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Using immune checkpoint inhibitors (ICIs), which target regulatory pathways in T cells to enhance anti-tumour responses, leads to important clinical advances and provides new weapons against cancer...

When monitoring phenology at ground level, it would be more important to continue observations in long terms and to detect the timing of various phenological events such as leafing, flowering and autumn senescence. In this study, to develop the methodology for plant phenology monitoring by using digital camera, we examined how multiple image indices, which are derived from multi-temporal visible images, respond to the changes of colors of leaves and flowers for several target species of plants, and tried to detect various phenology events by tracing time series changes of the coordinate in the feature spaces of two indices. As a result, we found out that it was possible to understand the characteristics of the phenological events for different species from each image index. Also, it was identified that the utility of combination with two indices would be effective to detect the timing of phenology events in the feature space of two indices. In the actual phenology monitoring, it would be effective to use a single index for understanding the seasonal characteristics and to use the combination of two indices for detection of the timing of phenology events by tracing the time series changes in the feature space.

The ESA/JAXA BepiColombo mission to Mercury was launched in October 2018. It includes two scientific Mercury orbiters, flying as a single stack during the seven years interplanetary transfer, and as individual spacecraft operated by their respective space Agencies ESA and JAXA once deployed in their respective scientific orbit around Mercury. Three ground segments are closely collaborating on this mission. The European Space Operations Center of the European Space Agency, in Darmstadt, Germany, responsible for mission operations of the composite stack during the interplanetary transfer and of the Mercury Planetary Orbiter (MPO) once at Mercury, the JAXA Sagamihara Space Operation Center (SSOC) in Sagamihara, Japan, responsible for Mercury Magnetospheric Orbiter (MMO) operations throughout the mission, and the European Space Astronomy Center of the European Space Agency, in Villanueva de la Canada, Spain, responsible for MPO scientific archiving and Mercury science operations. The mission benefits from infrastructure and concepts developed on previous interplanetary missions of ESA and JAXA. However, it also includes specific operational challenges, such as electric propulsion, and a complex Mercury Orbit Insertion sequence, exploiting weak stability boundaries, and interleaving three module separations with 15 chemical propulsion manoeuvers to deliver MPO and MMO in their respective science orbits, requiring specific developments and operational approaches. In view of the nominal mission duration of 8.5 years, the mission also requires the adoption of specific measures for knowledge preservation and long-term maintenance.

Objective The purpose of chemotherapy for recurrent cancer is to get survival benefit, relieve symptoms, and improve quality of life. We used oral cyclophosphamide (CPA) and bevacizumab (BEV) combination therapy in cases of recurrent ovarian and peritoneal cancer, where standard chemotherapy was difficult to conduct. We subsequently evaluated the safety and efficacy of this treatment. Methods Between August 2014 and June 2020, subjects who provided informed consent received the following regimen: oral CPA 50 mg daily and intravenous BEV15 mg/kg every 3 weeks as 1 cycle. Data from the two facilities were retrospectively studied. Result Twenty-two patients were enrolled (20 with ovarian cancer and 2 with peritoneal cancer). The median follow-up period was 18.9 months (range, 5.0–51.5), and median age was 60 years (range 37–81). Sixteen patients had platinum resistance. The median number of previous chemotherapy regimens was 2.5 (range 0–5). The median implementation cycle was 5 (range 2–14). Eighteen patients discontinued treatment: three due to side effects, and fifteen due to disease progression. Grade 2 toxicities included neutropenia (1), protein urea (1), hypertension (2), and esophagitis (1). Two patients had a complete response, and one patient had a partial response. Five patients had stable disease. The response rate was 13.6%. Median PFS was 5.3 months (range, 0.8–23.5). The median OS from the initiation of CPA/BEV was 9.2 months (range, 4.8–51.5+). Conclusions The combination therapy of oral cyclophosphamide and bevacizumab had relatively effective, and can be used safely in patients who have become difficult to treat after second-line chemotherapy.

Intracranial abscess is a rare but life-threatening disease. There have been no reports on intracranial abscess induced by the residual primary tooth and the impacted successive permanent tooth with infection. We report on an interesting case of a 29-year-old man suffering from an epidural abscess, potentially caused by an infection of the residual primary maxillary right canine and the impacted permanent maxillary right canine. The patient recovered completely after prolonged antibiotic treatment and extraction of both of the suspected teeth. Fusobacterium sp. was isolated from the culture of a peripheral blood sample. This case alerts us to realize that the lack of suitable and timely intervention in oral conditions might produce a harmful effect on general health.

The hygiene or "Old Friends" hypothesis proposes that the epidemic of inflammatory disease in modern urban societies stems at least in part from reduced exposure to microbes that normally prime mammalian immunoregulatory circuits and suppress inappropriate inflammation. Such diseases include but are not limited to allergies and asthma; we and others have proposed that the markedly reduced exposure to these Old Friends in modern urban societies may also increase vulnerability to neurodevelopmental disorders and stress-related psychiatric disorders, such as anxiety and affective disorders, where data are emerging in support of inflammation as a risk factor. Here, we review recent advances in our understanding of the potential for Old Friends, including environmental microbial inputs, to modify risk for inflammatory disease, with a focus on neurodevelopmental and psychiatric conditions. We highlight potential mechanisms, involving bacterially derived metabolites, bacterial antigens, and helminthic antigens, through which these inputs promote immunoregulation. Though findings are encouraging, significant human subjects' research is required to evaluate the potential impact of Old Friends, including environmental microbial inputs, on biological signatures and clinically meaningful mental health prevention and intervention outcomes.

PURPOSE To investigate the relationship between the change of daily step counts and low back pain (LBP) during pregnancy. Materials and METHODS Pregnant women at less than eight weeks of gestation (WG) were recruited. Daily step counts were measured with a pedometer. To assess LBP, the Oswestry disability index (ODI) score was recorded. Thirty-six individuals were divided into the LBP and non-LBP groups. The effect of step counts on LBP between the two groups was analyzed. RESULTS At 16-19 WG, step counts were not considerably changed in the non-LBP group but were significantly increased in the LBP group. At 24-27 and 32-35 WG, step counts were increased in the non-LBP group but were significantly decreased in the LBP group. CONCLUSIONS Acute increase of daily step counts in early pregnancy is a risk for LBP, and gradual increases of step counts after mid-pregnancy is recommended for women.

Solar radiation is a source of energy for ground surfaces. Clouds control energy budget on both local and global scales. We propose the simple ground-based observation method for various sky conditions instead of the existing visual observation. In the paper, we mainly describe how to discriminate clouds area on whole sky images, how to overlay the cloud areas to the satellite-based images and the test experiment. As for the discrimination of sky conditions, we use Sky Index (SI) and Brightness Index (BI) calculated from whole sky imageries. SI shows the extent of the blueness and grayscale and BI indicates the extent of the brightness. Sun, cloud and blue sky areas are divided by SI and BI threshold. As an extension of ground-based observation to satellite-based observation, clouds area discriminated by ground-based observation overlay to satellite images. Through this experiment, the utilities of ground-based cloud observation are discussed. The proposed ground-based cloud observation method and its satellite-based extension should be connected to satellite products with high quality by implementation of sky and clouds observation covering a wide area.

Background: BIIB021 is an oral, fully synthetic heat shock protein 90 inhibitor (Hsp90i) that selectively and potently inhibits the molecular chaperone Hsp90, thereby preventing proper assembly of oncogenic proteins such as HER2. Methods: The safety and tolerability of escalating doses of BIIB021 taken by mouth twice weekly (BIW) in combination with fixed doses of trastuzumab (8 mg/kg loading dose, then 6 mg/kg IV every 3 weeks [Q3W]) were determined using a 3+3 dose escalation design with dose expansion at MTD in patients with advanced HER2+ metastatic breast cancer (MBC) refractory to trastuzumab-based therapy. Pharmacokinetics (PK), efficacy, and pharmacodynamics were also assessed. Results: Thirty patients received BIIB021 within 4 dose groups: 200 (n = 3), 400 (n = 5), 600 (n = 20), and 700 mg (n = 2) BIW plus trastuzumab Q3W. All patients were female and median age was 58 years. All patients had ≥1 prior systemic therapy (median 8) and ≥1 prior treatment with trastuzumab (median 4) for HER2+ MBC. Median time on study was 45 days (range 8-213). Twenty (67%) patients withdrew due to progressive disease, 4 (13%) withdrew consent, 3 (10%) withdrew due to adverse events (AEs), and 1 was withdrawn by the Investigator. The MTD for BIIB021 with trastuzumab is 600 mg BIW. Dose-limitingtoxicities were Grade (G) 3 diarrhea (2/20 patients at 600 mg) and G4 aphasia (1/2 patients at 700 mg). The event of aphasia was serious, drug-related, and considered by the Sponsor to be a complex partial seizure. An additional drug-related SAE was G3 hypopituitarism reported for 1 patient at 600 mg. All AEs regardless of relationship occurring in ≥20% of patients included nausea (70%), dizziness (63%), fatigue (63%), diarrhea (57%), vomiting (50%), headache (37%), rash (33%), constipation (30%), hot flush (27%), chills (23%), back pain (23%), UTI (23%), and dyspnea (20%). PK analyses indicated dose-dependent increases in BIIB021 plasma Cmax and AUC, consistent with previous studies. Cmax and AUC did not change from Day 1 to Day 22 for any dose group. Terminal half-life ranged from 1-2 hours and Tmax from 0.5-1.5 hours. Trastuzumab PK was consistent with the product label. Significant induction of Hsp70 (7.5-fold increase) in PBMCs and/or inhibition of serum HER2-ECD (20% decrease) were observed in 50% of evaluable patients (n = 25). A >50% decrease in total circulating tumor cells (CTC) and in HER2+ CTC was observed in patients with >5 CTC at baseline. Antitumor activity was observed in 2 patients (400 and 600 mg) who experienced confirmed partial response (PR) by RECIST. These 2 patients also had metabolic PR (>25% reduction in SUVmax by FDG-PET) and significant changes in Hsp70 and HER2-ECD biomarkers. One confirmed PR is ongoing (>6 months). Conclusions: BIIB021 was tolerated at doses ≥600 mg BIW plus trastuzumab Q3W without apparent alteration in the PK profile of either drug. Consistent with previous combination studies with other Hsp90i in trastuzumab-refractory HER2+ MBC, antitumor activity was observed (2 confirmed PRs) along with significant changes in biomarker levels. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-14-02.

The minimal quantity of lubricant supply (MQL) technique has been applied to environment friendly machining processes. However, in the MQL technique, a large volume of oil mist is discharged to the environment. In this paper, a new lean lubrication system for a near dry machining process called “direct oil drop supply system (DOS)” is proposed. The performance of the DOS technique was evaluated by the milling processes. The DOS technique can supply a very small oil drop directly to the cutting edge without making oil mist, and the DOS shows almost same machining performances compared to the MQL technique.

Calcinosis is a common and debilitating complication of dermatomyositis. It is a hallmark of the disease, occurring mainly in pediatric patients. Little is known about its pathophysiology, and there is no universally recognized treatment. This is a report of two children with juvenile dermatomyositis and severe calcinosis who showed improvement with the use of alendronate and diltiazen in one patient, and intravenous immunoglobulin in the other.

Purpose: The aim of this study is to investigate the mechanism of long-term acceptance of ABO-incompatible renal allograft. Methods: Thirty-four ABO-incompatible kidney transplant recipients with blood group O were entered in this study. Eighteen and 16 recipients received a blood group B (B-to-O) and A1 (A1-to-O) allograft, respectively. Sixteen (O-to-O) recipients were control subjects. The titers of blood group antibodies were measured before pre-conditioning and following transplantation. Blood group antigens were stained in 32 graft biopsy specimen. Results: In 18 (B-to-O) and 16 (A1-to-O) recipients, only anti-B and anti-A1 antibodies, respectively, were significantly suppressed compared with those in 16 (O-to-O) more than 1 year post-transplantation. In eight (B-to-O) and seven (A1-to-O) recipients, only anti-B and anti-A1 antibodies, respectively, were significantly suppressed 1 year post-transplantation, compared with those pre-conditioning. Blood group antigens were stained with same intensity and pattern in any biopsy specimen under all conditions. There was no significant deposition of IgG and IgM in any biopsy specimen. These suggested that production of anti-donor blood group antibodies appeared to be specifically suppressed in long-term stable ABO-incompatible kidney transplant recipients. Conclusion: Accommodation of ABO-incompatible kidney transplantation could be explained by donor-specific blood group antibody suppression.

With welded steel structures, fatigue-cracks usually occur at the welded joints. Therefore the structures are designed to reduce stress at the points where fatigue damage is expected. It is, however, impossible to totally prevent fatigue-cracks from occurring. Moreover, in a complex structure, there is a possibility that a simple method such as visual inspection does not enable the detection of the occurrence of a fatigue-crack at the welded joint at an early stage, and hence it can have grown into a long crack by the time it is discovered.

The bare aluminum alloy (A5052) honeycomb is compressed in the longitudinal direction of the cell. Effect of the cell shape and the foil thickness on crush behavior is investigated by the numerical simulation using an explicit FEM code DYNA3D. Impact experiment using a drop-hammer apparatus whose impact velocity is 10 m/s and the corresponding quasi-static one are also performed. In the impact experiment, compressive stress increases with the hammer travel due to the air enclosed in the honeycomb cells. However, the nominal stress at the incipient compression is very similar for both the cases. In computation, numerical model of one ‘Y’ cross-sectional column is used and the impact velocity is 10 m/s. Internal angle of branch in ‘Y’ cross-section ranges from 30° to 180°. The numerical result shows that the cyclic buckling mode takes place in every case and that the crush strength is higher for smaller branch angle. It increases with the foil thickness. However, when the crush strength is evaluated with respect to the net cross-section of the material part only, it attains the maximum value when the cell shape is of regular hexagon. Numerical results are well consistent with the corresponding experimental ones.

We investigated autoantibodies and their epitope(s) in Hashimoto's encephalopathy associated with Hashimoto's thyroiditis. In a proteomic analysis, they proved to recognize alpha-enolase. We further searched the epitope region in alpha-enolase using different regions of recombinant proteins expressed in cultured human cells. The amino terminal region was recognized by autobodies from a much higher proportion of patients with Hashimoto's encephalopathy (83.3%; 5/6) than from patients with Hashimoto's thyroiditis (11.8%; 2/17), and not at all by sera from controls (25 healthy individuals and 25 controls with other neurological disorders) (0%; 0/50). Neither the carboxyl terminal nor the mid-region of alpha-enolase showed specificity for Hashimoto's encephalopathy. Autoantibodies against the amino terminal of alpha-enolase are a useful diagnostic marker for Hashimoto's encephalopathy.

The harmonic state-estimation (HSE) method appears to be effective but its applicability has yet been fully verified using actual data in power systems. Particularly in Japan, there has been no verification of the applicability of the method in actual power systems. In this paper, for Japanese field data synchronized with a Global Positioning System (GPS) clock, a practical method for power system harmonic analysis is proposed, which is based on HSE. In the proposed method, in order to improve the precision of HSE, uncertain parameters R, X, and Y of the transmission lines are determined from measured fundamental data, and bad measured harmonic data excluded systematically. It is also possible to estimate the error of each measurement instrument by using HSE. It is confirmed that by using only partial and selected measurement data synchronized with a GPS clock, the entire harmonic distribution of the actual power system has been obtained effectively. In this paper, field-test results of the HSE on an actual Japanese power system are shown. Furthermore, an example of harmonic analysis based on HSE in the actual power system is presented, which is prediction of harmonic voltage distribution after a change of the actual power system configuration.

Background: No method for the clinical diagnosis of MM2-type sporadic Creutzfeldt-Jakob disease (sCJD) has been established except for pathologic examination. Objective: To identify a reliable marker for the clinical diagnosis of MM2-type sCJD. Methods: CSF, EEG, and neuroimaging studies were performed in eight patients with MM2-type sCJD confirmed by neuropathologic, genetic, and western blot analyses. Results: The eight cases were pathologically classified into the cortical (n = 2), thalamic (n = 5), and combined (corticothalamic) (n = 1) forms. The cortical form was characterized by late-onset, slowly progressive dementia, cortical hyperintensity signals on diffusion-weighted imaging (DWI) of brain, and elevated levels of CSF 14-3-3 protein. The thalamic form showed various neurologic manifestations including dementia, ataxia, and pyramidal and extrapyramidal signs with onset at various ages and relatively long disease duration. Characteristic EEG and MRI abnormalities were almost absent. However, all four patients examined with cerebral blood flow (CBF) study using SPECT showed reduction of the CBF in the thalamus as well as the cerebral cortex. The combined form had features of both the cortical and the thalamic forms, showing cortical hyperintensity signals on DWI and hypometabolism of the thalamus on [18F]2-fluoro-2-deoxy-d-glucose PET. Conclusion: For the clinical diagnosis of MM2-type sporadic Creutzfeldt-Jakob disease, cortical hyperintensity signals on diffusion-weighted MRI are useful for the cortical form and thalamic hypoperfusion or hypometabolism on cerebral blood flow SPECT or [18F]2-fluoro-2-deoxy-d-glucose PET for the thalamic form.

C70 fullerenes evaporated onto rubbed polyimide substrates at greater than 150°C were found to orient almost parallel to the rubbing direction, as confirmed by atomic force microscopy and polarized absorption analysis. The directions of maximum absorption, including both linear and nonlinear absorption components, also appeared to be aligned with the rubbing direction. The third-order electrical susceptibility of the evaporated C70 fullerenes thin films was measured using a z-scan method and found to be χ(3)=Im χ(3): 10−6∼10−8 esu at a wavelength of 500 nm.

OBJECTIVES: We performed magnetic resonance (MR) sialography of parotid gland and/or submandibular gland ducts using three-dimensional fast asymmetric spin-echo (3D-FASE) sequencing. The objective was to make three-dimensional (3D) reconstruction images and virtual endoscopic views of the parotid gland ducts using MR sialography data sets of 3D-FASE sequences. METHODS: We reviewed the MR sialography data sets with 3D-FASE sequencing of 10 control volunteers and six patients. Three-dimensional reconstruction images and virtual endoscopic views of the parotid gland and/or submandibular gland ducts were generated with maximum intensity projection (MIP), shaded surface display (SSD), and volume rendering techniques (VRT). RESULTS: The main parotid gland and/or submandibular gland ducts, large branches within the glands, and small branches were fairly well defined in a very short acquisition time on MR sialographic images with 3D-FASE sequencing in nine of the 10 healthy volunteers. The 3D-reconstruction images of the parotid gland ducts and/or submandibular gland ducts showed the entire length of the branch paths and complete images from all angles, and the virtual endoscopic views showed the endoluminal tracts of the main ducts and the large branches in nine. In the patient with Sjogren's syndrome, chronic sialoadenitis, and salivary calculi in the Wharton ducts, the MR sialographic images showed diffuse areas of punctate high signal intensity, dilatation of Stensen's duct, or stones of Wharton's duct, respectively. Furthermore, the 3D-reconstruction images of the salivary gland ducts showed the stenoses and stones in the branch paths and complete images from all angles, and the virtual endoscopic views showed the stenoses and stones in the endoluminal tracts of the main and large branches. CONCLUSIONS: Our initial experience showed that virtual MR endoscopy could be performed to observe the endoluminal tracts of parotid and submandibular glands. The clinical use of the virtual MR endoscopy for salivary gland ducts has not been established yet. Future applications of the 3D-reconstruction images and virtual endoscopic views using MR sialography data sets of 3D-FASE sequences are very attractive and further expansion of this field is expected.

Objectives The impact of oral conditions on quality of life in overweight/obesity needs to be elucidated. The aim of this study was to evaluate the association between dental caries activity, quality of life and obesity in Brazilian adolescents. Materials and methods This study was conducted at public schools in Brazil, on a sample of 202 adolescents, 12 years of age. For anthropometric evaluation, the body mass index (BMI)-for-age was used. In oral examinations, the Decayed, Missing, Filled teeth (DMFT), significant caries (SiC) and dental caries activity (DCA) indices were used (κ > 0.94). The Child-Oral Impacts on Daily Performance (Child-OIDP) index was applied. The sample was divided into two groups: O (overweight/obese; n = 101) and N (normal weight; n = 101). For data analysis, chi-square, odds ratio (OR), Wilcoxon and Pearson correlation tests were used (P

Microchimerism in 23 female renal transplant recipients from male donors was studied using nested polymerase chain reaction (nPCR) and fluorescence in situ hybridization (FISH) to detect Y-chromosome. nPCR was a sensitive and specific assay enabling a detection rate of 1/10(6) male/female cells, compared with a sensitivity of 1/10(2) by standard PCR (sPCR). None of the 23 patients with a male allograft demonstrated Y-chromosome using sPCR. In contrast, 1 3 (56.5%) patients demonstrated Y-chromosome with nPCR. Of 9 patients proven to have microchimerism by nPCR, only 3 also demonstrated Y-chromosome using FISH. The existence of B cells and CD8 cells in donor chimeric cells were proved by separation with Dynabeads class I and class II. Dynamic changes of microchimerism occurred in 4 of 5 patients. Four patients were proven to have microchimerism within a year of transplantation and the microchimerism later disappeared in 3, although the sequential change was variable in individual patients. There was no correlation between microchimerism and patients'clinical factors such as donor-specific blood transfusion, HLA matching, immunosuppression, past history of acute rejection and chronic rejection. The degree of microchimerism in renal transplant recipients was relatively low, and its existence did not seem to be compatible with long-term graft acceptance. However, further studies are required to elucidate the immunological mechanism of microchimerism, and it might be an important clue to immunological tolerance.

This paper describes an optimal design method for superconducting magnets wound with high temperature superconducting (HTS) tapes (e.g. Bi2223/Ag tapes). The properties of HTS tapes have been advancing and HTS magnets have been constructed and demonstrated. However, the HTS tapes have thermally different characteristics compared with the low temperature superconducting (LTS) wires. Therefore it is necessary to consider these characteristics of HTS tapes at the magnet design stage. We propose a new configuration of the superconducting magnets using Bi2223/Ag tapes. The proposed configuration is optimized by using simulated annealing (SA), which is one of the optimization algorithms, under a lot of constraints such as B-I characteristic, central magnetic field, field homogeneity and so on. The details of the optimization method and an example of its application to a 12-Tesla superconducting magnet using Bi2223/Ag tape are shown.

O objetivo do estudo foi determinar a prevalência da artrite idiopática juvenil (AIJ) em crianças escolares de na Cidade do Embu das Artes do Estado de São Paulo. 2880 escolares provenientes de 7 escolas públicas, com idades entre 6 e 12 anos, foram examinados por um especialista em Reumatologia Pediátrica. Nos casos de alteração do exame reumatológico os indivíduos foram examinados novamente por um outro especialista com título na área de atuação em Reumatologia Pediátrica. Os casos suspeitos de artropatia inflamatória foram encaminhados para um serviço especializado. Cento e quarenta e uma crianças apresentaram alterações no exame do aparelho locomotor, sendo a dor à palpação isolada o achado mais comum na primeira avaliação (60,9%), com melhora em praticamente 100% dos casos na segunda avaliação. A maioria das alterações foi relacionada a traumatismos recentes ou malformações congênitas. Seis crianças apresentaram exame suspeito de artropatia crônica e foram encaminhadas para avaliação em um centro de referência em Reumatologia Pediátrica. Destas, uma menina de 12 anos preencheu os critérios para AIJ. Os outros diagnósticos foram necrose asséptica da cabeça do fêmur (1 paciente) e sinovite pós-trauma (4 pacientes). A prevalência da artrite idiopática juvenil em crianças com idades entre 6 e 12 anos foi de 1/2.880 (ou 0,34/1.000). The aim of the study was to study the prevalence of juvenile idiopathic arthritis (JIA) in school children in the city of Embu das Artes in São Paulo State. 2880 school children from seven public schools, aged between 6 and 12 years, were evaluated (clinical findings) by a pediatric rheumatologist. A board certified Pediatric Rheumatologist evaluated the subjects with suspected inflammatory arthropathy. Children with higher suspicion were referred to a specialized service. One hundred and forty-one children have presented abnormalities on examination of musculoskeletal system, with isolated pain on palpation the most common finding in the first evaluation (60.9%), with improvement in almost all cases in the second examination. Most of the abnormalities were related to recent injuries or congenital malformations. Six children have clinical findings suggestive of chronic arthropathy and were referred to a specialized pediatric rheumatology clinic. Of these, a 12 year-old girl fulfilled the criteria for JIA. The other diagnoses were aseptic necrosis of the hip (P = 1) of and post-trauma synovitis (P = 4). The prevalence of JIA in children aged between 6 and 12 years was 1/2.880 (or 0.34/1.000). Universidade Federal de São Paulo (UNIFESP) Departamento de Pediatria da Escola Paulista de Medicina Setor de Reumatologia UNIFESP, Depto. de Pediatria da Escola Paulista de Medicina Setor de Reumatologia SciELO

1 Respiratory failure is a frequent cause of death in moderate to severe paraquat poisoning, and a tran- sient fall in the gas transfer factor may be seen in mild poisoning. 2 The objectives of this study were to detect long-term changes in lung function in survivors of paraquat poisoning. 3 We analyzed 12 survivors retrospectively for age, sex, signs and symptoms, laboratory findings, chest X-ray findings, serum paraquat level, and lung function test. The first and the follow-up lung tests were performed at 3.7 + 1.4 weeks and 3.4 + 1.4 years, respectively. 4 Serum paraquat levels were assayed in all patients and 3/12 were above the Proudfoot's predictive line. Liver dysfunction (GOT > 50) and renal dysfunction (BUN > 30) were noted in 5/12 and 8/12, respectively. DL/VA was lower than the normal limit in the first study (3.9 + 0.6 L), but increased significantly and returned to the normal range in the follow-up study (4.5 + 0.6 L).%VC was within the normal range in either examina- tion, but significantly decreased in the follow-up.%TLC was within the normal range in the first study (87 + 13%), but significantly decreased below the normal limit in the follow-up (81 + 13%). 5 These results indicate that survivors of paraquat poisoning may be left with a restrictive type of pulmonary dysfunction and suggest that a long-term follow-up of lung function may be necessary for survivors of paraquat poisoning.

Introduced Lolium grasses are utilised in Japan for forage, turf and soil conservation. Many of these grasses have become naturalised in disturbed ecosystems. Neotyphodium endophytes in the tissues of grasses can increase host fitness by increasing tolerance to both biotic and abiotic stresses. Consequently, endophyte infection may be a factor enhancing invasion success of exotic grasses in the Japanese islands. We detected infection by Neotyphodium endophytes in 162 of 173 naturalised ryegrass populations in Japan. Italian ryegrass (L. multiflorum) had a higher infection rate than perennial ryegrass (L. perenne). Italian ryegrass also exhibited geographic variation in infection rate. It is unlikely that the infected Italian ryegrasses found in this study have come from cultivars used in meadows, since the use of forage ryegrass cultivars infected with Neotyphodium endophytes has been restricted in Japan to prevent toxicity problems. Possible sources of the ryegrasses may be turf seeds, soil conservation materials and/or contaminants in imported plant materials. Keywords:􀀁 alien species,􀀁 invasive plants, Italian ryegrass, Lolium multiflorum, Neotyphodium endophyte, perennial ryegrass, Lolium perenne

Summary Effects of prolonged sevoflurane, isoflurane and halothane anaesthesia in oxygen on clinical, cardiopulmonary, haematologic, and serum biochemical findings were compared in healthy, premedicated cats breathing spontaneously during 6h of anaesthesia using rebreathing (semi-closed circuit) or non-rebreathing (Bain coaxial circuit) system. Recovery from anaesthesia with sevoflurane was more rapid than that with halothane or isoflurane in both systems. Respiration and heart rates during sevoflurane anaesthesia were similar to those during isoflurane rather than halothane anaesthesia in both systems. The degree of respiratory acidosis during prolonged sevoflurane anaesthesia was similar to that during isoflurane anaesthesia, and was less than that during halothane anaesthesia in both rebreathing and non-rebreathing systems. Prolonged sevoflurane anaesthesia induced mean arterial pressure similar to isoflurane or halothane anaesthesia in the non-rebreathing system, but it depressed mean arterial pressure less than isoflurane or halothane anaesthesia in the rebreathing system. Time-related increase in the arterial carbon dioxide partial pressure was observed during halothane anaesthesia especially in the rebreathing system, however, no significant time-related changes in cardiopulmonary variables were observed during either sevoflurane or isoflurane anaesthesia in both systems. There were no significant differences among sevoflurane, isoflurane and halothane anaesthesia in serum biochemical values in both systems.

Background Interferon (IFN) therapy is a well-established antiviral treatment for hepatitis C virus (HCV) − infected patients. However, susceptibility to thrombocytopenia is a major obstacle in its initiation or continuation, particularly in patients with HCV who underwent liver transplantation (LT). We previously showed that the coexistence of splenomegaly and thrombocytopenia could result in persistent thrombocytopenia after LT. Here we retrospectively evaluated the validity of this criterion for simultaneous splenectomy in recipients with HCV. Patients and Methods Subjects included 36 recipients with HCV who received LT between January 2006 and February 2012 at Hiroshima University. We analyzed the spleen volume, body surface area, platelet (PLT) count, and rate of completion or continuation with IFN therapy in these recipients. Result Of these recipients, 30 did not require simultaneous splenectomy according to the criterion, and 24 actually did not receive simultaneous splenectomy. In this group, 21 (87.5%) started IFN therapy. Fifteen (71.4%) of these recipients completed or continued IFN therapy, whereas 13 (61.9%) achieved either a sustained virological response (SVR) or an end-of-treatment response. The PLT count increased to >100,000/mm 3 1 month after LT in 16 (66.7%) recipients from this group. Conclusion Our criterion detected the PLT count outcome after LT in recipients with HCV and achieved a better SVR result after IFN therapy.

Purpose Recent reports demonstrated that large retinal pigment epithelial detachments (PED) associated with neovascular age-related macular degeneration (AMD) was successfully treated with aflibercept. The aim of this study is to report unexpected short-term response of aflibercept in the treatment of AMD with associated large PED which had been failed to ranibizumab treatment. Methods The method comprised a retrospective review of the medical records of patients with PEDs associated neovascular AMD and recently treated with aflibercept and previously treated with ranibizumab. Results Two eyes of male Japanese patients of ages 79 and 80 years old with large serous PEDs and subretinal fluid (SRF) associated with occult choroidal neovascularization and neovascular AMD were treated with aflibercept after intravitreal ranibizumab had failed to resolve the lesions. All had complete resolution of SRF and complete or near- complete resolution of the serous PEDs after aflibercept injections over a 2-month period. However, after the second injection of aflibercep, all eyes displayed fibrovascular PED in the lesion where serous PED was observed. Moreover, one eye presented a sudden retinal hemorrhage and a recurrent PED just after the third injection of aflibercept, and the visual acuity decreased 10/20 to 2/20. Conclusion Intravitreal aflibercept may be carefully applied for for serous PED in neovascular AMD patients after ranibizumab have previously failed. Larger studies with longer follow-up are required to determine the role of aflibercept in treatment of serous PED in neovascular AMD.