In this report, we describe unilateral medial pontomedullary junction (MPMJ) syndrome as a novel brain stem stroke syndrome. A 68-year-old woman suddenly developed vertigo, ipsilateral facial paresis, contralateral thermal hypoalgesia (TH) and dysphagia without lateral gaze palsy, curtain sign and hoarseness. Magnetic resonance (MR) imaging showed a small infarction at the right MPMJ. MR angiography did not show vertebrobasilar arterial dissection, thrombosis or vasospasm. Finally, her dysphagia regressed over 4 weeks in synchronization with recovery of TH. To the best of our knowledge and based on a review of the literature, this MPMJ syndrome associated with the unilateral MPMJ infarction is a novel brain stem stroke syndrome different from Foville syndrome, Millard-Gubler syndrome, Wallenberg syndrome or Dejerine's syndrome. In the MPMJ syndrome, transient, albeit severe, dysphagia based on the TH-impaired swallowing reflex bothered the patient more than hemiparesthesia of TH did.
Pituitary tumor apoplexy is a rare clinical syndrome caused by acute hemorrhage or infarction in a preexisting pituitary adenoma. It typically manifests as an acute episode of headache, visual disturbance, mental status changes, cranial nerve palsy, and endocrine pituitary dysfunction. However, not all patients present with classical symptoms, so it is pertinent to appreciate the clinical spectrum of pituitary tumor apoplexy presentation. We report an unusual case of a patient with pituitary tumor apoplexy who presented with periorbital edema associated with hypopituitarism. An 83-year-old Japanese man developed acute anterior hypopituitarism; he showed anorexia, fatigue, lethargy, severe bilateral periorbital edema, and mild cardiac dysfunction in the absence of headache, visual disturbance, altered mental status, and cranial nerve palsy. Magnetic resonance imaging showed a 2.5-cm pituitary tumor containing a mixed pattern of solid and liquid components indicating pituitary tumor apoplexy due to hemorrhage in a preexisting pituitary adenoma. Replacement therapy with oral hydrocortisone and levothyroxine relieved his symptoms of central adrenal insufficiency, central hypothyroidism, periorbital edema, and cardiac dysfunction. Common causes of periorbital edema include infections, inflammation, trauma, allergy, kidney or cardiac dysfunction, and endocrine disorders such as primary hypothyroidism. In the present case, the patient’s acute central hypothyroidism was probably involved in the development of both periorbital edema and cardiac dysfunction. The present case highlights the need for physicians to consider periorbital edema as an unusual predominant manifestation of pituitary tumor apoplexy.
Greenhouse gas emissions and following global climate change problems are the most important human-being facing issues. The electrochemical CO 2 reduction reaction (CO 2 RR) is one of the most promising processes to obtain value-added hydrocarbons from carbon dioxide (CO 2 ) and water (H 2 O), and the process is being actively investigated as an alternative way to conventional hydrocarbon production by fossil resources. Among the electrocatalysts for CO 2 RR, copper (Cu) species are unique and most studied material group because of their capability of producing C 2+ species, such as ethylene (C 2 H 4 ), ethanol (C 2 H 5 OH) and propanol, through forming C-C bonding. Especially C 2 H 4 is the most highly demanded and profitable product [1] . Porous structure of electrodes is reported to be advantageous to CO 2 RR because it enables enrichment of reactants, CO 2 molecules, and intermediates [2–5] . Polytetrafluoroethylene (PTFE), a hydrophobic polymer, has been reported to be beneficial to increase the FE towards C 2+ products [6] and suppressing competitive reaction, hydrogen production [7,8] . In this study, we prepared PTFE modified porous Cu electrodes and investigated the influence of each factor and their synergistic effect on CO 2 RR activity. As a result, the introduction of porous structure increased FE to C 2 H 4 (FE(C 2 H 4 )) and suppressed both carbon monoxide (CO) and methane (CH 4 ) production. Further modification by PTFE enhanced FE(C 2 H 4 ) and improved durability significantly. Porous Cu electrode was prepared by de-alloying process [9] . First, Cu and Al metals were co-sputtered to form CuAl alloy on gas-diffusion layer (GDL, MFK-A, Mitsubishi Chemical) coated with micro porous layer (MPL). The samples were etched using 5 wt.% hydrochloric acid for approximately 20 minutes to remove Al from the alloy and obtained porous Cu electrodes. CO 2 RR test was carried out in flow cell with gas-diffusion electrode (GDE), the electrocatalyst coated GDL, as a cathode under applied current density of 300 mA cm -2 . Both gas phase products and liquidous products were quantified by gas chromatography (GC). Structural characterizations using scanning electron microscope (SEM) confirmed that porous Cu structure was successfully formed, and porous Cu electrodes exhibited higher FE(C 2 H 4 ) of 48%, and lower FE toward CO (FE(CO)) of 6% and FE toward CH 4 (FE(CH 4 )) of less than detection limit, while smooth Cu electrode showed FE(C 2 H 4 ) of 45%, FE(CO) of 12%, FE(CH 4 ) of 0.6%, respectively. However, FE(C 2 H 4 ) started to decrease 6 hours after the start of the reaction and decreased to 12% after 24 hours reaction. This could be caused by GDE soaking to electrolyte. To overcome these issues, we next investigated PTFE added porous Cu electrodes. PTFE was introduced into the porous Cu layer by electrostatic spray [10] .The introduction of PTFE further improved FE(C 2 H 4 ) from 48% to 55% and demonstrated over 80% of FE towards valuable C 2+ products at 300 mA cm -2 . PTFE introduction enhanced durability and resulted in FE(C 2 H 4 ) of 55% for over 24 hours. References [1] S. Nitopi, E. Bertheussen, S. B. Scott, X. Liu, A. K. Engstfeld, S. Horch, B. Seger, I. E. L. Stephens, K. Chan, C. Hahn, J. K. Nørskov, T. F. Jaramillo, I. Chorkendorff, Chem. Rev. 2019 , 119 , 7610–7672. [2] E. G. Derouane, J.-M. André, A. A. Lucas, Chem. Phys. Lett. 1987 , 137 , 336–340. [3] J.-J. Lv, M. Jouny, W. Luc, W. Zhu, J.-J. Zhu, F. Jiao, Adv. Mater. 2018 , 30 , e1803111. [4] T. T. H. Hoang, S. Ma, J. I. Gold, P. J. A. Kenis, A. A. Gewirth, ACS Catal. 2017 , 7 , 3313–3321. [5] W. Tang, A. A. Peterson, A. S. Varela, Z. P. Jovanov, L. Bech, W. J. Durand, S. Dahl, J. K. Nørskov, I. Chorkendorff, Phys. Chem. Chem. Phys. 2012 , 14 , 76–81. [6] J. Pellessier, X. Gong, B. Li, J. Zhang, Y. Gang, K. Hambleton, C. Podder, Z. Gao, H. Zhou, G. Wang, H. Pan, Y. Li, J. Mater. Chem. A Mater. Energy Sustain. 2023 , 11 , 26252–26264. [7] F. Huq, I. Sanjuán, S. Baha, M. Braun, A. Kostka, V. Chanda, J. R. C. Junqueira, N. Sikdar, A. Ludwig, C. Andronescu, ChemElectroChem 2022 , 9 , DOI 10.1002/celc.202101279. [8] P. An, L. Wei, H. Li, B. Yang, K. Liu, J. Fu, H. Li, H. Liu, J. Hu, Y.-R. Lu, H. Pan, T.-S. Chan, N. Zhang, M. Liu, J. Mater. Chem. A Mater. Energy Sustain. 2020 , 8 , 15936–15941. [9] M. Zhong, K. Tran, Y. Min, C. Wang, Z. Wang, C.-T. Dinh, P. De Luna, Z. Yu, A. S. Rasouli, P. Brodersen, S. Sun, O. Voznyy, C.-S. Tan, M. Askerka, F. Che, M. Liu, A. Seifitokaldani, Y. Pang, S.-C. Lo, A. Ip, Z. Ulissi, E. H. Sargent, Nature 2020 , 581 , 178–183. [10] Z. Xing, L. Hu, D. S. Ripatti, X. Hu, X. Feng, Nat. Commun. 2021 , 12 , 136.
Fecal calprotectin (Fcal) as well as the fecal immunochemical test (FIT) are useful biomarkers for detecting activity and mucosal healing in inflammatory bowel diseases. Here, we report the performance of simultaneous measurements of Fcal and FIT for ulcerative colitis (UC) patients using the newly-developed latex agglutination turbidimetric immunoassay (LATIA) system.Fcal and hemoglobin were measured by the LATIA system in 152 UC patients who underwent colonoscopy. Fcal was also quantified with a conventional enzyme-linked immunosorbent assay (ELISA). Fecal markers were evaluated in conjunction with the mucosal status of UC, which was assessed via the Mayo endoscopic subscore (MES) classification.The LATIA system could quantify calprotectin and hemoglobin simultaneously with the same fecal samples within 10 minutes. The values of the Fcal-LATIA closely correlated with those of the Fcal-ELISA (Spearman rank correlation coefficient, r=0.84; P<0.0001). The values of Fcal for each assay and the FIT all significantly correlated with the MESs (Spearman rank correlation coefficient, Fcal-LATIA: r=0.58, Fcal-ELISA: r=0.55, and FIT: r=0.72). The mucosal healing predictability (determined by an MES of 0 alone) of the Fcal-LATIA, Fcal-ELISA, and FIT-LATIA with the cutoffs determined by receiver operating characteristic curve analysis was 0.79, 0.78, and 0.92 for sensitivity, respectively, and 0.78, 0.69, and 0.73 for specificity, respectively.The performance of the novel Fcal-LATIA was equivalent to that of the conventional Fcal assay. Simultaneous measurements with FITs would promote the clinical relevance of fecal biomarkers in UC.
Embryonic stem (ES) cells have generated enormous interest because of their capacity to self-renew and differentiate into various cell types in vitro. Although numerous problems are encountered in the use of ES cells for regenerative medicine, such as ethical issues associated with the use of stem cells established from terminated human embryos and immunorejection due to transplantation of allogenic ES cell-derived cells into patients, recent technologies to generate induced pluripotent stem (iPS) cells from adult somatic cells have provided alternative ways to access pluripotent stem cells (Takahashi et al., 2007). However, the practical application of these pluripotent stem cells has yet to emerge, and regulatory mechanisms are not well known. Moreover, precise differentiation methodologies of ES and iPS cells have not been developed. These problems cause difficulties in the manipulation of pluripotent stem cells and derivation of functionally differentiated cells. Detailed analysis of the transcriptome has allowed elucidation of transcription networks that regulate the pluripotency of these stem cells. However, the specific nuclear infrastructures that maintain the pluripotent stem cell-specific transcription network have not yet been elucidated. We used proteomics to analyze the nuclear protein machinery in stem cells and identified some crucial components for the maintenance of pluripotent stem cells. In addition, various growth factors and extracellular matrix components regulate the pluripotency and differentiation of stem cells. Therefore, the cell surface receptors that bind these regulatory factors are important for the precise regulation of stem cells. We have also explored stem cell-specific cellsurface markers by proteomic analysis of mouse ES cells. These cell-surface membrane proteins can be useful to manipulate pluripotent stem cells. In this chapter, we describe some examples of new findings elucidated by proteomic analysis of ES cells.
A 56-year-old man with a 2.5-month history of anorexia developed sweating, weakness, and left hemiplegia and hemispatial neglect. Brain magnetic resonance imaging detected no abnormalities, but magnetic resonance angiography revealed narrowing of the right middle cerebral artery (MCA). The focal neurological signs and narrowing of the MCA resolved after detection and correction of hypoglycemia. Endocrinological examinations indicated adrenal insufficiency. Hemiplegia is a rare but important neurological manifestation of hypoglycemia, although the mechanisms involved remain unknown. Combined hypoglycemia and decreased MCA blood flow associated with vasospasm probably induced regionally severe neuroglycopenia with ischemia, which presented as focal neurological symptoms.
The reaction mechanism for the selective oxidation of methane with hydrogen peroxide was investigated for a H4PV1Mo11O40 catalyst precursor, which has been reported to be the most active among various Keggin-type heteropolyacids and vanadium complexes in trifluoroacetic acid anhydride. The conversion vs selectivity relationships, the comparison of reactivities of products with methane, and kinetic results show that the first step, selective oxidation of methane into methanol or methyltrifluoroacetate, is rate-determining. The facts that the oxidation was much suppressed by the addition of a radical scavenger, that chlorocyclohexane was formed by the oxidation of cyclohexane in the presence of carbon tetrachloride, and that the epoxidation of cis-stilbene proceeded without retaining the stereochemistry show that the reaction includes a radical path. UV−vis data revealed that monoperoxomonovanadate is an active species, which would promote the selective oxidation of methane into methanol or methyltrifluoroacetate.
The structural pathogenesis of Wernicke-Korsakoff syndrome remains debatable. Wernicke encephalopathy is acute and often reversible whereas Korsakoff syndrome (KS) is chronic and may be irreversible. The cognitive deficits observed in KS are considered to be primarily due to damage to the anterior nucleus of the thalamus, mammillary bodies, and corpus callosum. We present an extremely rare case of non-alcoholic "vascular" KS (vKS) as acute-onset amnesia. A 97-year-old man living alone was brought to our hospital, complaining of sudden-onset behavioral changes with amnesia. Diffusion-weighted images (DWIs) showed fresh cerebral infarction in the right thalamus involving the right mammillothalamic tract (MTT). T2*-weighted images (T2*WIs), in addition, revealed a microbleed scar over the left MTT. This case supports the hypothesis that bilateral MTT dysfunction can lead to KS. Furthermore, in collaboration with a prior report about non-alcoholic "acute" KS due to cerebral infarction, this case supports the existence of vascular KS as an acute-onset amnestic syndrome, as well as insight into the pathogenesis of KS as an irreversible amnestic syndrome.
