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From a young age, a 63-year-old Japanese man had experienced difficulties with hemostasis during tooth extraction and epistaxis and swelling of bruised areas. He had previously been diagnosed with mild hemophilia (FVIII:C 8.5%) at age of 60 due to swelling of a right hip bruise and was administered FVIII concentrate for the first time. He had frequent bleeding around his shoulder joints and was given FVIII concentrates every time, but his hemostasis was poor. He was referred to our hospital because his FVIII activity decreased to1% and a low-titer inhibitor (2.0 BU/ml) was detected. Because of a shoulder hematoma and new subcutaneous bleeding on both forearms, recombinant FVIIa was used to perform the hemostatic treatment. Following hemostasis, emicizumab was administered subcutaneously every 2 weeks at a dose of 3.0 mg/kg. Approximately 2 months after starting emicizumab, inhibitors were no longer detected, and FVIII activity increased to 8% after 9 months. We encountered a case of mild hemophilia A with an inhibitor that was first diagnosed in old age. The incidence of inhibitors in non-severe hemophilia A is about 10%, and about 70% of those resolves spontaneously. In this case, suppression of bleeding by emicizumab may have contributed to the spontaneous disappearance of the inhibitor.

Bone marrow necrosis (BMN) occurs most frequently in hematological malignancies and sometimes in non-hematological disorders. Lymphoid diseases causing necrosis are regarded as high-grade disease. B-lymphoblastic leukemia/lymphoma is the most common malignant cause of BMN. Here, we present two patients with follicular lymphoma (FL) and MYC gene abnormalities who developed BMN. In one case of BMN, the necrosis disappeared in response to chemotherapy, and the patient survived with complete remission. In the other case, BMN remained even after chemotherapy, and effective chemotherapy could not be administered due to suppressed hematopoiesis, which led to the lymphoma worsening and the patient's death. Indolent lymphomas, such as FL, as in these cases, have the potential to develop BMN. It is important to detect the development of BMN and administer chemotherapy early to improve patient prognosis, since severe BMN prevents patients from receiving effective treatment.

A very large enhancement of Raman scattering was observed for WOx nanorods with the {001}CS structure, enabling single-molecule detection of CO molecules adsorbed on WOx nanorods through Raman scattering.

The electronic, lattice, and magnetic properties of CoSb3, Cr-doped CoSb3, and related compound thin films were calculated by using the total energy pseudopotential method. A vacuum region and slab as a thin film were periodically repeated in the supercell. We considered three slab structures. One is symmetric, another is asymmetric, and the third is unusual. They are free-standing in the supercell. The magnetic moment of doped Cr atom is large in all Cr-doped cases. Magnetic moments of several Co atoms are enhanced in the asymmetric and unusual cases. The calculation results in this study indicate that electronic states of most thin films are ferromagnetic and they are energetically more favorable than nonmagnetic cases.

Neuropsychiatric symptoms comprise one of the five classic symptoms of autoimmune thrombotic thrombocytopenic purpura (aTTP). Although aTTP is typically transient, it is sometimes complicated by cerebral infarction with residual disability. This report presents the case of an 87-year-old man previously admitted to a different hospital with fever and transient consciousness loss. After receiving platelet transfusion with diagnosis of Evans syndrome, he was transferred to our hospital with worsening consciousness disturbance. He was subsequently diagnosed with aTTP with a PLASMIC score of 6 points, ADAMTS13 activity of less than 0.5%, and its inhibitor of 7.4 BU/ml. Platelet count and consciousness were rapidly improved with plasmapheresis and steroids, but motor aphasia emerged. MRI showed multiple cerebral infarctions, including a large infarction in the left frontal lobe. Thus, unfractionated heparin was administered. When his platelet count dropped once again on the 20th day, rituximab was added. The treatment eventually proved to be successful, and his aTTP remained in remission one year after the onset. Treatment for cerebral infarctions was switched to DOAC, and rehabilitation was continued. However, his ADL has not yet recovered. Advances in aTTP treatment have cured many similar cases. Thus, rituximab is now considered a treatment option for refractory cases. However, ischemic organ damage in acute phase and sequelae are observed. Therefore, early diagnosis and novel therapy are required.

Previous genomic studies have revealed the genomic landscape of myeloma cells. Although some of the genomic abnormalities shown are believed to be correlated to the molecular pathogenesis of multiple myeloma and/or clinical outcome, these correlations are not fully understood. The aim of this study is to elucidate the correlation between genomic abnormalities and clinical characteristics by targeted capture sequencing in the Japanese multiple myeloma cohort. We analysed 154 patients with newly diagnosed multiple myeloma. The analysis revealed that the study cohort consisted of a less frequent hyperdiploid subtype (37·0%) with relatively high frequencies of KRAS mutation (36·4%) and IGH-CCND1 translocation (26·6%) compared with previous reports. Moreover, our targeted capture sequencing strategy was able to detect rare IGH-associated chromosomal translocations, such as IGH-CCND2 and IGH-MAFA. Interestingly, all 10 patients harboured MAX mutations accompanied by 14q23 deletion. The patients with del(17p) exhibited an unfavourable clinical outcome, and the presence of KRAS mutation was associated with shorter survival in patients with multiple myeloma, harbouring IGH-CCND1. Thus, our study provides a detailed landscape of genomic abnormalities, which may have potential clinical application for patients with multiple myeloma.

Human endogenous retroviruses (HERVs) are retrotransposons that infect human germline cells and occupy 5-8% of the human genome. Their expression, though inhibited by mutation, deletion, and epigenetic mechanisms under normal conditions, is associated with diseases including cancer. This study aimed to clarify the association between HERVs and multiple myeloma (MM) progression. We found that HERV-K envelope (env) and long-term repeat (LTR) expression was statistically significantly higher within plasma cells in MM than in monoclonal gammopathy of undetermined significance or controls. HERV-K env knockdown increased proliferation in the MM.1S cell line and decreased the expression of the tumor suppressor genes TP53 and CDKN1A. TP53 and CDKN1A were highly expressed in MM, and their expression was correlated with HERV-K expression. HERV-K knockdown reduced apolipoprotein B mRNA editing enzyme catalytic polypeptide-like 3F, 3G, and 3H expression by 10-20% in MM.1S cells. The anti-retroviral agents nevirapine and nelfinavir suppressed proliferation and increased HERV-K expression in MM cell lines. Our results suggest that HERV-K is involved in MM progression, but its role is likely to go beyond promoting cell proliferation. Clarifying the role of HERV-K in MM will lead to the discovery of novel treatment strategies and supply new insights into MM pathogenesis.

We studied thin films of Fe2VAl, Fe2VAl/Si, and a related compound using the total energy pseudopotential method. The internal atoms in a supercell of the repeated slab model were fully relaxed, except for Fe2VAl/Si. The detailed electronic and magnetic properties of structurally relaxed thin films of Fe2VAl, Fe2VAl/Si, and a related compound were calculated. These films are free-standing in the supercell, except for Fe2VAl/Si, which comprises Fe2VAl and Si (substrate) layers in a supercell. A thin film comprising Fe2V, Al, and Si (substrate) layers in the supercell (denoted as Fe2V/Al/Si) was also studied. Although electronic states of bulk Fe2VAl (full-Heusler) are metallic with pseudo-gap states around the Fermi level and nonmagnetic, the calculation results for Fe2VAl, Fe2VAl/Si, and Fe2V/Al/Si thin films in this study indicate that the films have ferromagnetic properties and their ferromagnetic states are energetically more favorable than nonmagnetic states. The magnetic moments are large and enhanced in the thin films. The magnetic moments of Fe in Fe2VAl (Fe12V4Al4), Fe2VAl (Fe20V8Al8), Fe2VAl/Si, and Fe2V/Al/Si thin films are 2.07 μ B/per atom, 1.29 μ B/per atom, 1.83 μ B/per atom, and 2.22 μ B/per atom, respectively. Although thin films have net ferromagnetic properties, the magnetic moments of the up and down spin states of Fe and V are antiferromagnetically aligned.

Acquired factor V inhibitor (AFVI) results from the formation of autoantibodies to coagulation factor V (FV), and the clinical phenotype can range from asymptomatic laboratory abnormalities to life-threatening bleeds. We describe a 74-year-old man who developed AFVI along with a massive subcutaneous hematoma. He was initially treated with prednisolone (PSL), but AFVI recurred when the dose was reduced after a short period. We subsequently increased the PSL dose and added cyclophosphamide (CY), which resulted in a complete response. We then gradually tapered PSL and stopped CY, and the patient has since remained free of recurrent AFVI symptoms. We monitored FV activity, antigen concentrations, and inhibitor titers of this patient throughout the clinical course. The ratio of FV activity to antigen concentration was low at diagnosis and gradually increased along with the patient’s improvement. This ratio might be a useful parameter for evaluating the effects of immunosuppressive therapy in patients with AFVI.

Introduction: The number of elderly hemodialysis patients continues to grow. The aim of this study was to investigate differences in elderly high flow access patients compared with middle-aged and young patients. Methods: We performed a retrospective study to determine the characteristics of elderly patients (aged >60 years) following blood flow suppression procedures. Preoperative and postoperative data from 177 patients who underwent blood flow suppression procedures and 73 patients who underwent procedures for run-off vein ligation and subcutaneous fixation of the superficial artery were compared. Results: A high proportion of young (aged 20–40 years) and middle-aged (aged 41–60 years) patients met the criteria for blood flow suppression procedures (flow volume 1500 mL/min, flow volume/cardiac output 35%), whereas a high proportion of elderly patients did not. Moreover, heart strain could evidently be caused even with low flow volume. In elderly patients, a tricuspid regurgitation pressure gradient and right heart strain were observed more frequently. Conclusion: Elderly patients who underwent blood flow suppression procedures or subcutaneous fixation of the superficial artery exhibited lower flow volume, and the effects of high flow access in elderly patients depend on the nature of vascular changes. Ultimately, the underlying conditions and hemodynamics of each patient must be determined on an individual basis.

Surface structure relaxation of organic semiconductors affects the properties of organic devices, although such relaxation has not been well explored. Only two examples have been experimentally reported; tetracene shows a large surface relaxation, while rubrene exhibits no relaxation. Therefore, a systematic investigation of the surface relaxation is conducted on [ n]phenacenes ( n = 5, 7, and 9). Electron density analyses are performed based on the synchrotron surface X-ray scattering with the aid of first-principles calculations. The results show little surface relaxation in [ n]phenacenes.

Long noncoding RNAs (lncRNAs) are deregulated in human cancers and are associated with disease progression. Plasmacytoma Variant Translocation 1 (PVT1), a lncRNA, is located adjacent to the gene MYC, which has been linked to multiple myeloma (MM). PVT1 is expressed in MM and is associated with carcinogenesis. However, its role and regulation remain uncertain. We examined PVT1/MYC expression using real-time PCR in plasma cells purified from 59 monoclonal gammopathy of undetermined significance (MGUS) and 140 MM patients. The MM cell lines KMS11, KMS12PE, OPM2, and RPMI8226 were treated with JQ1, an MYC super-enhancer inhibitor, or MYC inhibitor 10058-F4. The expression levels of PVT1 and MYC were significantly higher in MM than in MGUS (p &lt, 0.0001) and were positively correlated with disease progression (r = 0.394, p &lt, 0.0001). JQ1 inhibited cell proliferation and decreased the expression levels of MYC and PVT1. However, 10054-F4 did not alter the expression level of PVT1. The positive correlation between MYC and PVT1 in patients, the synchronous downregulation of MYC and PVT1 by JQ1, and the lack of effect of the MYC inhibitor on PVT1 expression suggest that the expression of these two genes is co-regulated by a super-enhancer. Cooperative effects between these two genes may contribute to MM pathogenesis and progression.

Arranging molecules into highly symmetric, topological crystal structures has been recognized as the best approach to functionalize electronic properties in molecular crystals, where the constituent molecules have been assumed to be rigid in shape. Here, in striking contrast, we demonstrate that the molecules in a monolayer organic crystal can undergo a significant deformation in proximity to the substrate, which is reflected by an asymmetry in the electron density profile. X-ray reflectivity and X-ray absorption spectroscopies in conjunction with density-functional theory calculations reveal that the highly planarized π-core are deformed into a bent shape, while the bulk lattice parameters are maintained. The molecular shape change is found to be perfectly suppressed in a bilayer single crystal, which leads to a 40% increase in mobility in the bilayer crystal. Our finding of a unique, sub-molecular scale shape change in monolayer single crystals can offer possibilities for functionalizing electrical properties via nano-scale physisorption. Organic molecules exhibit intrinsic semiconducting properties as well as increased flexibility in comparison to their silicon counterparts and consequently are playing an increasing role in semiconductor technologies. Here, the authors demonstrate that monolayers of organic crystals can undergo deformation at the molecular level when in proximity to a substrate and that this has an effect on their electronic structure.

Polymer solar cells are one of the promising energy sources because of the easy solution-processable production with large area at a low cost without toxicity. Among the polymer materials, a donor–acceptor conjugated copolymer PTB7 has been extensively studied because of the typical high-performance polymer solar cells. Here, we show operando direct observation of charge accumulation in PTB7:PC71BM blend solar cells from a microscopic viewpoint using electron spin resonance spectroscopy. The accumulation of ambipolar charges in the PTB7-based cells is directly observed for the first time, which shows a clear correlation with the performance deterioration during device operation. The sites of the ambipolar charge accumulation are elucidated at the molecular level, whose information would be useful for improving the cell durability in addition to the performance improvement.

Organic field-effect transistors with ionic liquids have attracted much attention, since the ionic liquids induce an intense electric field at a semiconductor interface, resulting in a high concentration of charge carriers. It is expected that such strong electric fields and highly doped charges induce nontrivial effects on the electronic band structures. Recently, the blue shift of the peak wavelength in photo-absorption spectra for a DNBDT-monolayer transistor was experimentally observed by increasing an ionic-liquid gate voltage, although the origin of the shift is still under debate. Therefore, we investigate the hole-doping and external electric-field effects on the electronic states of the organic semiconducting monolayer within the framework of the density functional theory. The calculated results show that the photo-absorption energy is increased by hole doping while an external field decreases the photo-absorption energy. We demonstrated that the calculations give useful information to understand the origin of the experimentally observed wavelength shift of photo-absorption spectra.

We present theoretical calculations of the thermoelectric properties of a magnetic semi-conductor CuFeS2. The electrical contributions, namely the Seebeck coefficients, electrical conductances, and electronic thermal conductances, are investigated using first-principles calculation techniques based on density functional theory and the nonequilibrium Green's function formalism. The lattice thermal transport properties are analyzed using the nonequilbirium molecular dynamics simulation method. Using a combination of the calculated electronic contributions and the lattice thermal contribution, the thermoelectric figures of merit are calculated and analyzed in doped configurations for the theoretical prediction of the highest thermoelectic energy conversion efficiency. It is shown that dilute doping enhances the figure of merit by 2.5 times compared to 3% doping which was previously experimentally obtained to give the best thermoelectric performance among samples studied.

The thermoelectric properties of TiN/MgO surface nanostructures have been determined using first-principles calculations based on the nonequilibrium Green’s function (NEGF) method. Through structural modification of the surfaces at the atomistic level, we find that the metallic TiN thin-film layer becomes semiconducting with a small bandgap, which enhances the Seebeck coefficient, while the electrical conductivity remains high at room temperature. Hence, a much larger thermoelectric figure of merit is obtained compared with bulk. These findings indicate the possibility of designing thermoelectric devices with surface nanostructures.

Enhancing the efficiency of thermoelectric materials has been practiced extensively by either improving the power factor or reducing the lattice thermal conductivity. Magnetism, and the magnetic moment–charged carrier interactions, has been suggested to enhance the efficiency of some compounds. Nevertheless, decoupling of the magnetic and the carrier concentration–related effects has never been achieved to prove once and for all, the importance of magnetism in thermoelectricity. Herein, we report improved quality criterion of bismuth telluride upon chromium substitution. The magnetic interactions with the magnetic moment carried by Cr atoms have increased the electrons' effective mass, enhancing the thermopower. Combined with the decrease in the lattice thermal conductivity, the overall performance of these compounds has been enhanced by 25% at constant carrier concentration, an improvement seldom observed. This is a robust enhancement principle because magnetic interactions are effective at high temperatures above the transition temperature, unlike magnon drag which is dependent on ordering and typically a low temperature phenomenon. Our results indicate that taking advantage of such relatively easily implemented magnetic doping effects along with existing strategies can lead to enhanced efficiency of thermoelectric materials.

We present an order-$N$ methodology to evaluate mobilities of charge carriers coupled with molecular vibrations using quantum dynamics based on first-principles calculations that can be applied to micron-scale soft materials. As a demonstration, we apply it to several organic semiconductors and show that the calculated intrinsic hole mobilities and their temperature dependences are quantitatively in good agreement with those obtained in experiments. We also clarified which vibrational modes dominate the transport properties. The methodology paves the way for quantitative prediction of the transport properties of various soft materials.

We present a combined experimental and theoretical study of electron confinement in graphene nanoislands (GNs) grown on a Pt(111) substrate using scanning tunneling microscopy (STM) and density functional theory (DFT) calculations. We observed standing wave patterns in the STM images of GNs, and the bias dependency of the standing wave pattern was reproduced by considering free electrons with an effective mass of m* ≈ (0.27 ± 0.03)me. Because the effective mass of Pt is m* = 0.28me, our results reveal that the electron confinement is due to the effect of the Pt substrate rather than the massless Dirac electrons of graphene. Our calculated maps of the local density of states (LDOS) for the GNs confirm that the electronic properties of the confinement may be described in terms of electrons with an effective mass. The DFT-calculated charge distribution for graphene on the Pt system also shows a clear hybridization between the pz orbitals of both the first layer of the Pt substrate and the carbon atoms.

We present a theoretical study of relationships between charge transport properties and disorder in rubrene single crystals. We take into account two different types of disorder, namely, intrinsic dynamical disorder due to intermolecular vibrations and extrinsic static disorder. Then we evaluate the transport properties using our wave-packet dynamical approach which gives us a unified theoretical description from hopping to band transport behavior. We show that the mobilities are completely changed from the intrinsic power-law temperature dependence to the thermally activated behavior by introduction of the extrinsic trap potentials.

We developed and implemented a numerical code called SAKE, which stands for (simulation code for atomistic Kohn-Sham equation). We developed it for first-principle electron transport calculations based on density-functional theory and non-equilibrium Green's function formalism. First, we present the central calculation parts of the formalism of the electronic states and transport properties for open and non-equilibrium systems. We show specific computational techniques, such as the use of a complex contour integration for charge density from the density matrix, which is compared with the calculation method of summing the residues of the Fermi-Dirac distribution, as well as the efficient achievement of the self-consistent procedures. Thereafter, for applications of the present computation code, SAKE, we present first-principle calculation results of three different systems. We first analyze electronic structures of polythiophene molecular wires, compare summation techniques for the density matrix. We show thermoelectric properties of an n-type antiferromagnetic semiconductor CuFeS2 as a second application. The electrical conductance, electrical thermal conductance, and the Seebeck coefficients with carrier doping are examined, and the analytical form of the Seebeck coefficient is briefly described. For the third application, we analyze the electron transport properties of polyaniline molecular wires under structural deformations, i.e. rotations around the transport direction. The thermally averaged current-voltage characteristics are also analyzed. The results show that the current decreases as the temperature increases which are determined based on the competition between the thermal energy and the electronic energy, which increases with the rotation angle.

Prediction of material properties of newly designed molecules is a long-term goal in organic electronics. In general, it is a difficult problem, because the material properties are dominated by the unknown packing structure. We present a practical method to obtain charge transport properties of organic single crystals, without use of experimental single-crystal data. As a demonstration, we employ the promising molecule C10–DNBDT. We succeeded in quantitative evaluation of charge mobility of the single crystal using our quantum wave-packet dynamical simulation method. Here, the single-crystal data is computationally obtained by searching possible packing structures from structural formula of the molecule. We increase accuracy in identifying the actual crystal structure from suggested ones by using not only crystal energy but also similarity between calculated and experimental powder X-ray diffraction patterns. The proposed methodology can be a theoretical design technique for efficiently developing new high-performance organic semiconductors, since it can estimate the charge transport properties at early stage in the process of material development.

Background: Chromosomal abnormalities are strongly associated with prognosis of multiple myeloma (MM). Among them, t (14;16) resulting in high expression of c-MAF, and t (14;20) resulting in high expression of MAFB, lead to poor prognosis. However, clinical significance and mechanisms underlying high c-MAF and MAFB expression without these translocations have not been fully elucidated. Methods: A total of 96 MM and 38 MGUS patients, 10 controls, and 9 MM cell lines were included in this study. RNA was extracted from purified CD138+ plasma cells from bone marrow (BM) mononuclear cells. c-MAF, MAFB, p53, and p21 RNA expressions were determined by RQ-PCR. Their expression levels were normalized against ACTB levels and calculated with 2-ΔΔCt value. Inhibition studies using BRD4 inhibitor JQ1, and MYC inhibitor10058-F4, and MM cell lines expressing doxycycline-inducible p53 (Tet-on p53) or c-MAF knockdown (KD) with siRNA were used for in vitro studies. Results: c-MAF expression in MM patients was higher than in MGUS patients and control (median level 0.043, 0.025, 0.002, p Conclusion: Although the mechanism of high expression of c-MAF and MAFB has previously been reported in IgH translocation, the relationship between c-MAF and drug resistance remains to be determined. The induction of c-MAF expression by tumor suppressor gene p53 is suggested to be a mechanism underlying poor prognosis of MM with t (14;16), and suppressing c-MAF expression with chemotherapeutic drugs might prevent emergence of drug resistance in residual tumor cells. Disclosures Handa: Ono: Research Funding.

Background: DNA polymerases (DNA pols) are essential enzymes for DNA replication. In mammalian cells, DNA pols are divided into four families: A (Pol θ, Pol γ, and Pol ν), B (Pol α, Pol δ, Pol ε, and Pol ζ), X (Pol β, Pol λ, Pol μ, and TDT), and Y (Pol η, Pol ι, Pol κ, and REV1). These DNA pols are required for both genome duplication and protecting cells from DNA damage induced by endogenous and exogenous agents, such as ROS, UV, and chemotherapeutic drugs. For example, Pol β, Pol λ, and Pol ι participate in base excision repair. Contrastingly, Pol ζ, REV1, Pol η, Pol ι, and Pol κ can replicate over various DNA lesions to prevent DNA replication stalling, known as translesion synthesis. Although some DNA pols are highly expressed in cancer cells, indicating chemotherapeutic resistance and poor outcome, their exact roles and expression mechanisms have not been fully elucidated. Multiple myeloma (MM) is a hematological malignancy of terminally differentiated plasma cells, with multistep progression from pre-cancer stage namely. In this study we attempted to elucidate the involvement of DNA pols in multistep oncogenesis of MM. Methods: A total of 63 MM and 29 MGUS patients, 15 controls, and 9 MM cell lines were included in the study. RNA was extracted from purified CD138+ plasma cells. DNA pol expressions were determined by RQ-PCR. Their expression levels were normalized against ACTB levels and calculated with 2-ΔΔCt value. Doxycycline-inducible p53 system (Tet-on p53) and nutlin-3 were used for analyzing the role of p53 in DNA pol expressions in MM cell lines. Melphalan, doxorubicin, and bortezomib were used to examine DNA pol expressions in damaged cells in vitro. JQ1 and CPI203 were used to evaluate the role of bromodomain in DNA pol expressions. Results: Pol α and Pol ε expressions were significantly higher in MM than in control (p=0.007 and p=0.004, respectively), but Pol ε and Pol ζ levels were not significantly different (p=0.631, p=0.0826, respectively). Pol η, REV1, Pol ι, and Pol κ expressions were significantly higher in MM than control (p Conclusion: We found that Pol θ and Pol η are highly expressed in MM, and upregulated by DNA damage. These DNA pols are involved in drug resistance and genomic instability leading to poor prognosis. Thus, DNA pols can be used as novel therapeutic targets and prognostic markers. Disclosures Handa: Ono: Research Funding.

We have already demonstrated that the graphitized mechanical pencil lead show superior field emission features in high emission current regime [1]. In this paper, we present the results of additional detailed analysis of field emission from completely graphitized pencil lead including Raman scattering, FIM/FEM images and energy distributions of emitted electrons as well as field emission characteristics also in low emission current regime. It is concluded again that the fully graphitized pencil lead is promising as low cost but superior field emitters

We have demonstrated that the C 60 molecules adsorbed on a W tip show highly symmetric FEM patterns that are similar to that of well-defined atomic orbitals [1]. The observed image can be considered to be originated from super atomic molecular orbitals (SAMOs), which is confirmed with STM observations and theoretical calculations [2]. In this paper, we present the results of detailed analysis of field emission features from the C 60 molecules including energy distributions of emitted electrons.

We describe a rare case of chronic active Epstein-Barr virus (CAEBV) infection, with infiltration of the skeletal muscle. A 19-year-old woman with swollen cervical lymph nodes and a fever was referred to our hospital. Swelling of the trapezium muscle and elevation of creatinine kinase level were observed. Biopsy results of the brachialis muscle revealed infiltration of Epstein-Barr virus (EBV)-encoded RNA-positive CD8 T lymphocytes. The EBV virus load in the peripheral blood was high, and EBV monoclonality was determined by Southern blot analysis. Owing to the rarity of CAEBV with skeletal muscle infiltration, this case alerts physicians to the potential diagnostic pitfalls of CAEBV.

Acquired von Willebrand syndrome (AvWS) is a rare bleeding disorder with laboratory findings resembling those of congenital von Willebrand disease. AvWS usually occurs in association with a variety of underlying disorders, such as lymphoproliferative disease or cardiovascular disease, but autoimmune AvWS is very rare. We now describe the case of a 42-year-old woman with autoimmune AvWS with concurrent antiphospholipid syndrome (APS). The patient was suffering from epistaxis and menorrhagia from few years prior to referral. She was referred to our hospital because of Activated Partial Thromboplastin Time (APTT) prolongation. Autoimmune AvWS was diagnosed as hemostatic and immunological analyses showed very low (6%) levels of vWF ristocetin cofactor activity, low (6%) levels of vWF antigen and the presence of anti-vWF antibodies (IgG1 and IgG2) as well as antiphospholipid antibodies. Steroid therapy led to prompt AvWS remission, but deep vein thrombosis occurred in the left leg, on day 36 and APS was diagnosed. A combination of steroid and anti-coagulant was given for approximately 3 years. Thrombosis has not recurred; but AvWS re-exacerbated with steroid tapering. This is the first case report of autoimmune AvWS concurrent with APS, and the long-term disease course described here can be beneficial to clinicians.

Extramedullary myeloma (EMM) occurs when myeloma develops outside the bone marrow; it often develops after chemotherapy and is associated with the acquisition of chemo-resistance and a fatal course. The mechanisms underlying extramedullary spread have not yet been fully elucidated. MALAT1 is a highly abundantly and ubiquitously expressed long non-coding RNA that plays important roles in cancer metastasis. The aims of this study were to clarify the association of MALAT1 with EMM and to elucidate the underlying mechanism of EMM formation under chemotherapeutic pressure. MALAT1 expression was significantly higher in multiple myeloma (MM) than in monoclonal gammopathy of undetermined significance. Furthermore, MALAT1 expression was markedly higher in EMM compared with that in corresponding intramedullary myeloma cells. A higher MALAT1 level was associated with shorter overall and progression-free survival. MALAT1 expression level was positively correlated with expression of HSP90AA1, HSP90AB1 and HSP90B1 but not with TP53 expression. MALAT1 was significantly upregulated by bortezomib and doxorubicin. Considering the known functions of MALAT1, our results suggest that it acts as a stress response gene that is upregulated by chemotherapy, thereby linking chemotherapy to EMM formation. Elucidating the biological implication of long non-coding RNA contributes to deeper understanding concerning the pathogenesis and investigation of novel therapeutic targets for MM.

We present a wave-packet dynamical approach to charge transport using maximally localized Wannier functions based on density functional theory including van der Waals interactions. We apply it to the transport properties of pentacene and rubrene single crystals and show the temperature-dependent natures from bandlike to thermally activated behaviors as a function of the magnitude of external static disorder. We compare the results with those obtained by the conventional band and hopping models and experiments.

Summary Background Drug-induced hypersensitivity syndrome/drug rash with eosinophilia with systemic symptoms (DIHS/DRESS) is a severe drug eruption accompanied by multiorgan disorders. Several unique aspects of DIHS/DRESS, including herpesvirus reactivation, liver dysfunction and hypogammaglobulinaemia, have similarities to graft-versus-host disease (GVHD). Aim In this study, we focused on the dynamics of regulatory T cells (Tregs) infiltrating into the skin lesions of DIHS/DRESS and GVHD. Methods Skin biopsies were taken from patients with DIHS/DRESS, GVHD, or maculopapular drug eruption. Tregs were detected using immunostaining with anti-FoxP3. Results The ratio of FoxP3+ T cells to CD3+ T cells was significantly higher in the skin lesions of patients with DIHS/DRESS than in those of patients with GVHD, and was positively correlated with the number of days from disease onset in the acute phase. Conclusions The dynamics of Tregs in skin lesions are different between DIHS/DRESS and GVHD, despite there being many similarities between these conditions.