A Case of Dermatomyositis with Severe Myalgia and Muscle Weakness Testing Positive for Anti-melanoma Differentiation-associated Gene 5 Antibody

We report a case of a woman with typical dermatomyositis (DM) with skin manifestations, severe myalgia and muscle weakness complicated by interstitial lung disease (ILD) and pneumomediastinum. Pneumomediastinum persisted despite treatment with immunosuppressive therapy (steroids and cyclosporine). After the test for anti-melanoma differentiation-associated gene 5 (MDA5) antibody came out positive, we doubled the cyclosporine dose and her condition improved. Despite typical clinical features of DM, in cases complicated by pneumomediastinum or steroid resistance, measurement of anti-MDA5 antibody may be useful for immunosuppressant dose titration

Two Unique Cases with Anti-GluR Antibody-Positive Encephalitis

We report two cases of anti-glutamic acid receptor (anti-GluR) antibody-positive encephalitis in males with symptoms such as Parkinsonism, urinary retention, and paralytic ileus. Although non-herpetic encephalitis typically shows magnetic resonance imaging (MRI) lesions in the limbic system during early stages, the present cases showed MRI lesions during later stages in the bilateral claustrum and pons. In both cases, anti-GluRɛ2 and δ2 antibodies were later shown to be positive in the cerebrospinal fluid but negative in the serum. Although early detection of anti-GluR antibodies is essential, early treatment may be significantly more important

Spreading brain lesions in a familial Creutzfeldt-Jakob disease with V180I mutation over 4 years

BACKGROUND: We report a female patient with familial Creutzfeldt-Jakob disease with V180I mutation (fCJD with V180I), who was serially followed up with magnetic resonance imaging (MRI) and electroencephalogram (EEG) for up to four years. CASE PRESENTATION: At 6 months after the onset, diffusion-weighted images (DWI) and fluid-attenuated inversion recovery (FLAIR) of brain MRI revealed an increased signal intensity in the bilateral frontal, temporal, and parietal cerebral cortex with left dominancy except for the occipital lobe. However, her follow-up MRI at four years showed the high-signal regions spreading to the occipital cerebral cortex in DWI and FLAIR images, and bilateral frontal cerebral white matter in FLAIR images. EEG showed a progressive and general slow high-voltage rhythm from 7–8 to 3–5 c/s over four years, without evidence of periodic synchronous discharge. These findings correspond to the symptom progression even after akinetic mutism at 18 months. CONCLUSION: We suggest that serial MRI and EEG examinations are useful for early diagnosis of fCJD with V180I and for monitoring disease progression

Piezoelectric actuator-based cell microstretch device with real-time imaging capability

Cellular response to physical stretch has been extensively studied as a regulator of various physiological functions. For live cell microscopy combined with stretch experiments, cells are typically seeded on an extensible elastomer sheet. In this case, the position of the cells of interest tends to shift out of the field of view upon stretch, making real-time imaging of identical cells difficult. To circumvent this situation, here we describe a robust methodology in which these cell shifts are minimized. Cells are plated in a custom-designed stretch chamber with an elastomer sheet of a small cell culture area. The cell-supporting chamber is stretched on an inverted microscope by using a piezoelectric actuator that provides small, but precisely controlled displacements. Even under this small displacement within the filed of view, our device allows the cells to undergo physiologically relevant levels of stretch. Identical cells can thus be continuously observed during stretching, thereby potentially enabling imaging of stretch-triggered fast dynamics