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Background: Intravenously administered indocyanine green (ICG) accumulates in lung tumors, facilitating their detection via a fluorescence spectrum measurement. This method aids in identifying tumor locations that are invisible to the naked eye. We aim to determine the optimal ICG dose and administration method for accurate tumor identification during lung resection surgeries, utilizing a novel ICG fluorescence spectroscopy system for precise tumor localization. Materials and Methods: ICG should be dissolved in the provided solution or distilled water and administered intravenously approximately 24 h before surgery, beginning with an initial dose of 0.5 mg/kg. If the tumor detection rate is insufficient, the dose may be gradually increased to a maximum of 5.0 mg/kg to determine the optimal dosage for effective tumor detection. This fluorescence spectroscopy during surgery may reveal additional lesions that remain undetected in preoperative assessments. The primary endpoint includes the correct diagnostic rate of tumor localization. The secondary endpoints include the measurement of the intraoperative ICG fluorescence spectral intensity in lung tumors, the assessment of the operability and safety of intraperitoneal ICG administrations, the measurement of the ICG fluorescence spectral intensity in surgical specimens, the comparison of the spectral intensity in lung tissues during collapse and expansion, the correlation between ICG camera images and fluorescence spectral intensity, and the comparison of fluorescence analysis results with histopathological findings. The trial has been registered in the jRCT Clinical Trials Registry under the code jRCTs011230037. Results and Conclusions: This trial aims to establish an effective methodology for localizing and diagnosing malignant lung tumors, thereby potentially improving surgical outcomes and refining treatment protocols.

Human cysticercosis is a life-threatening zoonotic disease caused by infection with larvae (cysticerci) of the pork tapeworm, Taenia solium. This can affect the nervous system causing chronic headache and intracranial hypertension, potentially leading to epileptic seizures and paralysis. The disease is found in developing countries, especially in Southeast and South Asia, Sub-Saharan Africa, and Central and South America where porcine cysticercosis is endemic and people have a habit of eating undercooked pork. An immunochromatography-based test (ICT) kit, using T. solium cyst fluid as antigen, was manufactured to detect anti-T. solium IgG antibodies in human serum. To evaluate the kit, we used 187 serum samples including 24 from proven/confirmed cysticercosis cases, 133 from cases with other parasitosis and 30 healthy controls. Diagnostic efficiencies were calculated. The sensitivity, specificity, and accuracy were 83.3%, 92.0%, and 90.9%, respectively. Moreover, the ICT was positive before treatment but became negative after treatment, implying that this kit is also useful for follow-up monitoring post-treatment. In conclusion, we have successfully developed and present preliminary evaluation of an easy-to-handle rapid diagnostic tool for human cysticercosis in the form of an ICT platform using as antigen fluid from T. solium cysticerci.

Anti-metabotropic glutamate receptor 1 (mGluR1) encephalitis is a rare autoimmune disorder manifesting with cerebellar syndrome. Patients with mGluR1 encephalitis have been treated with immunomodulatory therapies; however, little is known about the efficacy of this therapy. A 58-year-old Japanese woman presented with dizziness when walking and standing up. Symptoms persisted and the patient gradually deteriorated. The neurological examination revealed a broad-based gait, horizontal and slightly gaze-evoked nystagmus, noticeable head titubation, and truncal ataxia without limb ataxia. Magnetic resonance imaging was normal. The 123I-isopropyl-iodoamphetamine single-photon emission-computed tomography scans showed normal cerebellar perfusion. Based on a positive antibody test for anti-mGluR1, the patient was diagnosed with anti-mGluR1 encephalitis. She was treated with intravenous methylprednisolone and intravenous immunoglobulin (IVIg). Symptoms gradually improved over 1 month and almost disappeared after additional IVIg therapy. Anti-mGluR1 encephalitis is a rare disease, and effective treatment is unclear. In this case, a favorable outcome was obtained with immunomodulatory therapy, even though the neurological disability of the disease course is worse. We emphasize the importance of early diagnosis and therapeutic intervention, suspecting the disease on the basis of its characteristic symptoms.

Background Amebic liver abscess (ALA) caused by Entamoeba histolytica is usually diagnosed based on its clinical symptoms, medical imaging abnormalities of the liver, and serological tests, the most common being the enzyme-linked immunosorbent assay (ELISA). For more than three decades, no investigation has evaluated the diagnostic performance of immunoglobulin G (IgG) subclasses in the serodiagnosis of ALA. Herein, we assessed the efficiencies of anti-amebic IgG and IgG subclasses for diagnosing ALA. Methods A serological ELISA-based test was performed to assess its diagnostic performance using a total of 330 serum samples from ALA patients (n = 14), healthy individuals (n = 40), and patients with other diseases (n = 276). Results ELISA targeting the total IgG antibody to E. histolytica antigen exhibited 100% sensitivity 95% CI [76.8–100.0] and 97.8% specificity 95% CI [95.5–99.1], whereas the assay targeting IgG1 showed the same sensitivity (100% 95% CI [76.8–100.0]) and a slightly higher specificity (99.1% 95% CI [97.3–99.8]). The other IgG subclasses (IgG2, IgG3, and IgG4) displayed a lower sensitivity and specificity. The sensitivity and specificity did not significantly differ between tests measuring total IgG and IgG1 (Exact McNemar’s test; p > 0.05), with a concordance of 98.2%, represented by a Cohen’s kappa of 0.83 (p < 0.001), indicating almost perfect agreement. Conclusion ELISA targeting IgG1 can provide valuable information to clinicians in differentiating ALA from other parasitic diseases, cancers, cirrhosis, and viral hepatitis. However, enzyme-conjugated anti-human total IgG is cheaper than anti-human IgG subclasses. Therefore, we suggest that total IgG-based ELISA is sufficient for the routine serodiagnosis of human ALA and possibly other clinical manifestations of invasive amebiasis.

Objective: Schistosomiasis japonica is an important helminthic disease in Asia. Sensitive and accurate diagnostic tools are indispensable for clinical diagnosis, screening infection and monitoring its control. In this study, we developed an immunochromatographic test (Sj-ICT) to detect anti-Schistosoma japonicum immunoglobulin G antibodies in human sera. Methods: Somatic extract from adult S. japonicum was used as an antigen. The Sj-ICT was developed and optimized as a point-of-care test. All 214 human serum samples were evaluated for diagnostic usefulness and comparison with an enzyme-linked immunosorbent assay (ELISA). Results: The diagnostic sensitivity, specificity, positive and negative predictive values, and accuracy of the Sj-ICT were 90.8%, 87.9%, 86.4%, 91.9% and 89.3%, respectively. For ELISA the values were respectively 91.8%, 87.9%, 86.5%, 92.7% and 89.7%. The concordance between both methods was 86.4 % (Cohen’s kappa value = 0.729). Conclusions: The immunochromatographic test kit developed can support clinical diagnosis and large-scale surveys in endemic areas without requiring additional facilities or ancillary supplies.

Abstract Idiopathic pure red cell aplasia (PRCA) and secondary PRCA associated with thymoma and large granular lymphocyte leukemia are generally considered to be immune-mediated. The PRCA2004/2006 study showed that poor responses to immunosuppression and anemia relapse were associated with death. PRCA may represent the prodrome to MDS. Thus, clonal hematopoiesis may be responsible for treatment failure. We investigated gene mutations in myeloid neoplasm-associated genes in acquired PRCA. We identified 21 mutations affecting amino acid sequences in 11 of the 38 adult PRCA patients (28.9%) using stringent filtering of the error-prone sequences and SNPs. Four PRCA patients showed 7 driver mutations in TET2, DNMT3A and KDM6A, and 2 PRCA patients carried multiple mutations in TET2. Five PRCA patients had mutations with high VAFs exceeding 0.3. These results suggest that clonal hematopoiesis by stem/progenitor cells might be related to the pathophysiology of chronic PRCA in certain adult patients.

Coronary artery aneurysms are rare conditions with potentially devastating consequences. We describe the case of an athletic 40-year-old woman who received a diagnosis of giant right coronary artery aneurysm while she was undergoing a work-up for lower extremity varicose veins. She underwent successful surgical treatment without any complications. (Level of Difficulty: Intermediate.)

Cyclophyllidean tapeworms obligatorily parasitize numerous mammalian species, including herbivores, domestic animals and humans, of which, the genera Taenia and Mesocestoides are well characterized. However, little is known about these parasitic infections in wild animals. This study aims to investigate the prevalence and distribution of Taenia sp. and Mesocestoides sp. in wild carnivores in Mongolia by identifying tapeworm species based on mtDNA analysis. The field survey was carried out in 2012–2013 in 19 provinces located in different ecological regions. A total of 405 fecal samples from wild carnivores were collected. Specific DNA markers in fecal samples was detected via copro-DNA analysis and tapeworm species were identified by DNA sequencing. From 27.7% (112/405) of samples, cox1 and 12S rRNA genes of tapeworms were amplified. Further, Taenia hydatigena (50.0%, 56/112) and two Mesocestoides species, including Mesocestoides sp.-1 (36.6%, 41/112) and Mesocestoides sp.-2 (13.4%, 15/112) were identified by DNA sequencing. The prevalence of T. hydatigena was 19.9% (27/136), 13.8% (23/167), 4.8% (3/62), and 7.5% (3/40) in wolves, red foxes, corsac foxes, and snow leopards, respectively. The prevalence of Mesocestoides sp.-1 was 14.7% (20/136), 9% (15/167), 9.7% (6/62) in wolves, red foxes, and corsac foxes, while the prevalence of Mesocestoides sp.-2 was 4.4% (6/136), 1.8% (3/167), 3.2% (2/62), and 10.0% (4/40) in wolves, red foxes, corsac foxes, and snow leopards, respectively. T. hydatigena was found throughout all ecological regions, while Mesocestoides sp.-1 was in the mountain taiga, forest-steppe, steppe, desert-steppe, and desert, and Mesocestoides sp.-2 in the alpine, forest-steppe, steppe, and desert-steppe ecoregions. This study revealed the prevalence and distribution of cyclophyllidean tapeworms in wild carnivores in Mongolia; while also confirming that wolves, red foxes, corsac foxes, and snow leopards serve as definitive hosts for unidentified Mesocestoides species. Keywords: Taenia hydatigena, Mesocestoides sp., cox1 gene, 12S rRNA gene, Wild carnivores, Mongolia

Unilateral arm paralysis is a common symptom of stroke. In stroke patients, we observed that self-guided biomechanical support by the nonparetic arm unexpectedly triggered electromyographic activity with normal muscle synergies in the paretic arm. The muscle activities on the paretic arm became similar to the muscle activities on the nonparetic arm with self-supported exercises that were quantified by the similarity index (SI). Electromyogram (EMG) signals and functional near-infrared spectroscopy (fNIRS) of the patients (n=54) showed that self-supported exercise can have an immediate effect of improving the muscle activities by 40-80% according to SI quantification, and the muscle activities became much more similar to the muscle activities of the age-matched healthy subjects. Using this self-supported exercise, we investigated whether the recruitment of a patient's contralesional nervous system could reactivate their ipsilesional neural circuits and stimulate functional recovery. We proposed biofeedback training with self-supported exercise where the muscle activities were visualized to encourage the appropriate neural pathways for activating the muscles of the paretic arm. We developed the biofeedback system and tested the recovery speed with the patients (n=27) for 2 months. The clinical tests showed that self-support-based biofeedback training improved SI approximately by 40%, Stroke Impairment Assessment Set (SIAS) by 35%, and Functional Independence Measure (FIM) by 20%.

Abstract Background Muscle synergies are now widely discussed as a method for evaluating the existence of redundant neural networks that can be activated to enhance stroke rehabilitation. However, this approach was initially conceived to study muscle coordination during learned motions in healthy individuals. After brain damage, there are several neural adaptations that contribute to the recovery of motor strength, with muscle coordination being one of them. In this study, a model is proposed that assesses motion based on surface electromyography (sEMG) according to two main factors closely related to the neural adaptations underlying motor recovery: (1) the correct coordination of the muscles involved in a particular motion and (2) the ability to tune the effective strength of each muscle through muscle fiber contractions. These two factors are hypothesized to be affected differently by brain damage. Therefore, their independent evaluation will play an important role in understanding the origin of stroke-related motor impairments. Results The model proposed was validated by analyzing sEMG data from 18 stroke patients with different paralysis levels and 30 healthy subjects. While the factors necessary to describe motion were stable across heathy subjects, there was an increasing disassociation for stroke patients with severe motor impairment. Conclusions The clear dissociation between the coordination of muscles and the tuning of their strength demonstrates the importance of evaluating these factors in order to choose appropriate rehabilitation therapies. The model described in this research provides an efficient approach to promptly evaluate these factors through the use of two intuitive indexes.

Abstract Brain damage due to stroke often leaves survivors with lateral functional motor deficits. Bimanual rehabilitation of the paretic arm is an active field of research aimed at restoring normal functionality by making use of the complex neural bindings that exist between the arms. In search of an effective rehabilitation method, we introduced a group of post-stroke rehabilitation patients to a set of bimanual motion tasks with inter-manual coupling and phasing. The surface EMG profiles of the patients were compared in order to understand the effect of the motion conditions. The paretic arms of the patients were more strongly affected by the task conditions compared with the non-paretic arms. These results suggest that in-phase motion may activate neural circuits that trigger recovery. Coupling also had an effect on behavior, but the response of patients was divided between those whom coupling helped or hindered.

Chronic human liver fluke infections caused by Opisthorchis viverrini and Clonorchis sinensis can last for decades and cause liver and biliary diseases, including life-threatening pathology prior to cholangiocarcinoma (CCA). CCA generally has a poor prognosis. Serological diagnosis can support parasitological examination in diagnosing disease and screening for the risk of CCA. Here, we present an improved and innovative lateral flow immunochromatographic test (ICT) kit that uses whole-blood samples (WBS) rather than serum to diagnose human opisthorchiasis, which also successfully diagnosed human clonorchiasis. This ICT includes a soluble worm extract of O. viverrini adults and colloidal-gold-labeled conjugates of the IgG antibody to evaluate the diagnostic values with simulated WBS (n = 347). Simulated WBS were obtained by the spiking infection sera with red blood cells. The diagnostic sensitivity, specificity, positive and negative predictive values, and accuracy for detecting opisthorchiasis were 95.5%, 87.0%, 80.5%, 97.2%, and 90.1%, respectively. For clonorchiasis, these findings were 85.7%, 87.0%, 53.6%, 97.2%, and 86.8%, respectively. Combined for both diseases, they were 93.2%, 87.0%, 84.0%, 94.6%, and 89.6%, respectively. The ICT kit can possibly replace the ICT platforms for antibody detection in serum samples in field surveys in remote areas where sophisticated equipment is not available.

Studies on serum leucine-rich alpha-2 glycoprotein (LRG) in inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), are scarce; the methods for estimating disease activity are less established, particularly for CD. This study is aimed at evaluating the utility of serum LRG as a potential inflammatory marker for IBD and to investigate the LRG gene expression in peripheral blood mononuclear cells (PBMCs) as a possible source of serum LRG. Overall, 98 patients with UC and 96 patients with CD were prospectively enrolled and clinically evaluated; 92 age-matched individuals served as the healthy controls. The blood samples were analyzed for serum LRG levels and routine laboratory parameters. Disease activity was assessed clinically and endoscopically. Finally, LRG gene expression in the PBMCs from a different cohort (41 patients with UC, 34 patients with CD, and 30 healthy controls) was examined. The serum LRG levels were higher during active disease than during inactive disease; additionally, serum LRG levels were positively correlated with clinical disease activity, C-reactive protein (CRP) levels, and other laboratory parameters in patients with UC and CD and with endoscopic disease activity in UC. UC and CD showed comparable areas under the curve (AUC) values for determining clinical remission and differentiating between endoscopic remission associated with LRG and CRP. The levels of LRG mRNA were also increased in PBMCs from patients with UC and CD and reflected disease activity. These data suggest that serum LRG, originated partially from PBMCs, is an inflammatory marker in UC and CD. A large-scale well-designed study should be conducted in the future to more accurately reveal the clinical significance of LRG in patients with IBD.

Toxocariasis is a zoonotic helminthiasis caused by the migrating larvae of Toxocara canis and T. cati, common roundworms of dogs and cats. Our previous study in Savannakhet Province of Lao PDR showed an infection rate of 44.1% of Toxocara spp. in dogs. Thus, we investigate if this previous high prevalence in the definitive hosts influenced the occurrence of human toxocariasis. For that we used a 38 kDa recombinant protein derived from T. canis larvae excretion secretion products in ELISA. Human serum samples were collected in the Lahanam area of Savannakhet province. The population attending the study in Lahanam village were aged from 7 to 59 years old (y/o) 65.9% (54/82) were male and 34.1% (28/82) were female. The total percentage of seropositivity to Toxocara sp. was 30.4% (25/82). Males were more likely to test positive for toxocariasis with a risk ratio of 2.70 (CI95 0.87–4.93). No significant differences between ages were seen. However, it was possible to observe an increase of optical density (OD) values in ELISA according to age. The awareness of the health system on the high prevalence of seropositivity to Toxocara sp. in Savannakhet can prevent irreversible consequences as permanent vision loss and seizures caused by this silent chronic disease revealed in the Lahanam area.

Thirteen species of Echinoderes with nearly identical spine/tube patterns, and apparently similar tergal extensions were re-examined and compared. Based on this, redescriptions and/or emended species diagnoses are provided for Echinoderes aureus, E. dujardinii, E. gerardi, E. imperforatus, E. pacificus, E. pilosus, E. sensibilis, E. sublicarum and E. worthingi, and new details about cuticular structures are added for E. kozloffi and E. gizoensis. The new information derived from the redescriptions, and the subsequent comparative studies revealed that: 1) the holotype of Echinoderes lanceolatus is identical with the types of Echinoderes aureus, and E. lanceolatus is thus a junior synonym of E. aureus; other potentially synonymous species that should be addressed further in the future include: E. dujardinii + E. gerardi; E. imperforatus + E. sensibilis, and E. pacificus + E. sublicarum; 2) the paratypes of E. lanceolatus represented a different yet undescribed species, here described as E. songae Sørensen & Chang sp. nov.; 3) a comparison with literature information about E. ehlersi showed that the species is so insufficiently described that a redescription of topotype material is required before the species should be considered for taxonomic comparison; 4) specimens from the Andaman Islands, India, that previously have been reported as Echinoderes cf. ehlersi represent two different undescribed species, of which one is described as E. chandrasekharai Sørensen & Chatterjee sp. nov. and the other is left undescribed due to the limited material available; 5) out of a total of fifteen addressed species, it is proposed that eleven represent a putatively monophyletic group that is named the Echinoderes dujardinii group. The group includes following species: E. dujardinii, E. ehlersi, E. gerardi, E. imperforatus, E. kozloffi, E. sensibilis, E. pacificus, E. sublicarum, E. songae Sørensen & Chang sp. nov., E. chandrasekharai Sørensen & Chatterjee sp. nov., and Echinoderes sp. from the Andaman Islands, and is supported by a similar spine/tube pattern (except for variation regarding the presence of lateral accessory tubes on segment 8); generally short middorsal spines, especially on segments 4 to 6; glandular cell outlets type 1 always present in middorsal positions on segments 1 to 3, and in subdorsal positions on segments 4 to 9; glandular cell outlets type 2 always present in laterodorsal or midlateral positions on segment 8, and sometimes in same positions on segment 9 but never at any other segments or positions; female papillae always present on sternal plates of segments 7 and 8, and occasionally also on segment 6; tergal extensions well-spaced, triangular, gradually tapered cones, and pectinate fringes of sternal extensions are differentiated into seta-like tufts. The comparisons furthermore showed potential taxonomic significance of two echinoderid character traits that previously have been slightly neglected as diagnostic traits, namely the presence and appearance of female papillae, and the dorsal pattern of glandular cell outlets type 1. Female papillae may occur on the sternal plates of segments 6 to 8, but the positions may differ from ventrolateral to ventromedial, and the morphology of the intracuticular substructure also differ at species level. Information about position and morphology of female papillae proved helpful for species recognition, but it might also provide information of phylogenetic importance. Analyses of glandular cell outlet type 1 patterns on the dorsal sides of segments 1 to 9 in species of Echinoderidae, revealed several apparently unique or rare patterns, but also three distinct patterns that applied to larger groups of species. One pattern is the one present in all species of the E. dujardinii group, whereas the other two common patterns included 1) middorsal outlets on segments 1 to 3, and paradorsal outlets on segments 4 to 9 (found in 27 species), and 2) middorsal outlets on segments 1 to 3, 5 and 7, and paradorsal outlets on segments 4, 6 and 8 to 9 (found in 27 species)

We report 958 cases of cestodiasis occurring in Japan during 2001–2016. The predominant pathogen was Diphyllobothrium nihonkaiense tapeworm (n = 825), which caused 86.1% of all cases. The other cestode species involved were Taenia spp. (10.3%), Diplogonoporus balaenopterae (3.3%), and Spirometra spp. (0.2%). We estimated D. nihonkaiense diphyllobothriasis incidence as 52 cases/year. We observed a predominance of cases during March–July, coinciding with the cherry salmon and immature chum salmon fishing season, but cases were present year-round, suggesting that other fish could be involved in transmission to humans. Because of increased salmon trade, increased tourism in Japan, and lack of awareness of the risks associated with eating raw fish, cases of D. nihonkaiense diphyllobothriasis are expected to rise. Therefore, information regarding these concerning parasitic infections and warnings of the potential risks associated with these infections must be disseminated to consumers, food producers, restaurant owners, physicians, and travelers.

Kinorhynchs rarely show a wide distribution pattern, due to their putatively low dispersal capabilities and/or limited sampling efforts. In this study, a new kinorhynch species is described, Echinoderes pterus sp. n., which shows a geographically and bathymetrically wide distribution, occurring on the Karasik Seamount and off the Svalbard Islands (Arctic Ocean), on the Sedlo Seamount (northeast Atlantic Ocean), and on the deep-sea floor off Crete and on the Anaximenes Seamount (Mediterranean Sea), at a depth range of 675–4,403 m. The new species is characterized by a combination of middorsal acicular spines on segments 4–8, laterodorsal tubes on segment 10, lateroventral tubes on segment 5, lateroventral acicular spines on segments 6–9, tufts of long hairs rising from slits in a laterodorsal position on segment 9, truncated tergal extensions on segment 11, and the absence of any type-2 gland cell outlet. The specimens belonging to the populations from the Arctic Ocean, the Sedlo Seamount, and the Mediterranean Sea show morphological variation in the thickness and length of the spines as well as in the presence/absence of ventromedial sensory spots on segment 7. The different populations are regarded as belonging to a single species because of their overlapping variable characters.

Background: Although muscle ultrasound (MUS) is known to facilitate the diagnosis and evaluation of the severity of amyotrophic lateral sclerosis (ALS), the number of fasciculation has been scarcely examined as a predictive marker of the prognosis in ALS. Objective: The objective of this study was to examine the predictive value of fasciculation number for the prognosis of ALS. Materials and Methods: We examined fasciculation count (FasC), defined as the number of fasciculation per unit of time and area in MUS, of 11 patients with clinically probable or definite ALS. Thereafter, they were observed for maximally 2 years, unless they reached the endpoint of decease or receiving tracheostomy. Results: Six patients, who thereafter reached the endpoint within 2 years, had significantly higher FasC (223 [49.3] vs. 34 [13], P = 0.0043) and shorter disease duration (7 [2.3] vs. 33 [17], P = 0.0022) at MUS than the remaining five patients without reaching the endpoint. Discussion and Conclusion: Our study suggested that high FasC in MUS can predict rapid progression in ALS. Due to the limitations such as small sample size, suboptimal length of the observational period, and confounding factor of disease duration, further investigations are required.

Human gnathostomiasis is a harmful food-borne zoonosis caused by roundworms of the genus Gnathostoma. The parasite can occasionally migrate to the central nervous system, causing life-threatening disease and death. Here, we report a new point-of-care (POC) test kit, the gnathostomiasis blood immunochromatographic test (GB-ICT) kit. The kit is based on recombinant Gnathostoma spinigerum antigen and detects specific IgG4 antibody in whole-blood samples (WBSs). The GB-ICT kit showed potentially high diagnostic values with simulated WBSs (n = 248), which were obtained by spiking patients’ sera with red blood cells. The accuracy, sensitivity, specificity, and positive and negative predictive values were 95.2%, 100%, 93.8%, 81.5%, and 100%, respectively. Ten WBSs from clinically suspected gnathostomiasis patients were all positive according to the GB-ICT kit, while 10 WBSs from healthy volunteers were negative. The GB-ICT kit is a simple and convenient POC testing tool using finger-prick blood samples: venous blood sampling and serum separation processes are not required. The GB-ICT kit can support clinical diagnosis in remote areas and field settings without sophisticated equipment facilities.

We examined the expression profile of transient receptor potential (TRP) channels in peripheral blood mononuclear cells (PBMCs) from patients with inflammatory bowel disease (IBD). PBMCs were obtained from 41 ulcerative colitis (UC) patients, 34 Crohn’s disease (CD) patients, and 30 normal subjects. mRNA levels of TRP channels were measured using the quantitative real-time polymerase chain reaction, and correlation tests with disease ranking, as well as laboratory parameters, were performed. Compared with controls, TRPV2 and TRPC1 mRNA expression was lower, while that of TRPM2, was higher in PBMCs of UC and CD patients. Moreover, TRPV3 mRNA expression was lower, while that of TRPV4 was higher in CD patients. TRPC6 mRNA expression was higher in patients with CD than in patients with UC. There was also a tendency for the expression of TRPV2 mRNA to be negatively correlated with disease activity in patients with UC and CD, while that of TRPM4 mRNA was negatively correlated with disease activity only in patients with UC. PBMCs from patients with IBD exhibited varying mRNA expression levels of TRP channel members, which may play an important role in the progression of IBD.

Tapeworm (cestode) infections occur worldwide even in developed countries and globalization has further complicated the epidemiology of such infections. Nonetheless, recent epidemiological data on cestode infections are limited. Our objectives were to elucidate the clinical characteristics and epidemiology of diphyllobothriosis and taeniosis in Tokyo, Japan.We retrospectively reviewed 24 cases of human intestinal cestode infection from January 2006 to December 2015 at a tertiary referral hospital in Tokyo, Japan. The patients included were diagnosed with cestode infection based on morphological and/or molecular identification of expelled proglottids and/or eggs and treated in our hospital. Fifteen and 9 patients were diagnosed with diphyllobothriosis and taeniosis, respectively. The median patient age was 31 years (interquartile range [IQR]: 26-42 years), and 13 (54%) were male. Most of the patients (91.7%) were Japanese. All patients were successfully treated with praziquantel without recurrence. Diphyllobothriosis was caused by Diphyllobothrium nihonkaiense in all patients. Taeniosis was due to infection of Taenia saginata in 8 [88.9%] patients and T. asiatica in 1 [11.1%] patient. All patients with taeniosis were infected outside Japan, as opposed to those with diphyllobothriosis, which were domestic. The source locations of taeniosis were mostly in developing regions. The median duration of the stay of the patients with taeniosis at the respective source location was 1 month (IQR: 1-8).The cestode infection, especially with D. nihonkaiense, has frequently occurred, even in Japanese cities, thereby implicating the probable increase in the prevalence of diphyllobothriosis among travelers, as the number of travelers is expected to increase owing to the Tokyo Olympics/Paralympics in 2020. In addition, medical practitioners should be aware of the importance of providing advice to travelers to endemic countries of taeniosis, including the potential risks of infection and preventive methods for these infections.

Two new species belonging to the Echinoderes coulli group are described with their external morphologies and sequences of nuclear 18S rRNA and 28S rRNA genes, and mitochondrial COI gene. The first species, Echinoderes komatsui sp. n., is characterized by absence of acicular spines, and presence of lateroventral tubules on segments 5 and 8, laterodorsal tubules on segment 10, inverted triangle or wide oval shaped large sieve plates, lateral terminal accessory spines in female, and short tips of ventral pectinate fringe on segment 10. The second species, Echinoderes hwiizaa sp. n., is characterized by absence of acicular spines, and presence of lateroventral tubules on segments 5 and 7–9, midlateral tubules on segment 8, laterodorsal tubules on segment 10, large narrow oval shaped sieve plates on segment 9, and thick, short and blunt lateral terminal spines about 10–15% of trunk length. The diagnostic characters and key to species of E.coulli group are provided as well.

The cause of diphyllobothriosis in 5 persons in Harbin and Shanghai, China, during 2008–2011, initially attributed to the tapeworm Diphyllobothrium latum, was confirmed as D. nihonkaiense by using molecular analysis of expelled proglottids. The use of morphologic characteristics alone to identify this organism was inadequate and led to misidentification of the species.

The body surface of aquatic invertebrates is generally thought to be hydrophilic to prevent the attachment of air bubbles. In contrast, some interstitial invertebrates, such as kinorhynchs and some crustaceans, have a hydrophobic body surface: they are often trapped at the water surface when the sediment in which they reside is mixed with air and water. Here, we directly measured the wettability of the body surface of the kinorhynch Echinoderes komatsui, using a microscopic contact angle meter. The intact body surface of live specimens was not hydrophobic, but the anterior part was less hydrophilic. Furthermore, washing with seawater significantly decreased the wettability of the body surface, but a hydrophilic surface was recovered after a 1 h incubation in seawater. We believe that the hydrophobic cuticle of the kinorhynch has a hydrophilic coat that is readily exfoliated by disturbance. Ultrastructural observations supported the presence of a mucus-like coating on the cuticle. Regulation of wettability is crucial to survival in shallow, fluctuating habitats for microscopic organisms and may also contribute to expansion of the dispersal range of these animals.

Depression is one of the most prevalent and livelihood-threatening forms of mental illnesses and the neural circuitry underlying depression remains incompletely understood. Recent studies suggest that the neuronal plasticity involved with brain-derived neurotrophic factor (BDNF) plays an important role in the recovery from depression. Some antidepressants are reported to induce BDNF expression in vivo; however, the mechanisms have been considered solely in neurons and not fully elucidated. In the present study, we evaluated the effects of imipramine, a classic tricyclic antidepressant drug, on BDNF expression in cultured rat brain astrocytes. Imipramine dose-dependently increased BDNF mRNA expression in astrocytes. The imipramine-induced BDNF increase was suppressed with inhibitors for protein kinase A (PKA) or MEK/ERK. Moreover, imipramine exposure activated transcription factor cAMP response element binding protein (CREB) in a dose-dependent manner. These results suggested that imipramine induced BDNF expression through CREB activation via PKA and/or ERK pathways. Imipramine treatment in depression might exert antidepressant action through BDNF production from astrocytes, and glial BDNF expression might be a target of developing novel antidepressants. Keywords:: astrocyte, antidepressant drug, brain-derived neurotrophic factor (BDNF), protein kinase A (PKA), cAMP response element binding protein (CREB)

Background/Aims: Frontal lobe dysfunction is believed to be a primary cognitive symptom in idiopathic normal pressure hydrocephalus (iNPH); however, the neuropsychology of this disorder remains to be fully investigated. The objective of this study was to delineate a comprehensive profile of cognitive dysfunction in iNPH and evaluate the effects of cerebrospinal fluid (CSF) shunt surgery on cognitive dysfunction. Methods: A total of 32 iNPH patients underwent neuropsychological testing of memory, attention, language, executive function, and visuoperceptual and visuospatial abilities. Of these 32 patients, 26 were reevaluated approximately 1 year following CSF shunt surgery. The same battery of tests was performed on 32 patients with Alzheimer’s disease (AD) and 30 healthy elderly controls. Results: The iNPH patients displayed baseline deficits in attention, executive function, memory, and visuoperceptual and visuospatial functions. Impairments of attention, executive function, and visuoperceptual and visuospatial abilities in iNPH patients were more severe than in those with AD, whereas the degree of memory impairment was comparable to that in AD patients. A significant improvement in executive function was observed following shunt surgery. Conclusion: Patients with iNPH are impaired in various aspects of cognition involving both ‘frontal’ executive functions and ‘posterior cortical’ functions. Shunt treatment can ameliorate executive dysfunction.

Primary sclerosing cholangitis (PSC) is an autoimmune disease of the hepatobiliary system for which effective therapy has not been established. Leukocytapheresis (LCAP) therapy is known to effective in patients with ulcerative colitis (UC). In addition, effects of LCAP therapy were reported on some autoimmune diseases such as Crohn’s disease, rheumatoid arthritis and rapidly progressive glomerulonephritis. Here we report the case of a 29-year-old man with PSC associated with UC who was treated with LCAP therapy. He had a 16-year history of UC and a 12-year history of PSC. Although he was under treatment with prednisolone and ursodeoxycholic acid, exacerbation of UC and PSC-associated cholestasis were seen. Since he showed side effects of prednisolone, he was treated with LCAP. Not only improvement of UC, but also decreased serum alkaline phosphatase, γ-guanosine triphosphate and total bile acids, suggesting improvement of PSC-associated cholestaisis, were seen after treatment with LCAP. Our experience with this case suggests that LCAP therapy could be a new effective therapeutic strategy for patients with PSC associated with UC.

The phylogeny of Kinorhyncha was analyzed using morphology and the molecular loci 18S rRNA and 28S rRNA. The different datasets were analyzed separately and in combination, using maximum likelihood and Bayesian Inference. Bayesian inference of molecular sequence data in combination with morphology supported the division of Kinorhyncha into two major clades: Cyclorhagida comb. nov. and Allomalorhagida nom. nov. The latter clade represents a new kinorhynch class, and accommodates Dracoderes, Franciscideres, a yet undescribed genus which is closely related with Franciscideres, and the traditional homalorhagid genera. Homalorhagid monophyly was not supported by any analyses with molecular sequence data included. Analysis of the combined molecular and morphological data furthermore supported a cyclorhagid clade which included all traditional cyclorhagid taxa, except Dracoderes that no longer should be considered a cyclorhagid genus. Accordingly, Cyclorhagida is divided into three main lineages: Echinoderidae, Campyloderidae, and a large clade, 'Kentrorhagata', which except for species of Campyloderes, includes all species with a midterminal spine present in adult individuals. Maximum likelihood analysis of the combined datasets produced a rather unresolved tree that was not regarded in the following discussion. Results of the analyses with only molecular sequence data included were incongruent at different points. However, common for all analyses was the support of several major clades, i.e., Campyloderidae, Kentrorhagata, Echinoderidae, Dracoderidae, Pycnophyidae, and a clade with Paracentrophyes + New Genus and Franciscideres (in those analyses where the latter was included). All molecular analyses including 18S rRNA sequence data furthermore supported monophyly of Allomalorhagida. Cyclorhagid monophyly was only supported in analyses of combined 18S rRNA and 28S rRNA (both ML and BI), and only in a restricted dataset where taxa with incomplete information from 28S rRNA had been omitted. Analysis of the morphological data produced results that were similar with those from the combined molecular and morphological analysis. E.g., the morphological data also supported exclusion of Dracoderes from Cyclorhagida. The main differences between the morphological analysis and analyses based on the combined datasets include: 1) Homalorhagida appears as monophyletic in the morphological tree only, 2) the morphological analyses position Franciscideres and the new genus within Cyclorhagida near Zelinkaderidae and Cateriidae, whereas analyses including molecular data place the two genera inside Allomalorhagida, and 3) species of Campyloderes appear in a basal trichotomy within Kentrorhagata in the morphological tree, whereas analysis of the combined datasets places species of Campyloderes as a sister clade to Echinoderidae and Kentrorhagata.

We have reported that connexin (Cx) 32 acts as a tumor suppressor gene in renal cancer cells partly due to Her-2 inactivation. Here, we determined if a Her-2/Her-1 inhibitor (PKI-166) can enhance the tumor-suppressive effect of Cx32 in Caki-2 cells from human renal cell carcinoma. The expression of Cx32 in Caki-2 cells was required for PKI-166-induced cytotoxic effect at lower doses. The cyctotoxicity was dependent on the occurrence of apoptosis and partly mediated by Cx32-driven gap junction intercellular communications. These results suggest that PKI-166 further supports the tumor-suppressive effect of the Cx32 gene in renal cancer cells through the induction of apoptosis. Keywords:: connexin 32, PKI-166, renal cancer cell

Taenia saginata, T. solium, and T. asiatica are causative agents of taeniasis in humans. The difficulty of morphological identification of human taeniids can lead to misdiagnosis or confusion. To overcome this problem, several molecular methods have been developed, but use of these tends to be time-consuming. Here, a rapid and high-throughput pyrosequencing approach was developed for the identification of three human taeniids originating from various countries. Primers targeting the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene of the three Taenia species were designed. Variations in a 26-nucleotide target region were used for identification. The reproducibility and accuracy of the pyrosequencing technology was confirmed by Sanger sequencing. This technique will be a valuable tool to distinguish between sympatric human taeniids that occur in Thailand, Asia and Pacific countries. This method could potentially be used for the molecular identification of the taeniid species that might be associated with suspicious cysts and lesions, or cyst residues in humans or livestock at the slaughterhouse.

The role of docosahexaenoic acid (DHA) in the fluidity of the annular lipid regions and their associated membrane-bound proteins is still not as well understood as that in the global (bulk) lipid regions. We therefore studied the effects of dietary DHA on the relationship between annular and global lipid fluidity and membrane-bound enzymes such as 5′-nucleotidase and Mg2+-ATPase in the rat bile canalicular membrane. Dietary DHA caused significant increases in 5′-nucleotidase and Mg2+-ATPase activity and in global and annular lipid fluidity, a higher increase in fluidity in the annular lipids than the global lipids, and a decrease in the cholesterol-to-phospholipid molar ratio in the canalicular membrane. Plasma total cholesterol and LDL cholesterol decreased, and fecal cholesterol increased in the DHA-fed rats. No changes were observed in oxidative markers, but glutathione peroxidase increased in the liver with DHA feeding. Annular lipid fluidity, but not global lipid fluidity, correlated remarkably well with DHA, synchronously with the activities of 5′-nucleotidase and Mg2+-ATPase. The data indicate that the DHA-induced increase in annular lipid fluidity is responsible for the increases observed in the enzyme activity.We therefore concluded that the increased activity of membrane-bound enzymes and transporters induced by DHA and the concomitant increase in annular lipid fluidity comprise one of the mechanisms involved in DHA-induced clearance of plasma cholesterol.—Hashimoto, M., M. S. Hossain, T. Shimada, H. Yamasaki, Y. Fujii, and O. Shido. Effects of docosahexaenoic acid on annular lipid fluidity of the rat bile canalicular plasma membrane. J. Lipid Res. 2001. 42: 1160–1168.

Immunodetection of human IgG anti-Toxocara canis was developed based on ELISA and on the use of polysiloxane/polyvinyl alcohol (POS/PVA) beads. A recombinant antigen was covalently immobilized, via glutaraldehyde, onto this hybrid inorganic-organic composite, which was prepared by the sol-gel technique. Using only 31.2 ng antigen per bead, a peroxidase conjugate dilution of 1:10,000 and a serum dilution of 1:200 were adequate for the establishment of the procedure. This procedure is comparable to that which utilizes the adsorption of the antigen to conventional PVC plates. However, the difference between positive and negative sera mean absorbances was larger for this new glass based assay. In addition to the performance of the POS/PVA bead as a matrix for immunodetection, its easy synthesis and low cost are additional advantages for commercial application.

Left main coronary artery (LMCA) thrombus is a clinically rare event and is thought to be secondary to plaque rupture with subsequent thrombus formation, persistent hypercoagulable state, cocaine use, or vasospasm. (Klein et al., 2008) here we present a case of LMCA thrombus that presented as an ST elevation myocardial infarction (STEMI) in a hypercoagulable patient.

BackgroundBoth epilepsy and paragonimiasis had been known to be endemic in Southwest Cameroon. A total of 188 people (168 and 20 with and without symptoms confirmed by clinicians, respectively, 84.6% under 20 years old) were selected on a voluntary basis. Among 14 people (8.3%) with history of epilepsy, only one suffered from paragonimiasis. Therefore, we challenged to check antibody responses to highly specific diagnostic recombinant antigens for two other helminthic diseases, cysticercosis and toxocariasis, expected to be involved in neurological diseases. Soil-transmitted helminthic infections were also examined.Methodology/principal findingsFecal samples were collected exclusively from the 168 people. Eggs of Ascaris lumbricoides, Trichuris trichiura and hookworms were found from 56 (33.3%), 72 (42.8%), and 19 (11.3%) persons, respectively. Serology revealed that 61 (36.3%), 25 (14.9%) and 2 (1.2%) of 168 persons showed specific antibody responses to toxocariasis, paragonimiasis and cysticercosis, respectively. By contrast, 20 people without any symptoms as well as additional 20 people from Japan showed no antibody responses. Among the 14 persons with epilepsy, 5 persons were seropositive to the antigen specific to Toxocara, and one of them was simultaneously positive to the antigens of Paragonimus. The fact that 2 children with no history of epilepsy were serologically confirmed to have cysticercosis strongly suggests that serological survey for cysticercosis in children is expected to be useful for early detection of asymptomatic cysticercosis in endemic areas.Conclusions/significanceAmong persons surveyed, toxocariasis was more common than paragonimiasis, but cysticercosis was very rare. However, the fact that 2 children were serologically confirmed to have cysticercosis was very important, since it strongly suggests that serology for cysticercosis is useful and feasible for detection of asymptomatic cysticercotic children in endemic areas for the early treatment.

Using a specific enzyme-linked immunosorbent assay, IL-10 concentrations were measured in serum from 62 patients with ulcerative colitis (UC), 43 with Crohn's disease (CD), 25 with other colitides, and 44 normal control subjects. Serum IL-10 concentrations were increased in patients with active UC but not in those with active CD when compared with normal control subjects. A time course study showed that in patients with UC and CD, serum concentrations of IL-6 and C-reactive protein increased during the acute phase and returned to normal as patients go into remission. Notably, serum IL-10 concentrations increased during the phase of disease resolution and declined thereafter regardless of the treatment modality. Gel filtration analysis indicated that IL-10 circulated predominantly as a dimer. In conclusion, this study shows that serum IL-10 is increased during disease recovery in patients with inflammatory bowel disease, and may be a helpful marker in monitoring disease status.

We confirmed sympatric occurrence of Taenia solium, T. saginata, and T. asiatica in western Thailand. DNA analysis of morphologically identified T. saginata, in a dual infection with T. solium, indicated it was T. asiatica. To our knowledge, this report is the first of T. asiatica and a dual Taenia infection from Thailand.

Spirometra infections in companion animals and wildlife in Japan have been diagnosed based on the morphology of the adult worms and eggs, and the etiological agent has been mainly ascribed to Spirometra erinaceieuropaei. However, recent studies have revealed that two other species, Spirometra mansoni and Spirometra asiana, coexist in Japan. Spirometra asiana is a new species recently discovered in Japan. Although morphological discrimination between these two species is difficult, molecular identification is useful. Therefore, to understand which species commonly parasitizes companion animals and wildlife in Japan, a preliminary study was performed based on mitochondrial DNA analysis. Eleven adult worms examined were identified as S. mansoni, suggesting that S. mansoni infects companion animals and wildlife commonly than S. asiana in Japan. [ABSTRACT FROM AUTHOR]