A Case of Dermatomyositis with Severe Myalgia and Muscle Weakness Testing Positive for Anti-melanoma Differentiation-associated Gene 5 Antibody.

We report a case of a woman with typical dermatomyositis (DM) with skin manifestations, severe myalgia and muscle weakness complicated by interstitial lung disease (ILD) and pneumomediastinum. Pneumomediastinum persisted despite treatment with immunosuppressive therapy (steroids and cyclosporine). After the test for anti-melanoma differentiation-associated gene 5 (MDA5) antibody came out positive, we doubled the cyclosporine dose and her condition improved. Despite typical clinical features of DM, in cases complicated by pneumomediastinum or steroid resistance, measurement of anti-MDA5 antibody may be useful for immunosuppressant dose titration.

The early evolutionary history of belemnites: new data from Japan.

Belemnites (Order Belemnitida), a very successful group of Mesozoic coleoid cephalopods, dominated the world's oceans throughout the Jurassic and Cretaceous. According to the current view, the phylogenetically earliest belemnites are known from the lowermost Jurassic (Hettangian, 201-199 Ma) of northern Europe. They are of low diversity and have small sized rostra without clear grooves. Their distribution is restricted to this area until the Pliensbachian (191-183 Ma). Here we describe two new belemnite taxa of the Suborder Belemnitina from the Sinemurian (199-191 Ma) of Japan: Nipponoteuthis katana gen et sp. nov., which represents the new family Nipponoteuthidae, and Eocylindroteuthis (?) yokoyamai sp. nov. This is the first reliable report of Sinemurian belemnites outside of Europe and the earliest record of typical forms of Belemnitina in the world. The Sinemurian belemnites from Japan have small to large rostra with one deep and long apical groove. Morphologically these forms are completely different from coeval European genera of Hettangian-Sinemurian age. These new findings suggest that three groups of Belemnitina existed in the Hettangian-Sinemurian: 1) European small forms, 2) Japanese very large forms, and 3) the typical forms with a distinctive apical groove, reported here. The Suborder Belemnitina therefore did not necessarily originate in the Hettangian of northern Europe. The new material from Japan documents that the suborder Belemnitina had a much higher diversity in the early Jurassic than previously thought, and it also shows strong endemisms from the Sinemurian onwards.

Mesorbitolina (Cretaceous larger foraminifera) from the Yezo Group in Hokkaido, Japan and its stratigraphic and paleobiogeographic significance.

In this paper, we describe an Aptian (Early Cretaceous) larger foraminiferal species Orbitolina (Mesorbitolina) parva from the limestone olistoliths in the lower part of the Yezo Group in the Yubari-Ashibetsu area, central Hokkaido and from limestone pebbles in the lowermost part of the Yezo Group in the Nakagawa area, northern Hokkaido. This is the first report of this species from the circum-North Pacific regions. Based on its occurrences, the shallow-marine carbonates, re-deposited in the lower part of the Yezo Group, are precisely assigned in age to the Late Aptian. Comparison of the lower part of the Yezo Group in central and northern Hokkaido indicates differences of the Aptian-Albian depositional history between the two areas. This study reveals that after Late Aptian, Mesogean key taxa (typical Cretaceous Tethyan biota) demised in the Northwest Pacific.

Anaphylaxis to aprotinin in fibrin sealant.

A 50-year-old man with chronic otitis media was admitted to our hospital for investigation of lung cancer. He had received repeated instillations of fibrin sealant (Bolheal) in myringoplasty 7 times over 12 months. During the lower lobectomy, soon after fibrin sealant was applied to seal bronchopleural fistulas, systolic blood pressure decreased to 60 mmHg. Treatment with epinephrine and dopamine was required until his condition improved 2 days later. The specific IgE antibody was detected for the solution for fibrinogen and factor XIII containing bovine aprotinin. Cross-reactivity between purified aprotinin and the solution was noted by competitive ELISA inhibition tests.