Acute coronary syndrome after liver transplantation in a young primary biliary cholangitis recipient with dyslipidemia: a case report

BACKGROUND: Primary biliary cholangitis (PBC) is a chronic, progressive liver disease associated with dyslipidemia. There is a consensus that PBC does not accelerate coronary artery disease despite high cholesterol levels, so the screening test for the coronary artery is not routinely performed before liver transplantation (LT). To date, no report has described the potential risk of PBC-related dyslipidemia for developing acute coronary syndrome (ACS) after LT. CASE PRESENTATION: A 40-year-old Asian female with a known history of PBC underwent ABO-incompatible living-donor LT, with her husband as the donor. Although she had high cholesterol and triglyceride levels that were refractory to medications, she passed all routine preoperative examinations, including cardiopulmonary function tests and infection screenings. One week after LT, she developed ACS with 90% stenosis of both the left anterior descending artery and left circumflex artery. Emergent stent implantation was successfully performed followed by dual antiplatelet therapy. The long history of PBC and associated severe dyslipidemia for 10 years would have accelerated the atherosclerosis, causing latent stenosis in the coronary artery. Inapparent stenosis might have become apparent due to unstable hemodynamics during the acute phase after LT. CONCLUSIONS: PBC-related dyslipidemia potentially brings a risk for developing ACS after LT. This experience suggests that the preoperative evaluation of the coronary artery should be considered for high-risk patients, especially those who have drug-resistant dyslipidemia

Development of pericardial fat count images using a combination of three different deep-learning models

Rationale and Objectives: Pericardial fat (PF), the thoracic visceral fat surrounding the heart, promotes the development of coronary artery disease by inducing inflammation of the coronary arteries. For evaluating PF, this study aimed to generate pericardial fat count images (PFCIs) from chest radiographs (CXRs) using a dedicated deep-learning model. Materials and Methods: The data of 269 consecutive patients who underwent coronary computed tomography (CT) were reviewed. Patients with metal implants, pleural effusion, history of thoracic surgery, or that of malignancy were excluded. Thus, the data of 191 patients were used. PFCIs were generated from the projection of three-dimensional CT images, where fat accumulation was represented by a high pixel value. Three different deep-learning models, including CycleGAN, were combined in the proposed method to generate PFCIs from CXRs. A single CycleGAN-based model was used to generate PFCIs from CXRs for comparison with the proposed method. To evaluate the image quality of the generated PFCIs, structural similarity index measure (SSIM), mean squared error (MSE), and mean absolute error (MAE) of (i) the PFCI generated using the proposed method and (ii) the PFCI generated using the single model were compared. Results: The mean SSIM, MSE, and MAE were as follows: 0.856, 0.0128, and 0.0357, respectively, for the proposed model; and 0.762, 0.0198, and 0.0504, respectively, for the single CycleGAN-based model. Conclusion: PFCIs generated from CXRs with the proposed model showed better performance than those with the single model. PFCI evaluation without CT may be possible with the proposed method

Isolated congenital megacystis without intestinal obstruction: A mild variant of chronic intestinal pseudoobstruction syndrome?

Megacystis is frequently involved with chronic intestinal pseudoobstruction syndrome; however, isolated megacystis without intestinal obstruction is extremely rare. We present the case of a female patient with isolated congenital megacystis without severe intestinal obstruction. In this case, barium enema did not reveal any significant findings; however, histologic evaluation of her rectum showed hypoganglionosis of the submucous and myenteric plexuses. These findings indicate that this case may be a mild variant of chronic intestinal pseudoobstruction syndrome. The presence of megacystis should alert the physician to the possibility of chronic intestinal pseudoobstruction syndrome. © 2011 Elsevier Inc. All rights reserved

Effects of Intermediates between Vitamins K2 and K3 on Mammalian DNA Polymerase Inhibition and Anti-Inflammatory Activity

Previously, we reported that vitamin K3 (VK3), but not VK1 or VK2 (=MK-4), inhibits the activity of human DNA polymerase γ (pol γ). In this study, we chemically synthesized three intermediate compounds between VK2 and VK3, namely MK-3, MK-2 and MK-1, and investigated the inhibitory effects of all five compounds on the activity of mammalian pols. Among these compounds, MK-2 was the strongest inhibitor of mammalian pols α, κ and λ, which belong to the B, Y and X families of pols, respectively; whereas VK3 was the strongest inhibitor of human pol γ, an A-family pol. MK-2 potently inhibited the activity of all animal species of pol tested, and its inhibitory effect on pol λ activity was the strongest with an IC50 value of 24.6 μM. However, MK-2 did not affect the activity of plant or prokaryotic pols, or that of other DNA metabolic enzymes such as primase of pol α, RNA polymerase, polynucleotide kinase or deoxyribonuclease I. Because we previously found a positive relationship between pol λ inhibition and anti-inflammatory action, we examined whether these compounds could inhibit inflammatory responses. Among the five compounds tested, MK-2 caused the greatest reduction in 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced acute inflammation in mouse ear. In addition, in a cell culture system using mouse macrophages, MK-2 displayed the strongest suppression of the production of tumor necrosis factor (TNF)-α induced by lipopolysaccharide (LPS). Moreover, MK-2 was found to inhibit the action of nuclear factor (NF)-κB. In an in vivo mouse model of LPS-evoked acute inflammation, intraperitoneal injection of MK-2 in mice led to suppression of TNF-α production in serum. In conclusion, this study has identified VK2 and VK3 intermediates, such as MK-2, that are promising anti-inflammatory candidates

Activities of Japanese Party in McMurdo Sound Area During the 1978-1979 Field Season

To carry out four research programs, three Japanese scientists visited McMurdo Station and Victoria Land for a period from October 27, 1978 to January 19, 1979. Search for Antarctic meteorites : A U. S. -Japan meteorites search project was continued in the 1978-79 season in Victoria Land. Four U. S. participants and three Japanese revisited the bare ice field in the Allan Hills in Victoria Land, 230km north of McMurdo Station. Newly selected searching sites for this season are located in the blue ice field around the Darwin Glacier, namely, Boomerang Range, Warren Range, Finger Ridges, Butcher Ridge, Upper Darwin Glacier, Darwin Mountains, Turnstile Ridge, Westhaven Nunatak, Bates Nunataks and Lonewolf Nunataks. During this season, a total of 310 individual specimens were collected. Glaciological survey in the Allan Hills bare ice field : To clarify the accumulation mechanism of many meteorites on the bare ice surface of a limited small area near the Allan Hills, a triangulation line about 15 km long was installed in the bare ice field on the plateau side of the Allan Hills during the period from December 7, 1978 to January 2, 1979. Ice samples for the dating and crystallography were collected from this bare ice field. Geological survey in the Dry Valley area : Survey of the basement metamorphic rocks was conducted in the Dry Valley and Miers Valley area. Many dikes and their mutual relationship near Vanda Station of the Wright Valley were surveyed. The succession of intrusion is as follows in order of time : Black-colored lamprophyre A and B, grey-colored lamprophyre, porphyry A, B, and C, granite porphyry A and B, felsitic dike, basalt (Ferrer dolerite) and acidic dike in dolerite. Sampling of palaeomagnetic rock specimens : About 420 specimens were collected from Mt. Circe, Mt. Fleming, Mt. Knobhead, Allan Hills, Carapace Nunatak and Ross Island area. These specimens consist of various gneisses, marble, and granitic varieties of the basement ; sandstone, shale, coal, and petrified wood of the Beacon Formation ; many dike rocks in the Beacon Formation ; Ferrer dolerite and McMurdo volcanic rocks