Paraneoplastic Opsoclonus-myoclonus Syndrome with Anti-Hu and Anti-SOX-1 Antibodies after Immune-checkpoint Inhibitor Treatment Combined with Chemotherapy in a Patient with Small-cell Lung Cancer

A 69-year-old man with advanced small-cell lung cancer achieved partial remission after 3 courses of immunochemotherapy that included atezolizumab. Ten days after the last treatment, he developed paraneoplastic opsoclonus-myoclonus syndrome and required mechanical ventilation. Serology testing detected anti-Hu and anti-SOX-1 antibodies. Despite steroid pulse therapy, various anticonvulsants, continuous intravenous sedation, and a fourth course of chemotherapy without atezolizumab, his condition failed to improve. Paraneoplastic opsoclonus-myoclonus syndrome with autoantibodies after immune-checkpoint inhibitor treatment has not been reported previously. Although a causal relationship between immune-checkpoint inhibitors and paraneoplastic syndromes has been suggested, the mechanism remains unknown.     

Convenience Food Options and Adequacy of Nutrient Intake among School Children during the COVID-19 Pandemic

The COVID-19 pandemic has caused changes in the family food environment, resulting in more families relying on convenience food options. This study aimed to investigate diet quality by convenience food options (namely instant, frozen, and take-out foods) among Japanese school children during the COVID-19 pandemic. We examined the relationship between the frequency of consumption of convenience food options and nutritional status of the school children. The participants (671 children, 10–14 years old) were chosen to form a nationally representative sample of the Japanese population. Using questionnaires completed by the participants’ guardians, information was collected on the frequency of instant, frozen, and take-out food consumption. Habitual food and nutrient intake were collected using a validated food frequency questionnaire, completed by the children with help from their guardian(s). “Frequent” consumption was defined as consumption of instant, frozen, and/or take-out foods on more than 5 days per week. Using 19 nutrients and their respective dietary reference intake (DRI) values, an index was created to label each child’s nutrient intake as “Adequate”, “Inadequate”, “Excess”, or “Deficient.” Compared to children with non-frequent consumption, school children with frequent instant food consumption had significantly higher rates of inadequate nutrient intake (risk ratio (RR) = 3.0 [95% CI: 1.6–5.6]) and excess nutrient intake (RR = 2.3 [95% CI: 1.3–4.2]), while school children with frequent take-out food consumption had significantly higher rates of inadequate nutrient intake (RR = 2.1 [95% CI: 1.3–3.3]). There were no significant differences for children with frequent frozen-food intake. These associations did not change when adjusting for sociodemographic factors. Our results suggest that the frequent consumption of instant or take-out foods among school children results in non-adequate nutritional intake.     

Synthesis and Characterization of High-Entropy-Alloy-Type Layered Telluride MBi2Te4 (M = Ag,In, Sn,Pb, Bi)

Recently, high-entropy alloys (HEAs) and HEA-type compounds have been extensively studied in the fields of material science and engineering. In this article, we report on the synthesis of a layered system MBi₂Te₄ where the M site possesses low-, middle-, and high-entropy states. The samples with M = Pb, Ag_1/3Pb_1/3Bi_1/3, and Ag_1/5In_1/5Sn_1/5Pb_1/5Bi_1/5 were newly synthesized and the crystal structure was examined by synchrotron X-ray diffraction and Rietveld refinement. We found that the M-Te2 distance was systematically compressed with decreasing lattice constants, where the configurational entropy of mixing at the M site is also systematically increased. The details of structural refinements and the electrical transport property are presented.     

Spreading depression induces long-lasting brain protection against infarcted lesion development via BDNF gene-dependent mechanism

Preconditioning the rat brain with spreading depression for 48 h induces potent ischemic tolerance (infarct tolerance) after an interval of 12-15 days, consequently reducing the infarcted lesion size in the acute phase following focal cerebral ischemia. However, persistence of the morphological and functional neuroprotection has not yet been proven. We tested whether tolerance-derived neuroprotection against focal cerebral ischemia persists or merely delays the progress of cerebral infarction. Prolonged spreading depression was induced in mice by placing a depolarized focus with intracerebral microinfusion of KCl for 24 h; after intervals of 3, 6, 9 or 12 days, temporary focal ischemia was imposed. In the analysis of the infarcted lesion volume 24 h after ischemia, groups with 6 or 9 day interval demonstrated significantly smaller lesion volume compared to time-matched vehicle control group (P=0.002). Significant reduction in cerebral infarction was also observed at the chronic phase, namely 14 days after ischemia (33% reduction) (P=0.021) accompanied with less severe neurological deficits (38% reduction) (P=0.020). Using this technique, we also investigated if the mice with targeted disruption of a single BDNF allele (heterozygous BDNF-deficient mice) can gain the same potency of tolerance as the wild mice. In the result on infarcted lesion volumes following temporary focal ischemia, potent tolerance developed in the wild type (35% reduction) (P=0.007) but not in the heterozygous BDNF-deficient mice (<19% reduction) (P=0.155), indicating that BDNF expression level following spreading depression is contributing to infarct tolerance development.     

Treatment outcome of selective digestive decontamination and enteral nutrition in patients with severe acute pancreatitis

Background/Purpose Sepsis due to infected pancreatic necrosis is the most serious complication in the late phase of severe acute pancreatitis (SAP). Bacterial translocation from the gut is thought to be the main cause of pancreatic infection. The possibility has recently been reported that selective digestive decontamination (SDD) and enteral nutrition (EN) may alleviate the complications and reduce the mortality rate in patients with SAP. We analyzed the treatment outcome of SDD and EN in patients with SAP. Methods We divided 90 patients with SAP into three groups: SDD(−)EN(−),group A; SDD(+)EN(−), group B; and SDD(+)EN(+), group C. Clinical outcome was analyzed retrospectively. The effect of SDD was compared in groups A and B, and the effect of EN was compared in groups B and C. Results The background of patients was not significantly different between the groups. SDD reduced the incidence of organ dysfunction (from 70% to 59%) and the mortality rate (from 40% to 28%), but the differences were not significant. EN reduced the incidence of infected pancreatic necrosis (from 31% to 24%) and the frequency of surgery for pancreas (from 28% to 18%), and further reduced the mortality rate (from 28% for SDD to 16%), but the differences were not significant. The peripheral lymphocyte count was significantly increased in patients with EN. Conclusions SDD and EN did not significantly affect the treatment outcome in SAP. However, the results in this study raise the possibility that SDD and EN may decrease the complications and reduce the mortality rate in SAP. The efficacy of SDD and EN for SAP should be evaluated in a randomized controlled trial.     

A study of arteriosclerosis in healthy subjects with HBV and HCV infection

Background It is unclear whether infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) affects arteriosclerosis. We performed a cross-sectional study to clarify the effect of HBV and HCV infection on arteriosclerosis. Methods The study subjects were 1806 healthy individuals who visited Shimane Environment and Health Public Corporation for routine medical check-ups. Serum levels of total cholesterol, high-density lipoprotein (HDL)-cholesterol, triglycerides, and blood glucose were investigated in all subjects. The degree of arteriosclerosis was assessed using systolic blood pressure, the bilateral ankle brachial index (ABI), the heart-carotid pulse wave velocity (HCPWV), and the heart-ankle PWV (HAPWV). These cardiovascular parameters were compared between control subjects and subjects with HBV and HCV infection, using analysis of covariance to adjust for confounding factors (sex, age, body mass index, and smoking and drinking). Results Of the 1806 subjects, 39 and 31 were diagnosed as positive for HBV and HCV infection, respectively. The remaining 1736 were considered to be the controls. Adjusted serum lipid levels in the subjects with HBV and those with HCV infection tended to be lower than those in the control subjects. Adjusted arteriosclerotic parameters in the subjects with HBV and HCV infection were similar to those in the control subjects, even after adjusting for serum lipid levels. Conclusions Infection with HBV or HCV does not influence the severity of arteriosclerosis in healthy subjects.