into the colon is the main mechanism of colonic invasion. If the colonic stenosis develops, it is necessary to manage it surgically. We report a case who arrived at the hospital with watery diarrhea and abdominal distension in the recovery period of acute alcoholic pancreatitis and was diagnosed as a colonic obstruction in the splenic flexure. The patient underwent loop ileostomy instead of the resection of the lesion because of severe adhesion around the splenic flexure. The patient died due to sepsis 5 days after the operation.     

Associations of HLA-DRB1 and -DQB1 alleles with severe recurrent respiratory papillomatosis in Korean patients

Recurrent respiratory papillomatosis (RRP) is characterized by frequent recurrences of papilloma of the larynx with significant morbidity. It is caused by human papillomavirus (HPV) types 6 and 11. Some associations of HLA genes with RRP have been reported, mainly in Caucasians. We performed HLA class II (DRB1 and DQB1) genotyping using Dynal RELI™ HLA-DRB1 SSO kit and PCR-single strand conformation polymorphism on 22 Korean patients with severe RRP and 207 healthy controls. The gene frequencies of HLA-DRB1*11:01 (18.2% vs 3.6%, p = 0.0006, p_c = 0.02, odds ratio [OR] = 5.9) and DQB1*03:01 (36.4% vs 14.5%, p = 0.0009, p_c = 0.01, OR = 3.4) and the haplotype frequency of DRB1*11:01-DQB1*03:01 (15.9% vs 3.6%, p = 0.003, OR = 5.0) was higher in RRP patients than controls. DRB1*11:01 and DRB1*11:01-DQB1*03:01 haplotype were strongly associated with disease susceptibility to severe RRP in Koreans.