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Pyoderma gangrenosum (PG) is a sterile inflammatory skin condition that is frequently associated with immune-related diseases, including inflammatory bowel disease (IBD). PG causes noninfectious ulcers. Facial PG is uncommon while PG usually occurs on the trunk and lower limbs. Herein, we report a case of a male teenager with fever, pustules, ulcers, and necrosis on both cheeks. He was initially diagnosed with complicated acne with bacterial infection, but the condition progressed to subcutaneous ulcers despite treatment. Biopsy revealed inflammatory lesions in dermal and subcutaneous tissue with neutrophil infiltration, consistent with PG. Although lacking typical IBD symptoms, blood tests revealed anemia and positive fecal occult blood. Sigmoidoscopy revealed inflammation, ulcers, and pseudopolyps in the colon and rectum, thereby diagnosing ulcerative colitis (UC). After treating PG and UC with prednisolone and skin grafts, golimumab was prescribed. The patient is now in remission. Necrotic tissue buildup can complicate closure in PG cases;this emphasizes the need for effective IBD treatment to facilitate procedures such as skin grafts.

A woman in her 40s, previously diagnosed with ulcerative colitis (UC), presented with anterior chest pain. A CT scan of her chest and skin examination showed no abnormal findings. She was initially managed with antibacterial agents, but her chest pain worsened, she developed a fever, and there was an overall deterioration of her general condition. A repeat CT scan found abscesses on the anterior surface of her sternum and gluteal region, and colonoscopy found worsening UC lesions. Her multiple subcutaneous abscesses were aseptic, and she was diagnosed with pyoderma gangrenosum (PG), an extraintestinal manifestation of UC. Steroid treatment was initiated and her overall condition as well as her subcutaneous abscesses improved rapidly. There are only a few case reports of PG without skin manifestation but only subcutaneous aseptic abscesses. However, subcutaneous abscesses may progress to PG with skin ulcers if initial treatment is delayed. Even with non-specific clinical features, prompt diagnosis of relapsed UC with potential extraintestinal manifestations must be considered. This is a rare case and aims to highlight the importance of early diagnosis and treatment of PG, which is an extraintestinal manifestation of relapsed UC.

A 51-year-old man with chronic myeloid leukemia undergoing treatment with dasatinib received colonoscopy for a positive fecal occult blood test. Colonoscopy revealed more than 100 erythematous, multilobulated polyps with mucoid discharge. Endoscopic mucosal resection was performed for diagnosis, and the histological analysis of polyps showed hyperplastic glands and proliferative smooth muscle cells. Our findings suggested that the polyposis was caused by inflammation triggered due to the adverse effects associated with dasatinib. The patient discontinued dasatinib;the follow-up colonoscopy performed four months later revealed significantly improved polypoid lesions in the colon. The erythematous heads of the polyps and mucoid discharge disappeared. The cessation of dasatinib seemed to contribute to the improvement of inflammatory reactive polyposis;therefore, we inferred that the polyposis was caused by dasatinib in the present case.

A 48-year-old man with locally advanced pancreatic cancer underwent combined treatment with gemcitabine and proton radiation therapy. Because of subsequent obstruction of the common bile duct, a metallic biliary stent was placed and he received further gemcitabine chemotherapy. During chemotherapy, he developed an acute abdomen with a sudden-onset of tarry stool and jaundice. Gastroduodenoscopy revealed hemobilia from the biliary metallic stent. Contrast-enhanced abdominal computed tomography revealed the presence of a pseudoaneurysm arising from the right hepatic artery adjacent to the top of the stent. Hemostasis of the right hepatic artery pseudoaneurysm was achieved via transcatheter arterial embolization using cyanoacrylate.

Schizophrenia patients consistently show some deficiency in electrophysiological measures, such as PPI (Prepulse Inhibition), ERP (Event-Related Potential) components (mismatch negativity, P50, P300), EEG (Electroencephalography), and MEG (Magnetoencephalography). These components have been intensively studied as quantitative biological markers (i.e., endophenotypes) for psychiatric disorders. Recently brain oscillations, especially gamma (30-80 Hz) band activity (GBA), are being increasingly investigated as new candidate endophenotypes. In this review, we summarize the current status, perspective, and limitations of representative paradigms for investigating abnormal electrophysiological components of schizophrenia, along with relevant genetic polymorphism.

A 32-year-old woman was admitted with intermittent rectal bleeding with disseminated intravascular coagulation (DIC)-like coagulopathy. CT and MRI revealed a retroperitoneal tumor, and we diagnosed giant retroperitoneal hemangioma complicated with Kasabach-Merritt syndrome, following blood pool scintigraphy. Corticosteroid and interferon-alpha were not effective, and gabexate mesilate was also ineffective for coagulopathy. Immediately after receiving danaparoid sodium, she recovered from DIC. We performed tumor resection successfully, and she had no symptoms of coagulopathy thereafter.

We report herein a case of spindle cell type hepatocellular carcinoma responding to hepatic intra-arterial infusion chemotherapy. A 50-year-old woman was hospitalized for right epigastralgia. A computed tomography scan demonstrated cloudy liver tumor with a diameter of 12 cm in S5 and S8. Surgery was performed based on the diagnosis of liver tumor. However, because the tumor was also present in the left lobe, we did only a biopsy for a part of tumor. From the pathological findings, this was diagnosed as a spindle cell type hepatocellular carcinoma. After the operation, hepatic intra-arterial injection therapy of continuous infusion with 5-FU was conducted for two weeks. A small reduction in the tumor was seen with computed tomography after the completion of two courses.

Effects of diltiazem, a calcium antagonist, on the cardiovascular system in the pentobarbital anesthetized dogs were investigated. Diltiazem (100 micrograms/kg and 300 micrograms/kg, i.v.) decreased blood pressure, heart rate and total peripheral resistance, while cardiac output and stroke volume were markedly increased. The max dp/dt of left ventricular pressure tended to increase with a dose of 100 micrograms/kg. Left ventricular end-diastolic pressure was slightly increased with a dose of 400 micrograms/kg. Rate pressure product was significantly reduced. Diltiazem (30 micrograms/kg and 100 micrograms/kg) increased pulmonary arterial flow together with the increase in both systolic and diastolic pulmonary arterial pressure. Diltiazem (100 micrograms/kg) increased common carotid, femoral and superior mesenteric arterial blood flow by 30 to 40%, whereas vertebral blood flow was increased by over 100%. The dose dependency in the vertebral blood flow was remarkable. Response of the vertebral artery to diltiazem was similar to that reported in the case of the coronary artery. In the His bundle electrogram, diltiazem increased the AH interval by about 10% at 100 micrograms/kg and 25% at 200 micrograms/kg, without changing the HV interval. Diltiazem-induced AH prolongation was completely depressed by epinephrine but only partially so by CaCl2. Thus, the effects of diltiazem on sinus rhythm and AV conduction in the anesthetized dog were more potent than the effects on cardiac contractility, although weaker than the effects of the vasodilating action. The vasodilator effects appear to be the primary action of diltiazem on the cardiovascular system.

Effects of diltiazem (Dil) on cardiac function were studied in the anesthetized open chest and heart-lung preparation of dogs. In the anesthetized dog, Dil (0.03-0.3 mg/kg, i.v.) increased max dp/dt and raised left ventricular end-diastolic pressure (LVEDP). Dil also produced an increase in cardiac output and coronary blood flow, but produced a decrease in blood pressure and heart rate (HR). In the cardiac denervated dog (bilateral stellectomy and vagotomy), the increase in max dp/dt caused by Dil, although not so remarkable was apparent. Therefore, the effects of Dil on cardiac function were examined in the heart-lung preparations of the dog, in which arterial pressure (AP) and venous pressure (VP) were kept constant (spontaneously beating) or AP, VP and HR were kept constant (atrial pacing). In these preparations Dil (about 1 mg/l) decreased max dp/dt and raised LVEDP. The cardiac function curve (relationship between stroke work and LVEDP) was shifted rightward by Dil. On the other hand, max dp/dt was increased when VP was increased under constant AP and HR. This increase in max dp/dt was also found under the influence of Dil. These results suggest that the augmentation of max dp/dt induced by Dil in the open chest dog is due both to a neural reflex in response to the systemic hypotension and to the Starling mechanism produced by increase in venous return, though Dil itself has a negative inotropic property.

The vasodilator action of CV-705 was investigated in a number of vascular regions of anesthetized mongrel dogs and this action was compared with that of papaverine. When CV-705 was administered intravenously the vertebral, common carotid and internal carotid blood flow was increased considerably and was long-lasting. These effects were most remarkable among the regions tested. Femoral, aortic and coronary blood flow were also increased. On the other hand, the blood flow through superior mesenteric artery and portal vein increased only slightly. Renal blood flow was decreased slightly after an intravenous administration, whereas an increase was observed after an intra-arterial administration. Such a regional distribution of blood flow after CV-705 was quite similar to that observed with papaverine. CV-705 was well absorbed through the digestive tract. CV-705 given intravenously showed a weak hypotensive and positive chronotropic action. The increase in common carotid blood flow induced by intra-arterial administration of CV-705 was not affected by pre-treatment with atropine or triprolidine, but was partially suppressed by pre-treatment with propranolol. These results suggest that CV-705 has a papaverine-like action as well as a weak beta-adrenoceptor stimulating action, consequently a vasodilator action occurs.

Bronchodilator effects of diltiazem were investigated in the isolated guinea pig tracheal chain and in the anesthetized cat. Interaction of diltiazem with isoproterenol (iso) was also examined. Diltiazem (10(-4) g/ml) relaxed by 70% the tracheal chain contracted by histamine, 10(-5) g/ml. This effect of diltiazem was not affected by pretreatment with propranolol, 3 X 10(8) g/ml. Diltiazem (400 microgram/kg, i.v.) diminished by 20% the elevation of intratracheal pressure induced by serotonin aerosol, the effect of which lasted for approximately 20 min. On the other hand, diltiazem (10(-5) g/ml) produced no influence on the iso-induced relaxation of the guinea pig trachea. In the anesthetized dog, diltiazem (20 microgram/kg/min, i.v.) did not affect the iso-induced bronchodilation when histamine was used as a spasmogen, while the positive chronotropic action of iso was diminished. On the contrary, propranolol (30 microgram/kg, i.v.) potentiated the bronchoconstrictor effect of histamine and suppressed both the bronchodilating and positive chronotropic actions of iso. Thus, the effects of diltiazem differed from those of propranolol. In summary, diltiazem showed bronchodilation both in vitro and in vivo, although the activity was not so potent, With regard to the iso-induced bronchodilation, diltiazem had no effect at a dose which diminished the positive chronotropic action of iso.

Bronchodilating action of l-MTI was investigated by intravenous administration to anesthetized animals and the results were compared to those seen with isoproterenol. Bronchoconstriction was induced by histamine or serotonin. Under pentobarbital anesthesia, the bronchodilating activity of l-MTI was approx. 1/20 that of isoproterenol in cats and dogs, but less than 1/100 that of isoproterenol in monkeys and guinea pigs. The results indicate that the bronchodilating activity of l-MTI is variable and species dependent. It was demonstrated, however, that in guinea pigs, l-MTI did not produce any bronchodilating activity, when the animals were anesthetized with urethane. The absence of the bronchodilating response in animals under this anesthesia was also seen in vagotomized, adrenalectomized and reserpinized, norepinephrine-infused guinea pigs. On the contrary, l-MTI exhibited the bronchodilating action in reserpinized, pithed or hexamethonium-treated guinea pigs anesthetized with urethane. On th other hand, isoproterenol produced a bronchodilating action in all preparations mentioned above. It was also evident that l-MTI suppressed the bronchodilating action of isoproterenol in pentobarbital anesthetized guinea pigs. In addition, l-MTI increased the heart rate of guinea pigs with a low beating rate, but decreased it when the control rate was high. These results suggest that at least in guinea pigs, l-MTI acts as a partial agonist and that the effect of l-MTI on the bronchial system depends on the sympathetic tone and/or sympathetic bronchodilator reflex, as proposed by McCULLOCH ET AL. (9).