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Background/AimsEarly mobilisation after acute stroke is recommended worldwide, and autonomic dysfunction is a common complication. However, little is known about autonomic adaptation to postural changes during early mobilisation. The aim of the present study was to clarify the recovery process of autonomic dysfunction after acute stroke regarding adaptation to postural changes.MethodsA total of 23 patients (mean age 60 ± 11 years) were included in this observational study. Those with a history of arrhythmia, heart failure and diabetes mellitus with diabetic neuropathy were excluded. Autonomic functions were assessed using heart rate variability. Electrocardiograms were recorded when the patients were lying down, sitting up and then lying back down again for 5 minutes in each position. The indices of heart rate variability, total power, high frequency band and low frequency/high frequency ratio, which correspond to total, parasympathetic and sympathetic activity respectively, were calculated to evaluate participants' autonomic function during the 7 days after the onset of stroke.ResultsFrom days 3 to 7 after stroke onset, the low frequency/high frequency ratio was significantly higher, and the total power and high frequency were reciprocally lower in the sitting position than in the supine position. On day 7, the total power and high frequency were significantly higher while the low frequency/high frequency ratio was lower than the total power and high frequency values that were recorded on the second and third days after stroke. Blood pressure levels and heart rates also changed, corresponding to changes in heart rate variability.ConclusionsThe patients' autonomic function, as well as heart rate and blood pressure levels, changed gradually during the first 7 days after onset of stroke. The results could lead to optimised clinical practice in safe early stroke rehabilitation.

The patient was an 86-year-old man who was admitted with obstructive jaundice. Computed tomography revealed a tumor in the hilar choledochus with peripheral hepatic duct dilatation. Endoscopic cholangiography (ERC) demonstrated the defect in the choledochus. Brushing cytology during ERC showed Orange-G-philic keratinized atypical cells, which led to a diagnosis of squamous cell carcinoma. Chemotherapy with tegafur-gimeracil-oteracil potassium was ineffective and was discontinued due to adverse effects. The patient died 5 months after the diagnosis and autopsy revealed tubular adenocarcinoma of the hilar bile duct with squamous cell carcinoma component. Progression of the disease might influence the distribution of adenosquamous carcinoma. The clinicopathological sequence of adenosquamous carcinoma of the choledochus was documented.

ObjectivesTo compare the effects of anterior cruciate ligament (ACL) injuries and the preoperative period on functional status in different sports using preoperative patient data from the Multicenter Arthroscopic Knee Surgery (MAKS) study, a multicentre prospective cohort study of patients who underwent ACL reconstructions and meniscal surgeries conducted in 2013.MethodsOf the 1648 patients registered in the MAKS study cohort, 826 underwent unilateral primary ACL reconstruction. These patients were divided into three groups based on sports activity type: contact, fighting and non-contact. The patients were further divided into two subgroups according to preoperative period data: acute (≤3 months) and chronic (>3 months). We standardised the preoperative evaluation items (Knee injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC) subjective form, and Lysholm score) and surgical records.ResultsThe mean Lysholm score in the non-contact group was statistically significantly better than that in the fighting group. The two KOOS subcategories were statistically significantly superior in the non-contact group than in the fighting group. In the contact group, acute cases showed statistically significantly lower IKDC subjective scores and lower scores in two KOOS subcategories than the chronic cases. In the fighting group, chronic cases showed better IKDC subjective scores and scores for three KOOS subcategories than the acute cases. In the non-contact group, chronic cases showed better IKDC subjective scores and scores for all KOOS subcategories than the acute cases.ConclusionWhen athletes with ACL injuries are divided by sport type into fighting, contact and non-contact groups, the functional status of fighting sport athletes was more negatively influenced by ACL injury than those of non-contact sport athletes. When divided into acute and chronic phases, overall acute cases showed lower scores than the chronic cases in all sport types. In acute cases, the functional status of fighting sport athletes was more negatively influenced than non-contact sport athletes, whereas in chronic cases, there were no differences among the different sport types. The sport types and postinjury period should be considered for decision-making on therapeutic measures of patients with ACL injuries.Level of evidenceLevel II.

We fabricated a multi-chip module of 4H-SiC reduced surface field (RESURF)-type lateral JFETs. A single chip consists of 4 unit devices of 2.0 mm × 0.5 mm in size, which were isolated electrically from each other. The multi-chip module consists of 8 chips mounted on an AMC substrate. The drain current and the breakdown voltage of the module are over 3 A and 771 V, respectively. The turn-on time and the turn-off time are 36ns and 166ns, respectively. The module resistance is proportional to the absolute temperature to the 1.05th power.

Nectins are Ca2+-independent immunoglobulin (Ig)-like cell-cell adhesion molecules. The trans-interactions of nectins recruit cadherins to the nectin-based cell-cell adhesion, resulting in formation of cell-cell adherens junctions (AJs) in epithelial cells and fibroblasts. The trans-interaction of E-cadherin induces activation of Rac small G protein, whereas the trans-interactions of nectins induce activation of not only Rac but also Cdc42 small G protein. We showed by the fluorescent resonance energy transfer (FRET) imaging that the trans-interaction of E-cadherin induced dynamic activation and inactivation of Rac, which led to dynamic formation and retraction of lamellipodia. Moreover, we found here that the nectins, which did not trans-interact with other nectins (non–trans-interacting nectins), inhibited the E-cadherin–induced activation of Rac and reduced the velocity of the formation of the E-cadherin-based cell-cell AJs. The inhibitory effect of non–trans-interacting nectins was suppressed by the activation of Cdc42 induced by the trans-interactions of nectins. These results indicate a novel role of nectins in regulation of the E-cadherin–induced activation of Rac and formation of cell-cell AJs.

Nectins and afadin constitute a novel cell-cell adhesion system that plays a cooperative role with cadherins in the organization of adherens junctions (AJs). Nectins are Ca2+-independent immunoglobulin-like cell-cell adhesion molecules, and afadin is a nectin- and actin filament-binding protein that connects nectins to the actin cytoskeleton. Rac and Cdc42 small G proteins have been implicated in the organization of AJs, but their modes of action remain unknown. The trans-interaction of E-cadherin has recently been shown to induce the activation of Rac, but not that of Cdc42. We show here that thetrans-interactions of nectins induce the formation of filopodia and lamellipodia through the respective activation of Cdc42 and Rac. The Cdc42 activation is necessary, but not sufficient, for the Rac-induced formation of lamellipodia, whereas the Rac activation is not necessary for the Cdc42-induced formation of filopodia. These effects of nectins require their cytoplasmic tail but not their association with afadin. We propose here the functional relationship between nectins and the small G proteins in the organization of AJs.

Purpose: This study assessed the clinical outcomes of periprosthetic joint infection patients who underwent two-stage revision total knee arthroplasty with antibiotic-loaded cement spacers fabricated using a handmade silicone mold. Materials and methods: This study included seven patients (average age 77 years, average follow-up time 54 months) who underwent surgery at our hospital between 2009 and 2013. Clinical outcomes including knee scores, function scores, knee range of motion, and walking ability at the final observation, period from the primary total knee arthroplasty to implant removal, period from implant removal to revision total knee arthroplasty, and follow-up period after revision total knee arthroplasty were investigated. Results: At the final follow-up, the average knee range of motion was 99°, with no significant differences at each stage; average knee and function scores were 84 and 77, respectively. With cement spacers, five patients were able to walk with a t-cane. No recurrence of infection was observed. Conclusions: The clinical outcomes of the current case series demonstrated good knee function with preserved walking ability, without any recurrence of periprosthetic joint infection. This study suggests that using a handmade silicone mold could be an effective option for periprosthetic joint infection after a total knee arthroplasty.

In vitro mitogenic responses of lymphocytes of patients with advanced cancer of the stomach or lung were determined and the cells involved in the depressed responses of patients characterized. Proliferative responses to phytohemagglutinin and concanavalin A of lymphocyte rich mononuclear cells of the patients were impaired, but increased after in vitro unstimulated culture for seven days. Mitogenic responses were enhanced by depletion of monocytes using a Sephadex G-10 column, and further enhanced by removal of nylon wool nonadherent cells. Nylon wool nonadherent cells of the patients suppressed the mitogenic responses of autologous and allogeneic lymphocytes, but lost the suppressive activity during seven days' in vitro culture. Nonadherent cells of normal donors did not inhibit mitogenic responses. The results suggest that peripheral blood mononuclear cells of cancer patients may contain at least two populations of suppressor cells for mitogenic responses, monocytes and nylon wool nonadherent cells, which could be one of the causes of impaired mitogenic responses in these cancer patients.

OBJECTIVE: To determine whether heat-treated thyroid cancer cells augment the susceptibility of target cells to lysis by autologous lymphokine-activated killer cells. DESIGN: Peripheral blood lymphocytes from patients with thyroid cancer were incubated with recombinant interleukin 2 (100 U/mL) for 7 days, and thyroid cancer cells obtained from surgical specimens were heated at 44°C for 20 minutes and incubated at 37°C for 18 hours before performing the radioactive chromium Cr 51 release assay. RESULTS: The susceptibility of heat-treated thyroid cancer cells to lysis by autologous and allogeneic lymphokine-activated killer cells was significantly greater than that of untreated tumor cells. The mechanism of enhanced susceptibility was unclear. However, the effect depended on de novo protein synthesis, because inhibition of RNA synthesis by dactinomycin completely abolished the heat-enhanced susceptibility of tumor cells. CONCLUSION: Immunotherapy combined with hyperthermia may be useful in management of thyroid cancer.(Arch Otolaryngol Head Neck Surg. 1995;121:1009-1014)

Patients with laryngeal cancer were examined immunologically before treatment and for 1–10 years after treatment. In the pretreatment group, the percentage of T cells, lymphocyte blastoid reaction (PHA, concanavalin A), and skin reactions (PHA) were generally in the normal range, but absolute numbers of T cells and lymphocytes were reduced in most patients. In the group with no recurrence after surgery, the absolute number of T cells and lymphocytes, IgG · FcR+T cells (T?), and skin reactions was normal in many cases. The group with recurrence showed reduced percentage of T cells and an absolute number of T cells and lymphocytes. The absolute number of T cells and lymphocytes and the PPD skin reaction increased after surgery in some cases, but reductions in some of the parameters were noted in a few cases long after surgery. Radiation therapy for patients with tumors at early stages did not significantly change the percentage of T cells or the skin reactions.

Abstract:  The case of a 51-year-old man with Ewing’s sarcoma of the thumb is presented. The tumor involved the distal phalanx of the right thumb, associated with an impressive extraskeletal mass. Histology revealed a round cell sarcoma with a positive immunoreactivity with monoclonal antibody O13. Five years after disarticulation at the metacarpophalangeal joint, the patient is alive without recurrence or metastasis.

OBJECTIVE: Swainsonine (SW), an inhibitor of mammalian Golgi α-mannosidase II, blocks the processing of high mannose to complex type oligosaccharides. In this study, the effect of SW on the cytotoxicity of lymphokine-activated killer (LAK) cells against autologous thyroid cancer was investigated. DESIGN: Peripheral blood lymphocytes from patients with thyroid cancer were incubated with recombinant interleukin 2 (100 U/mL) and 0.5 mg/L of SW for 7 days, and thyroid cancer cells obtained from surgical specimens were pretreated with SW (0.5 mg/L) for 18 hours. The cytotoxicity of SW-treated LAK cells against tumor cells tested in a standard 4-hour radioactive chromium Cr 51 release assay. RESULTS: The cytotoxicity of SW-treated LAK cells against autologous thyroid cancer cells was found to be significantly greater than that of standard LAK cells incubated with interleukin 2 alone. The N-α-benzyloxycarbonyl–L-lysine thiobenzyl ester esterase activity of LAK cells, this activity being a cytotoxic factor that is necessary for the lethal hit stage, was also increased by SW treatment. Further, thyroid cancer cells incubated with SW, as compared with nontreated tumor cells, showed much higher susceptibility to LAK killing. CONCLUSIONS: Our results suggest that SW might have potential immunomodulatory properties in the treatment of thyroid cancer.(Arch Otolaryngol Head Neck Surg. 1994;120:389-394)

The orthogonal segment intersection search problem is stated as follows: given a setSofnorthogonal segments in the plane, report all the segments ofSthat intersect a given orthogonal query segment. For this problem, we propose a simple and practical algorithm based on bucketing techniques. It constructs, inO(n) time preprocessing, a search structure of sizeO(n) so that all the segments ofSintersecting a query segment can be reported inO(k) time in the average case, wherekis the number of the reported segments. The proposed algorithm as well as existing algorithms is implemented in FORTRAN, and their practical efficiencies are investigated through computational experiments. It is shown that ourO(k) search time,O(n) space, andO(n) preprocessing time algorithm is in practice the most efficient among the algorithms tested.

The reaction of hydrogen atoms with acrylaldehyde was investigated in a fast flow reactor equipped with a time-of-flight type mass spectrometer under reduced pressure. Main reaction products were carbon monoxide, ethylene, ethane, methane, and propanal. Consideration of the distributions of the reaction products under various reaction conditions showed that hydrogen atoms attacked the C=C double bond, especially its inner carbon side under reduced pressure. Resulting hot radicals caused subsequent reactions. The relative value of the apparent bimolecular rate constant of the reaction against that of trans-2-butene with hydrogen atoms was 1.6±0.2, which supported the above-mentioned initial reaction.

Without Abstract:

The splitting of methylene peaks in the 1H NMR spectra of surfactants of various alkyl length was studied in aqueous solutions solubilized with aromatic compounds, as a function of the carbon numbers of alkyls. In these spectra the methylene signals of long alkyls split into doublets. The location of the solubilization site is discussed while comparing the results with previous 1H NMR observations of long-alkyl-substituted molecules in aromatic solvents.

Ten patients with carcinomatous pleural effusions were treated with single intrapleural (i.pl.) injections of the streptococcal preparation OK432 on day 0 and the effects of i.pl. OK432 on the lysis of fresh or cryopreserved autologous tumor cells isolated from the pleural effusions were observed on day 7. In eight patients tumor cells in the effusions had decreased or disappeared by day 7. The other two patients, however, had no clinical evidence of therapeutic benefit from i.pl. OK432. Effusion tumor cells were relatively resistant to lysis by autologous lymphocytes when tested in a 4-h 51Cr-release assay. Positive reactions were recorded for blood and effusion lymphocytes in two of ten untreated patients. Injection of OK432 i.pl. resulted in an induction or augmentation of cytotoxicity against autologous tumor cells and K562 in the effusions of seven of ten subjects by day 7. In contrast, autologous tumor killing activity of blood lymphocytes was not always modified by i.pl. OK432. Purification of large granular lymphocytes (LGL) by discontinuous Percoll gradient centrifugation enriched autologous tumor killing activity, with no reactivity in LGL-depleted, small T lymphocytes. Significant lysis of autologous tumor cells was observed with effusion LGL from seven of ten untreated patients. Seven days after i.pl. OK432 injection, effusion LGL expressed enhanced cytotoxicity against autologous effusion tumor cells, whereas T cells were still not cytotoxic to autologous tumor cells on day 7. The frequency of LGL among effusion lymphocytes was not altered by i. pl. OK432. Adherent effusion cells were not involved in lysis of autologous effusion tumor cells in either untreated or OK432-treated patients. In vitro treatment of blood and effusion lymphocytes with OK432 induced an enhancement of autologous tumor-killing activity in patients who subsequently responded to i.pl. OK432 treatment. OK432 augmented in vitro autologous tumor killing activity of LGL, whereas T cells failed to lyse autologous tumor cells even after in vitro activation with OK432. These results indicate that i.pl. administration of OK432 to cancer patients will result in an augmentation of autologous tumor killing activity of LGL in the pleural effusions, and that this could be responsible for the antitumor activity of i.pl. OK432 therapy.

The rates of absorption of pure oxygen in alkaline aqueous solutions containing sodium salt of 1,4-naphthoquinone 2-sulfonic acid (NQS) as a catalyzer for the Takahax desulfurization process were measured at 25°C using a liquid jet column.The kinetics of the absorption was examined based on the theory for gas absorption accompanied by an irreversible second order chemical reaction. The pH of the solution, that is, the concentration of hydroxyl ion plays an important role in a reaction of first order with respect to oxygen and to NQS. The reaction rate constant is directly proportional to pH in the range 9.8-11.5, for more alkaline solutions being found to be 4.5 × l06L/mole • s.

The splitting of the methylene peaks in 1H NMR spectra was studied for alkyl compounds with various substituents in 1-chloronaphthalene solutions. The solvent shifts for the higher field split methylene peak and the α-methylene peak varied with a dependence on the magnitude of the electric group moment of the terminal substituent; those for the lower- and middle-field split methylene peaks and the terminal methyl peak remained constant. It was found that the different behaviors of the solvent shifts of the methylene signals could be ascribed to the origin of the peak splitting observed for long alkyl compounds.

The incidence of leukemia is higher among those closely exposed than among those more remote from the hypocenter. This increase was first manifest approximately three years following exposure. It apparently reached its peak between the years 1950 and 1952. Thereafter, the incidence has been diminishing, but 13 years after exposure it is still higher than would be expected in the general population. The type of leukemia most increased in incidence is the chronic granulocytic variety. No apparent difference in the natural history of the specific types of leukemia in exposed and nonexposed Japanese has been observed. Preliminary analyses of the data show a linear relation between dose of radiation and incidence of leukemia above 50 to 100 rad. Below this dose, the shape of the curve is not certain.

Myleran was used in the therapy of nine relapses of polycythemia vera in five patients. Clinical examinations, blood studies, and, in three instances, radioisotope tracer tests before and after treatment demonstrated the effectiveness, safety and simplicity of the treatment. Further trial of Myleran therapy in polycythemia vera seems warranted.

In a survey having a 90 percent chance of detecting a quadrupling of risk, no significant increase in leukemia has been observed in the offspring of persons exposed to atomic bomb radiation in Hiroshima and Nagasaki. In the children with leukemia who were born to previously irradiated parents, there was no unusual finding in regard to the interval from parental exposure to onset, age at onset, or type of leukemia. Failure to demonstrate a radiation effect does not mean that there is no such effect. It merely means that within the experience thus far open to observation, no effect is to be seen. There now is sufficient experience to justify a long period of observation of the F1 and subsequent generations for a possible increase of leukemia.

In Hiroshima and Nagasaki chronic lymphocytic leukemia is rare in comparison to the United States. No patient with this disorder was identified among the residents of Hiroshima City during a 20 year period of study. The incidence of chronic lymphocytic leukemia in Nagasaki City, however, was similar to that for all Japan. There is no evidence that the development of chronic lymphocytic leukemia in these cities was related to exposure to the atomic detonations of 1945.

Male Wistar rats were divided into 3 groups: Group I. Rats given the triamcinolone daily by gastric catheter all developed neutrophilia accompanied by lymphopenia. Group II. Rats given daily intraperitoneal injections of plasma from normal rats manifested no significant alteration in the peripheral blood elements. Group III. Rats given daily intraperitoneal injections of plasma from rats given triamcinolone invariably developed neutrophilia without lymphopenia. Studies of the bone marrow of these groups at the end of the experiments revealed increased myeloid:erythroid ratios in Groups I and III but not II. It is therefore believed that this experiment suggests the existence of a neutrophilia-promoting factor in the plasma following the administration of triamcinolone.

A malignant myeloproliferative disorder occurred in a Japanese child with Down's syndrome. In addition to the features of acute myeloblastic leukemia, the patient demonstrated extensive megakaryocytic infiltrates in spleen, liver, lymph nodes, kidneys, and pancreas. The disturbance of bone marrow function in Down's anomaly may involve thrombopoiesis as well as granulopoiesis.

Jones fractures sometimes occur in athletes and are known to have complications, such as nonunion, delayed union, and recurrence, even with treatment. We describe three cases of Jones fractures in sumo wrestlers with treatment-related difficulties. All patients discontinued treatment at their own discretion. The two conservative cases had nonunion or delayed union, and the operative case had a broken screw. However, all patients continued sumo wrestling, with little impact on their careers. The risk factors of Jones fractures in sumo wrestling may be heavy weight, and training or competition characteristics unique to sumo wrestling. In cases of a complete Jones fracture, operative treatment is most commonly selected, as the risk for nonunion or refractures is less than that for conservative treatment. However, in the case of sumo wrestlers, there are risks of infection and problems with treatment compliance. As taking a rest may result in a lowered rank, completing a sufficient duration of treatment is difficult. Treatment is difficult and controversial in sumo wrestlers; all three patients discontinued treatment of their own accord. These cases suggest that it is important to thoroughly inform sumo wrestlers of the treatment options, and to decide the most appropriate treatment method for each patient.

The splitting of methylene peaks in 1H NMR spectra was studied for long-chain methyl alkanoates in 1-chloronaphthalene as a function of the carbon number, nc, of alkyls. With increase in nc, the singlet peak of methylene is first split into a doublet and then into a triplet.

It is demonstrated that ellipsometry combined with reflectance measurement provides useful information on the distribution of each pits due to crystal defects on the (100) surface of undoped, semi-insulating LEC GaAs etched with molten KOH.