Multiple-system atrophy and anesthesia

Multiple-system atrophy is an adult-onset progressive neurodegenerative disease affecting the central nervous system, including the spinal cord. There has been no perioperative guideline of the muscle relaxants used in multiple-system atrophy, although a recent article recommends anesthesiologists to use shorter-acting drugs at the lowest possible doses in the patients. Here, we document the first case with multiple-system atrophy undergoing surgery managed with a combination of rocuronium and sugammadex. The recovery time to the train-of-four count 2 after intravenous rocuronium 0.6 mg / kg, or the time from the start of sugammadex 2 mg / kg intravenously to the train-of-four ratio over 0.9 was prolonged in our case more than 20 and 2 minutes compared with those in healthy subjects, respectively. Neuromuscular monitoring, in addition to the careful vigilance in the perioperative period, seems mandatory in the patients

Well-Posedness for a System of Quadratic Derivative Nonlinear Schrodinger Equations with Radial Initial Data

Hirayama H, Kinoshita S, Okamoto M. Well-Posedness for a System of Quadratic Derivative Nonlinear Schrodinger Equations with Radial Initial Data. ANNALES HENRI POINCARE. 2020;21(8):2611-2636.In the present paper, we consider the Cauchy problem of the system of quadratic derivative nonlinear Schrodinger equations. This system was introduced by Colin and Colin (Differ Integral Equ 17:297-330, 2004). The first and second authors obtained some well-posedness results in the Sobolev space H-s(R-d). We improve these results for conditional radial initial data by rewriting the system radial form

Mesenteric desmoid tumor of the interposed jejunal pouch after total gastrectomy

BACKGROUND: Desmoid tumor is a rare entity, and most desmoid tumors are located in abdominal wall or extra-abdominal tissues. Occurrence of desmoid tumor in mesentry is extremely rare. CASE PRESENTATION: we report a mesenteric desmoid tumor in a 73-years-old woman who had undergone total gastrectomy reconstructed with jejunal pouch interposition for gastric carcinoma. After 1 year, a tumor was originating from mesentery of the interposed jejunal pouch was identified, and the patient underwent resection of the large mass which was found to invade pancreas. Histological examination revealed desmoid tumor. CONCLUSION: Desmoid tumor is rare, and it was difficult for the differential diagnosis of desmoid tumor or recurrent tumor

Antitumor Immunity Produced by the Liver Kupffer Cells, NK Cells, NKT Cells, and CD8+ CD122+ T Cells

Mouse and human livers contain innate immune leukocytes, NK cells, NKT cells, and macrophage-lineage Kupffer cells. Various bacterial components, including Toll-like receptor (TLR) ligands and an NKT cell ligand (α-galactocylceramide), activate liver Kupffer cells, which produce IL-1, IL-6, IL-12, and TNF. IL-12 activates hepatic NK cells and NKT cells to produce IFN-γ, which further activates hepatic T cells, in turn activating phagocytosis and cytokine production by Kupffer cells in a positive feedback loop. These immunological events are essentially evoked to protect the host from bacterial and viral infections; however, these events also contribute to antitumor and antimetastatic immunity in the liver by activated liver NK cells and NKT cells. Bystander CD8+CD122+ T cells, and tumor-specific memory CD8+T cells, are also induced in the liver by α-galactocylceramide. Furthermore, adoptive transfer experiments have revealed that activated liver lymphocytes may migrate to other organs to inhibit tumor growth, such as the lungs and kidneys. The immunological mechanism underlying the development of hepatocellular carcinoma in cirrhotic livers in hepatitis C patients and liver innate immunity as a double-edged sword (hepatocyte injury/regeneration, septic shock, autoimmune disease, etc.) are also discussed

Duodenoportal fistula caused by peptic ulcer after extended right hepatectomy for hilar cholangiocarcinoma

BACKGROUND: A fistula between the duodenum and the main portal vein near a peptic ulcer is extremely rare, and only two cases of duodenal ulcers have been reported in the past. CASE PRESENTATION: We report a 68-year-old man with a diagnosis of anemia who had a history of extended right hepatectomy for hilar cholangiocarcinoma 20 months previously. The first endoscopic examination revealed a giant peptic ulcer with active bleeding at the posterior wall of the duodenal bulbs, and hemostasis was performed. Endoscopic treatment and transarterial embolization were performed repeatedly because of uncontrollable bleeding from the duodenal ulcer. Nevertheless, he died of sudden massive hematemesis on the 20(th )hospital day. At autopsy, communication with the main portal vein and duodenal ulcer was observed. CONCLUSION: It should be borne in mind that the main portal vein is exposed at the front of the hepatoduodenal ligament in cases with previous extrahepatic bile duct resection

水溶液中における茶カテキン類とカフェインのクリーミングダウン現象により生じる沈殿の解析(発表論文抄録(2012))

The content of a crude precipitate formed by creaming, which was made from a catechin mixture and caffeine, was investigated by an integral volume of H-2 proton signals of tea catechins in the 1H-NMR spectrum. Gallated catechins formed a crude precipitate more predominantly than non-gallated catechins. The 2,3-cis-non-gallated catechin (−)-epicatechin (EC) formed a 1 : 1 complex with caffeine, and 2,3-cis-gallated catechin (−)-epicatechin gallate (ECg) formed a 2 : 4 complex with caffeine. The π–π complexation site of EC with caffeine was only the A ring, whereas that of ECg included all aromatic rings, A, B, and B′. It was thought that the hydrophobicity of the 2 : 4 complex of ECg and caffeine was stronger than that of the 1 : 1 complex of EC and caffeine, with the result that the 2 : 4 complex of ECg and caffeine precipitated by creaming more predominantly than the 1 : 1 complex of EC and caffeine in aqueous solution.The content of a crude precipitate formed by creaming, which was made from a catechin mixture and caffeine, was investigated by an integral volume of H-2 proton signals of tea catechins in the 1H-NMR spectrum. Gallated catechins formed a crude precipitate more predominantly than non-gallated catechins. The 2,3-cis-non-gallated catechin (−)-epicatechin (EC) formed a 1 : 1 complex with caffeine, and 2,3-cis-gallated catechin (−)-epicatechin gallate (ECg) formed a 2 : 4 complex with caffeine. The π–π complexation site of EC with caffeine was only the A ring, whereas that of ECg included all aromatic rings, A, B, and B′. It was thought that the hydrophobicity of the 2 : 4 complex of ECg and caffeine was stronger than that of the 1 : 1 complex of EC and caffeine, with the result that the 2 : 4 complex of ECg and caffeine precipitated by creaming more predominantly than the 1 : 1 complex of EC and caffeine in aqueous solution

各種茶カテキン類・カフェイン錯体の立体配置研究(発表論文抄録(2011))

Crystals of the complexes of (+)-catechin (CA) of non-galloylated catechin and (−)-catechin-3-O-gallate (Cg) of galloylated catechin with caffeine were prepared, and their stereochemical structures and intermolecular interactions were determined by X-ray crystallographic analysis. CA formed a 1 : 1 complex with caffeine by intermolecular hydrogen bonds, whereas Cg formed a 1 : 2 complex with caffeine, which was formed by face-to-face and offset π–π interactions and intermolecular hydrogen bonds. A solution of two kinds of non-galloylated catechin, CA and (−)-epicatechin (EC), and caffeine (molar ratio 1 : 1 : 2) in water afforded a 1 : 1 : 2 complex, the crystal structure of which had two layers, one layer in which CA and caffeine formed alternate lines and an other layer in which EC and caffeine formed alternate lines. The 1 : 1 : 2 complex was formed by offset π–π and CH–π interactions and intermolecular hydrogen bonds.Crystals of the complexes of (+)-catechin (CA) of non-galloylated catechin and (−)-catechin-3-O-gallate (Cg) of galloylated catechin with caffeine were prepared, and their stereochemical structures and intermolecular interactions were determined by X-ray crystallographic analysis. CA formed a 1 : 1 complex with caffeine by intermolecular hydrogen bonds, whereas Cg formed a 1 : 2 complex with caffeine, which was formed by face-to-face and offset π–π interactions and intermolecular hydrogen bonds. A solution of two kinds of non-galloylated catechin, CA and (−)-epicatechin (EC), and caffeine (molar ratio 1 : 1 : 2) in water afforded a 1 : 1 : 2 complex, the crystal structure of which had two layers, one layer in which CA and caffeine formed alternate lines and an other layer in which EC and caffeine formed alternate lines. The 1 : 1 : 2 complex was formed by offset π–π and CH–π interactions and intermolecular hydrogen bonds