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Intravenous administration of magnesium with a short hydration regimen is recommended for patients receiving high-dose cisplatin to protect against cisplatin-induced nephrotoxicity. However, the optimal dose of magnesium supplementation has not been clarified. The aim of this trial was to investigate the safety and efficacy of a short hydration regimen with 20 mEq of magnesium supplementation for lung cancer patients receiving cisplatin-based chemotherapy. The key eligibility criteria included cytologically or histologically diagnosed lung cancer, candidacy for cisplatin-based (≥ 60 mg/m2) chemotherapy or chemoradiotherapy, no prior chemotherapy, aged 20–75 years, and adequate renal function. Cisplatin was administered with pre-hydration with 20 mEq of magnesium sulfate. Mannitol was administered just before cisplatin infusion to enforce diuresis. The primary endpoint was the proportion of patients who underwent cisplatin-based chemotherapy with a short hydration regimen with 20 mEq of magnesium supplementation without a grade 2 or higher elevation in creatinine. Forty patients with a median age of 66 years (range 35–74) were prospectively enrolled. Median baseline creatinine was 0.71 mg/dL. Median dose of cisplatin in the first cycle was 80 mg/m2. In the first cycle, no patients developed grade 2 creatinine toxicity. During the treatment period, one patient developed grade 2 creatinine elevation; thus, the proportion of patients without a grade 2 or higher elevation in creatinine was 97.5% (95% confidence interval 86.8–99.9). A short hydration regimen with 20 mEq of magnesium supplementation is safe and feasible for patients with lung cancer receiving cisplatin-based chemotherapy.

We developed an ultrahigh-definition (UHD)-2/8K camera recorder that uses a complementary metal–oxide semiconductor (CMOS) image sensor with an organic thin-film, instead of photodiodes for the opto-electrical conversion element. The advent of UHD-2/8K Super Hi-Vision broadcasts and an increase in the production of UHD-2/8K programs across a variety of genres necessitate the development of a sensor with a good signal-to-noise ratio (SNR) and high-dynamic range (HDR) to capture the full range of HDR video. To ensure successful use of this sensor, we studied the level diagrams (e.g., balancing of sensitivity, SNR, and dynamic range) that would best fit the sensor’s characteristics and use its strengths, and then proceeded accordingly. For the current UHD-2/8K location shooting, a workflow is needed to record raw data and post-process them into a practical video format. To implement a more efficient workflow, we chose to use Grass Valley HQX compression encoding while adding features that make it possible to store video data in a compressed form and simultaneously generate high-definition television (HDTV) proxy data. The workflow that we envisioned uses proxy data for offline editing and relinks them using online editing equipment.

Chemotherapy-induced nausea and vomiting (CINV) can cause anorexia, weight loss and deterioration of patient quality of life. It is one of the most unpleasant adverse effects of chemotherapy treatment regimens. For the optimal treatment of gastrointestinal symptoms during urothelial carcinoma chemotherapy, the present study investigated the association between gastrointestinal symptoms and therapeutic effects of gemcitabine plus platinum [cisplatin (GC) or carboplatin (GCa)] therapies. The incidence and frequency of nausea/vomiting with GC split therapy (gemcitabine, 1,000 mg/m(2) on days 1 and 8; split-dose cisplatin, 35 mg/m(2) on days 1 and 8; 21-day schedule) and GCa therapy [gemcitabine, 750-1,000 mg/m(2) on days 1, 8 and 15; carboplatin, area under the blood concentration-time curve=5 mg min/ml (Calvert formula) on day 2; 28-day schedule] were lower compared with those of GC therapy (gemcitabine, 1,000 mg/m(2) on days 1, 8 and 15; single-dose cisplatin 70 mg/m(2) on day 2; 28-day schedule). However, no differences in therapeutic outcomes were observed among therapies. GCa therapy, regardless of renal function, and GC split therapy demonstrated significant increases compared with GC therapy in alleviating gastrointestinal symptoms associated with cancer chemotherapy in patients with urothelial carcinoma. Overall, these results suggested that split-dose cisplatin administration or the use of carboplatin instead of cisplatin may be useful in patients who experience CINV without compromising treatment effectiveness.

This paper highlights our developments in hardware compression for production applications. The underlying compression scheme shows a minimal quality degradation through multiple encode/decode cycles, making it suitable for production systems. The Tiny Codec (TICO) codec takes an uncompressed UHDTV-2 bitstream of 48 Gbits/s (59.94 Hz, 10 bits, 4:2:2) and compresses it to fit into a single 12G-Serial Digital Interface (SDI) cable. The device can also be fitted with IP interfaces. These changes permit significant reductions in cable and switcher complexity.

AIM To investigate the real-world efficacy and safety of sofosbuvir/ribavirin (SOF/RBV) therapy for Japanese patients with genotype 2 hepatitis C virus (GT2-HCV). METHODS A total of 182 patients with GT2-HCV infection who received SOF/RBV therapy for 12 wk at our hospital were enrolled. The patients comprised 122 men and 60 women (age range: 17-84 years; mean age ± SD: 60.1 ± 12.1 years). Relationships between virological response and clinical data were examined by logistic regression analyses. RESULTS The proportions of patients with liver cirrhosis and history of hepatocellular carcinoma (HCC) were 29.0% and 17.3%, respectively. The proportion of patients with prior interferon (IFN)-based therapy was 25.6%. SOF/RBV therapy rapidly decreased HCV RNA levels. Several patients required RBV dose reduction because of anemia or fatigue. Four patients discontinued the therapy. The rates of sustained virological response at 12 wk after the end of treatment were 87.9% (intention to treat: 160/182) and 94.1% (per protocol: 159/169). Multivariate analyses showed that history of HCC or IFN-based therapy independently reduced the efficacy of SOF/RBV therapy. CONCLUSION SOF/RBV therapy for GT2-HCV is safe, highly tolerated, and effective. History of HCC or IFN-based therapy independently reduces the efficacy of this treatment.

Background Although opioid-induced nausea and vomiting (OINV) often result in analgesic undertreatment in patients with cancer, no randomized controlled trials have evaluated the efficacy of prophylactic antiemetics for preventing OINV. We conducted this randomized, placebo-controlled, double-blind trial to evaluate the efficacy and safety of prophylactic treatment with prochlorperazine for preventing OINV. Materials and Methods Cancer patients who started to receive oral oxycodone were randomly assigned in a 1:1 ratio to receive either prochlorperazine 5 mg or placebo prophylactically, given three times daily for 5 days. The primary endpoint was the proportion of patients who had a complete response (CR) during the 120 hours of oxycodone treatment. CR was defined as no emetic episode and no use of rescue medication for nausea and vomiting during 5 days. Key secondary endpoints were the proportion of patients with emetic episodes, proportion of patients with moderate or severe nausea, quality of life, and proportion of treatment withdrawal. Results From November 2013 through February 2016, a total of 120 patients were assigned to receive prochlorperazine (n = 60) or placebo (n = 60). There was no significant difference in CR rates (69.5% vs. 63.3%; p = .47) or any secondary endpoint between the groups. Patients who received prochlorperazine were more likely to experience severe somnolence (p = .048). Conclusion Routine use of prochlorperazine as a prophylactic antiemetic at the initiation of treatment with opioids is not recommended. Further research is needed to evaluate whether other antiemetics would be effective in preventing OINV in specific patient populations. Implications for Practice Prophylactic prochlorperazine seems to be ineffective in preventing opioid-induced nausea and vomiting (OINV) and may cause adverse events such as somnolence. Routine use of prophylactic prochlorperazine at the initiation of treatment with opioids is not recommended. Further research is needed to evaluate whether other antiemetics would be effective in preventing OINV in specific patient populations.

AIM This study aimed to compare the incidence of infusion site reactions (ISRs) induced by intravenous administration of brand-name and generic vinorelbine (VNR) for treating non-small cell lung cancer. METHOD This single-centre retrospective cohort study was conducted by medical chart review of VNR infusions. ISRs were defined as symptoms around the infusion site, including pain, redness and swelling. ISRs requiring treatment were defined as ISRs requiring treatments including steroid ointments, vein repuncture and local steroid injections. RESULTS In all, 1973 VNR infusions were administered to 340 patients (brand-name 141 patients, generic 199 patients). ISRs and ISRs requiring treatment were observed in 161 and 100 patients, respectively. The ISR incidence per patient and per injection was significantly higher in generic VNR-treated patients than in brand-name VNR-treated patients (53.3% vs 39.0%, P = 0.0112 and 15.0% vs 9.9%, P = 0.0008, respectively). The frequency of ISRs requiring treatment was also significantly higher in the generic group (per patient 36.7% vs 19.2%, P = 0.0005; per injection 11.3% vs 5.5%, P < 0.0001). Multivariate analysis revealed that generic VNR was significantly associated with an increased risk of ISRs (per patient adjusted odds ratio [AOR] 1.775, P = 0.0155; per injection AOR 1.672, P = 0.004) and ISRs requiring treatment (per patient AOR 2.422, P = 0.0012; per injection AOR 2.286, P = 0.001). CONCLUSION Intravenous infusion of generic VNR was associated with an increased risk of ISRs. Further research is needed to elucidate the mechanism underlying the increased incidence of ISRs with generic VNR.

The dosage of cisplatin is adjusted according to creatinine clearance (Ccr) estimated by the Cockcroft-Gault formula, which is commonly used as a marker for renal function. It is known that different serum creatinine (Scr) levels are reported depending on the analytical methods utilized such as the Scr level by the enzyme method being lower than that by the Jaffe method. Although the enzyme method is used in Japan, most drug dosages, including cisplatin, are adjusted according to the estimated Ccr using the Jaffe method-based Scr level. The purpose of this study was to investigate whether assessment of renal function with or without Scr adjustment affects cisplatin-based chemotherapy in cervical cancer patients. The patients were divided into two groups, normal (Ccr≥60 mL/min with adjusted Scr) and false normal (Ccr

Ten-Koh is a 23.5 kg, low-cost satellite developed to conduct space environment effects research in low-Earth orbit (LEO). Ten-Koh was developed primarily by students of the Kyushu Institute of Technology (Kyutech) and launched on 29 October 2018 on-board HII-A rocket F40, as a piggyback payload of JAXA&rsquo, s Greenhouse gas Observing Satellite (GOSAT-2). The satellite carries a double Langmuir probe, CMOS-based particle detectors and a Liulin spectrometer as main payloads. This paper reviews the design of the mission, specifies the exact hardware used, and outlines the implementation and operation phases of the project. This work is intended as a reference that other aspiring satellite developers may use to increase their chances of success. Such a reference is expected to be particularly useful to other university teams, which will likely face the same challenges as the Ten-Koh team at Kyutech. Various on-orbit failures of the satellite are also discussed here in order to help avoid them in future small spacecraft. Applicability of small satellites to conduct space-weather research is also illustrated on the Ten-Koh example, which carried out simultaneous measurements with JAXA&rsquo, s ARASE satellite.

NHK, Nippon Hoso Kyokai (Japan Broadcasting Corporation), is going to present highly realistic broadcasts of the 2020 Olympic Games in Tokyo via 8K Super Hi-Vision (also known as ultrahigh definition TV (UHDTV)), the world's most sophisticated broadcasting system. Here, we describe our preparations for the 8K broadcasting, particularly for the test broadcasting via satellite that began in 2016. In particular, we describe our activities related to standardization and development of program production equipment, play-out, and a distribution system for the 8K broadcasting. Regarding the production and distribution systems, we present the results of experimental satellite broadcasting performed in 2016. We also discuss the current status of the high dynamic range function for the 8K system, the multiformat production workflow, and remaining issues.

A method called “adaptive channel diversity” (ACD), which improves wireless performance in terms of reliability and latency, is proposed. With ACD, the optimum frequency channels are selected on the basis of the amount of dynamic radio interference. ACD was implemented in two prototype systems operating in the 2.4-GHz industry–science–medical band based on the ISA100.11a standard, namely, time-division multiple access and frequency channel hopping. According to an evaluation of the prototype systems, a 10−4 packet error rate was achieved within a 1.3-s latency for a 30-terminal star topology and within a 0.85-s latency for a 5-terminal multihop topology. These evaluation results are consistent with the results of simulations based on probabilistic analysis.

Axitinib is a selective tyrosine kinase inhibitor of VEGF receptors, approved for advanced renal cell carcinoma (RCC). Associations between axitinib plasma exposure, genetic polymorphisms of ABC transporters and axitinib-induced toxicities have not been adequately explored. Twenty RCC patients treated with axitinib were enrolled in this study. Blood samples were collected 0, 0.5, 1, 2, 4, and 6 h after administration of axitinib on day 1 and at steady state. Plasma concentrations of axitinib were analyzed by UPLC–MS/MS. The ABCG2 (421C>A) and ABCB1 (1236C>T, 2677G>T/A, 3435C>T) genetic polymorphisms were determined by real-time PCR. ABCB1 haplotype was associated with increased dose-adjusted area under the plasma concentration–time curve (AUC) of axitinib at steady state. The incidence of fatigue during therapy was associated with high AUC0–6 of axitinib (P = 0.013). The treatment period without discontinuation or dose reduction due to adverse events in patients with high AUC0–6 of axitinib was significantly shorter than for those with low AUC0–6 (P = 0.024). No significant differences were found in the frequency of adverse events among the ABCG2 genotype and ABCB1 haplotype groups. Our results have demonstrated that adverse events leading to discontinuation or dose reduction in axitinib were associated with increased axitinib plasma exposure, but not directly with genetic polymorphisms of ABC transporters. Therefore, measurement of steady state axitinib plasma concentrations may be useful in avoiding adverse events in axitinib therapy.

Background: Serum lactate dehydrogenase (LDH) levels could be a prognostic factor for sorafenib-treated patients with several types of solid tumor because it reflects hypoxic circumstances in aggressive tumors. For hepatocellular carcinoma (HCC), however, the prognostic role of LDH has been controversial. Liver fibrosis can potentially cause hypoxia in the liver, which has not been previously studied in the patients with advanced HCC. Thus, we aimed to analyze the prognostic role of LDH based on the degree of fibrosis. Methods: Eighty-nine consecutive patients with HCC (Child-Pugh class A) who were treated using sorafenib were enrolled into this study. Pretreatment characteristics and changes in hepatic functional tests based on early response to sorafenib and serum LDH levels were analyzed. The degree of fibrosis was estimated using the aspartate aminotransferase (AST) to platelet ratio index (APRI), and the tumor response was evaluated after 3 months of sorafenib treatment. Results: Overall, five patients discontinued sorafenib within 4 weeks. For the other 84 patients, those with progressive disease (PD) had significantly high pretreatment LDH levels, which correlated with the APRI score but not with the tumor stage. Multivariate logistic analysis revealed that older age and lower pretreatment LDH levels were independent prognostic factors for a better response to sorafenib. In patients who discontinued sorafenib early, three experienced acute liver failure accompanied with an increase in serum LDH. Conclusions: We demonstrated that baseline serum LDH levels in HCC patients were affected by liver fibrosis but not by the tumor stage, and these LDH levels could be a marker for early response to sorafenib. A marked increase in serum LDH levels during sorafenib administration might also indicate subsequent acute liver failure. Close observation of serum LDH levels before and during sorafenib treatment could be useful in managing treatment of patients receiving this therapy.

We, herein, report a 61-year-old male patient with amyotrophic lateral sclerosis (ALS) complicated pneumomediastinum while using mechanical insufflation-exsufflation (MI-E) after recovery from riluzole (RZ)-induced interstitial lung disease (RZ-ILD). After the treatment of RZ-ILD, he required non-invasive mechanical ventilation (NIV) at minimal pressure settings and MI-E to manage ALS-related breathing and airway-clearance issues, respectively. After a while, he developed progressive worsening dyspnoea, and chest computed tomography revealed extensive pneumomediastinum that had spread to the area surrounding the oesophagus, the retrosternal space, and the pericardial space. He was treated with immediate discontinuation of MI-E; however, he had to keep using NIV to support his severe respiratory muscle involvement. Pneumomediastinum gradually reduced in size and no recurrence of pneumomediastinum occurred. The clinical course of our patient suggests that excessive coughing associated with MI-E combined with his previous RZ-ILD, which potentially renders his lungs vulnerable to airway pressure, may have been the aetiological factors for secondary pneumomediastinum, i.e. barotrauma. Clinicians should be aware of the risk of pneumomediastinum while using MI-E in patients with ALS, who have other pre-existing risk factors for pneumomediastinum, such as drug-induced ILD in our case., Highlights • Pneumomediastinum could occur while using MI-E in ALS patients who recovered from drug-induced interstitial lung disease. • MI-E could be a cause of secondary pneumomediastinum in patients with pre-existing risk factors for pneumomediastinum. • Pneumomediastinum should be considered when acute progressive dyspnoea develops during the use of MI-E in ALS patient.

Satellites must endure the hostile environement during their launching to space via rocket; therefore, they should be exposed to the real launch conditions for ground testing, including all subsystems and components which should be carefully tested. Several solid-state-ceramic batteries have been selected to be evaluated under the launch environment after been evaluated under the space environment, which has shown so far good results. This paper focuses on the physical degradation and the electrical performances of the batteries based on the discharge capacity, the open-circuit voltage, and charge/discharge modes. Batteries have been exposed to shock, then tested under vibration within different frequencies’ levels with sinewave, sine burst, and random. Before and after the test, the physical properties of all batteries have been checked, several cycles of discharge and charge have been performed to check their performances and survivability after the evaluation test. With 95% of capacity, batteries could demonstrate their ability to withstand the launch conditions successfully, they could be able to operate during several cycles after the test, so far, showing no degradation on their performances within the limits. Also, the paper is providing the main requirements and criteria for batteries’ launch ground testing for the small satellite project.

The patient was an 81-year-old woman. At age 73, she developed difficulties in climbing stairs and swallowing, and became unable to open bottles at age 74. She had been walking with a cane since age 76. Accidental chest X-ray findings showed bilateral hilar lymphadenopathy at age 78. Angiotensin converting enzyme (ACE) was elevated. Lymphocyte proliferation was prominent in bronchoalveolar lavage fluid. Sarcoidosis was suspected, but she was followed without treatment due to lack of respiratory symptoms. She became unable to walk without assistance at age 80 and visited our hospital with a complaint of gait disturbance at age 81. Moderate diffuse muscle atrophy in extremities was evident. Muscle weakness of finger flexion and knee extension were remarkable. The muscle involvement pattern was similar to sporadic inclusion body myositis (sIBM). However, radiographically, rectus femoris and semitendinosus muscles are selectively preserved. This radiogaphic finding was consistent with chronic sarcoid myopathy (CSM). We reached a final diagnosis of CSM based on the presence of granulomas in the muscle biopsy specimen, BHL in fluorodeoxyglucose positron-emission tomography, the previous finding of elevated ACE, and bronchoscopy results. In conclusion, CSM is a treatable disease and should thus be differentiated from sIBM. This should not be done solely based on clinical findings, but instead, muscle biopsy should be performed. Moreover, muscle selectivity may be useful in distinguishing between CSM and sIBM.

There are individual differences in the frequency of chemotherapy-induced nausea and vomiting (CINV) in cancer patients. We investigated the individual variability in susceptibility to CINV with focus on both behavioral factors and genetic factors in Japanese cancer patients. We performed a prospective study to investigate the association between patient attributes (backgrounds and habits as well as gene polymorphisms) and anorexia, nausea, or vomiting in 55 Japanese cancer patients undergoing chemotherapy at Nagoya University Hospital. We found that gender (female), use of non-steroidal anti-inflammatory drugs, susceptibility to motion sickness, and anxiety were associated with the frequency of CINV. Gene polymorphisms of rs1076560 (dopamine D2 receptor gene), rs6766410 (serotonin 5-HT3C receptor gene) and rs4680 (catechol-O-methyltransferase gene) were also associated. Our data suggest that these attributes may thus be risk factors for CINV. Our results provide novel information that can be used to predict the incidence of CINV in Japanese patients undergoing chemotherapy; this can help provide a substantial improvement in supportive care for patients with different types of cancer.

An 85-year-old man complained of a 2-month history of pain on the left side of his face. Brain computed tomography (CT) and magnetic resonance imaging/magnetic resonance angiography did not clearly show any intracranial abnormality and only showed fluid effusion in his left sphenoid sinus. Filamentous fungi were detected from the left sphenoid sinus specimen. The isolate was Scedosporium apiospermum. He was empirically treated with voriconazole, to which the isolate was susceptible. His consciousness decreased rapidly. Urgent 3D-CT angiography revealed an intracranial aneurysm near the left sphenoid sinus. Despite urgent coil embolization, the aneurysm ruptured, and he died.

Atopic dermatitis is a chronic inflammatory skin disease associated with CD4+ Th2 cell-shifted immune responses. Although the infiltration of skin lesions by CD8+ T cells has been recognized, their roles have not been fully defined. In this study, we examined the relationship between CD4+ and CD8+ cells in antigen-induced skin lesions of mice. BALB/c mice were repeatedly challenged with Dermatophagoides farinae (Der f) applied to the right ear nine times. Pre-treatment with anti-CD4 monoclonal antibody (mAb) during the third to sixth challenges, but not the post-treatment during the sixth to ninth challenges, exacerbated the development of Der f-induced ear swelling; pre-treatment with anti-CD25 mAb, which depletes regulatory T cells (Tregs), also exacerbated the lesions. Furthermore, the number of CD8+ T cells in lymph nodes was augmented by these pre-treatments. These findings prompted us to examine the effect of anti-CD8 mAb. Pre-treatment with anti-CD8 mAb, but not post-treatment, strongly inhibited the development of Der f-induced ear swelling; additionally, the epidermal hyperplasia and infiltration of mast cells were inhibited by the pre-treatment. Collectively, we revealed that CD8+ T cells regulated by CD4+CD25+ Tregs in the early stage are key contributors to the development of Der f-induced skin lesions via increasing mast cell infiltration, indicating that CD8+ T and Tregs could be potential therapeutic targets for atopic dermatitis.

Background: Nedaplatin (NDP)-related hypersensitivity reactions (HSRs) trigger adverse clinical events. Prediction and prevention of NDP-HSRs are thus essential to minimize the risk and maximize the benefit of NDP therapy. However, the incidence of NDP-HSRs and the associated risk factors remain unclear. Methods: We retrospectively examined patients who received NDP monotherapy between April 2011 and July 2015 in Nagoya University Hospital. HSRs severity was defined according to the Common Terminology Criteria for Adverse Events version 4 (CTCAE ver.4). Risk factors for NDP-HSRs were determined using multivariate logistic regression. Results: Of 111 patients who received NDP monotherapy, 90 (81%) were female; median age was 59 years (range, 29–78 years). Eighty-eight patients had gynecological cancer and 20 suffered from head and neck cancer. Eight of 111 patients (7.2%) experienced NDP-HSRs, six of which developed in the second NDP cycle. However, all patients with NDP-HSRs were treated with carboplatin (CBDCA) for more than three cycles. Grade 3 and 4 HSRs developed in 2 patients. NDP-HSRs were significantly associated with a history of CBDCA-HSRs (odds ratio 37.5, 95% confidence interval 5.38–262, p < 0.001) and with the interval between NDP administration and the previous platinum treatment (odds ratio 13.9, 95% confidence interval 1.23–158, p = 0.034). Conclusion: The risk of NDP-HSRs increases in patients with a history of CBDCA-HSRs and in those administered NDP for more than 6 months after previous platinum treatment. Such individuals must be closely monitored if given NDP, even if they are expected to benefit from the treatment.

Background Genotype frequencies for chemotherapy-induced nausea and vomiting (CINV)-related polymorphisms have not yet been reported for Japanese subjects. Methods We analyzed 10 genotype frequencies for following polymorphisms associated with the development of CINV: serotonin 5-HT3 receptors (HTR3); neurokinin-1 receptors (Tachykinin-1 receptors, TACR1); dopamine D2 receptors (DRD2); and catechol-O-methyltransferase (COMT). Results All polymorphisms were successfully genotyped in 200 Japanese subjects and were in Hardy-Weinberg equilibrium. Almost all genotype frequencies were similar to those in the HapMap database or in the previous reports, while frequencies for the Y192H polymorphism in TACR1 were different in Japanese subjects from those in a previous report. Conclusions The present study revealed genotype frequencies for polymorphisms, which were related to the appearance of CINV in Japanese subjects. Individual therapy based on genotype variations for each race is needed to allow cancer patients to undergo chemotherapy more safely and to understand etiology of CINV.

Despite recent advances in chemotherapy, the treatment of pulmonary Mycobacterium avium complex (MAC) disease remains unsatisfactory. Judging from its MIC, fluoroquinolones including gatifloxacin (GFLX) are expected to demonstrate efficacy against MAC disease. However, there have been few clinical studies using fluoroquinolones. Therefore, a prospective study to evaluate the clinical efficacy and safety of a fluoroquinolone-containing regimen for the treatment of pulmonary MAC disease was conducted. In this trial, patients with pulmonary MAC disease received protocol-guided combined chemotherapy with rifampin (RFP) and ethambutol (EB) plus either GFLX or clarithromycin (CAM). Adult patients who fulfilled the criteria of the ATS definition of pulmonary MAC disease were enrolled in this study. The patients provided their informed consent, and treatments were administered for 1 year. Of 27 patients enrolled from three facilities, 14 patients were treated with the CAM-containing regimen and 13 patients were treated with the GFLX-containing regime. Four patients did not complete the 1-year treatment because of adverse events. Nine patients (64.3%) in the CAM group and 11 patients (84.6%) in the GFLX group achieved eradication of pathogens. Adverse events were observed more frequently in the GFLX group than in the CAM group. However, there were no severe adverse events in either group. The long-term results showed a similar relapse rate between the CAM and GFLX groups. The fluoroquinolone-containing regimen demonstrated both high efficacy and relative safety for pulmonary MAC disease that was similar to that of the CAM-containing regimen, which is considered to be the standard regimen.

Background and Aims: Disturbances in hepatic microcirculation are believed to be involved in the mechanisms regulating the progression of acute liver injury (ALI). Evaluation of hepatic hemodynamics in patients with acute liver injury might be helpful in understanding the extent of the intrahepatic microcirculatory disturbances. Therefore, we investigated whether contrast-enhanced ultrasonography (CEUS) is useful to evaluate the changes in hepatic hemodynamics in patients with ALI. Methods: CEUS was performed in 21 patients with ALI and coagulopathy. Participants were injected with 0.0075 mL Sonazoid/kg body weight, and time-intensity curves were simultaneously recorded for the hepatic and portal veins. The data were compared with those of 10 healthy volunteers. Results: The arrival time of Sonazoid in the hepatic vein was similar to that in the portal vein in the patients, whereas the arrival time in the hepatic vein was delayed relative to that in the portal vain in the controls (interval between the hepatic and portal vein arrival times, control vs patients 6.74 ± 3.07 s vs 1.13 ± 1.07 s, P

In this work, a time-of-arrival/time-difference-of-arrival (TOA/TDOA) hybrid relative positioning system based on UWB-IR technology is developed. The system reduces both the complexity of system configuration and the number of wireless transmissions in a positioning sequence. The system performance over various distances between access points is verified by computer simulations and experiments under the assumption that the distance between the access points is less than that between the access point and the target node. For the experiments, the proposed system is implemented with in-house developed UWB transceivers. The experiments confirm that the developed TOA/TDOA hybrid system can detect the relative positions of target nodes (under the condition of two access points 4 m apart) with a measured-angle accuracy of 8.6 degrees.

In this work, an ultra-wideband impulse radio (UWB-IR) transceiver with accurate time-of-arrival (TOA) estimation for a ranging/positioning system was developed for wireless sensor network applications. The system uses an impulse radio characterized by a low duty cycle and direct-sequence spreading, which enable very precise ranging and good receiver sensitivity. An algorithm enabling the TOA of the first-path signal to be measured accurately in a multi-path environment with simple, low-power and low cost implementations was proposed. UWB chips with CMOS 0.18-μm technology and UWB transceiver modules performed that the accuracy of the proposed ranging system is 18.5 cm in a closed space.

Kazuhiro Kotoh, Akihiro Ueda, Masatake Tanaka, Masayuki Miyazaki, Masaki Kato, Motoyuki Kohjima, Munechika Enjoji, Makoto Nakamuta, Ryoichi TakayanagiDepartment of Medicine and Bioregulatory Science, Graduate School of Medical Science, Kyushu University, Fukuoda, JapanAbstract: Although the mechanism underlying acute liver failure (ALF) has not been clarified, recent reports indicate overactivation of macrophages is involved in its progression. In diseases in which activated macrophages participate in the progression, elevated serum ferritin concentration counts among the characteristic laboratory findings. If activated macrophages play a key role in the development of ALF, serum ferritin levels might reflect the severity of acute liver injury. To confirm this, we evaluated the correlation between the serum ferritin concentration and other laboratory measurements in patients with acute hepatitis including ALF. One hundred consecutive patients with acute liver injury were enrolled, of whom 19 fulfilled the criteria for ALF. Serum ferritin concentrations correlated with serum alanine transferase activity as a whole. Interestingly, the correlation was strong in patients infected by hepatitis viruses, but weak in others. Although most patients with ALF had high levels of serum ferritin, not a few patients without ALF showed similar results. The serum ferritin level was generally increased in acute hepatitis patients, probably reflecting the degree of macrophage activation in the liver. Overactivation of macrophages appears to be essential, but not sufficient, for the development of ALF. Keywords: acute hepatitis, acute liver failure, ferritin, macrophage

A 1-GHz input bandwidth analog-to-digital (A/D) converter for an ultra-wideband impulse radio (UWB-IR) receiver is developed. Both an under-sampling sample-and-hold (S/H) circuit and a dynamic current-reduction comparator are proposed for the A/D converter. An under-sampling S/H circuit, which digitizes an input signal at a higher frequency than the sampling frequency with low power consumption, is required because the UWB-IR system utilizes intermittent ultrashort impulses. The proposed S/H circuit executes sampling by separating a sampling capacitor from an operational amplifier and accumulating the offset voltage of the amplifier in the other capacitor. The proposed dynamic current reduction comparator reduces bias current dynamically corresponding to its input-voltage level. The A/D converter is implemented in a 0.18-µm CMOS process technology, which achieves an effective number of bits of 5.5, 5.4, and 4.9 for input signals with frequencies of 1, 513, and 1057MHz, respectively, at 32M samples/s. The converter consumes 0.89mA and 0.42mA in the analog and digital component, respectively, at a 1.8-V supply.

The first one-cc or one-cubic-centimeter computer (OCCC) that integrates a sensor, ultra-wideband impulse radio (UWB-IR) transmitter, computing engine, and battery is demonstrated. Cross-layer integration includes SPIKE control, which achieves a record low power communication of 3.4-nW/bps with reduced operating time. Miniaturization techniques, such as wafer-level chip-size packaging and flip-chip packaging, were used to shrink the module to a volume of 1 cc. The fabricated OCCC is shown to operate as designed, communicating at distances of 10 and 30 m and at transmission rates of 10.7 Mbps and 258 kbps, respectively. The life of a 150-mAh battery in an OCCC that operates once every five minutes is estimated to be longer than 10 years. The communication-location integration (CLI) technique, which achieves 22-cm location accuracy with only a 1.3% chip area overhead, is also proposed.

A direct-sequence ultra-wideband impulse radio (DSUWB-IR) system is developed for low-power wireless applications such as wireless sensor networks. This system adopts impulse radio characterized by a low duty cycle, and a direct-sequence 0.7-GHz bandwidth, which enables low-power operation and extremely precise positioning. Simulation results reveal that the system achieves a 250-kbps data rate for 30-mdistance wireless communications using realistic specifications. We also conduct an experiment that confirms the feasibility of our system.

A reliable wireless communication method for next-generation decentralized control of power distribution systems is described; the method is based on TDMA combined with broadcast and data redundancy. The communication reliability (packet non-arriving rate [PNR] and latency) of the method was evaluated for a case study in a simulation under a realistic condition using Japanese next-generation power distribution system and an experimentally derived radio propagation model. The simulation results show that a certain level of PNR (∼10−1) can be rapidly achieved for low data redundancy (n∼2). In addition, high data redundancy provides a very low PNR with less latency. For 50-kbps data speed on 920– MHz/250-mW wireless media, up to 20 nodes can wirelessly communicate with a PNR of 10−2 and 2 s latency to achieve P2P communication and data exchange among all control devices, which means the target specifications for the next-generation distributed control can be achieved with the method.

本研究は, がん性疼痛マネジメントにおける患者の主体性と医療者の役割遂行について,「痛み計」の使用頻度をもとに, その効果を検討した. オピオイド使用中のがん患者10名は2週間, 随時「痛み計」に主観的な疼痛の強さを記録し, そのデータをグラフ化して患者と医療スタッフが共有した. その後, 患者と家族, 医療スタッフに質問紙調査を行った. その結果, 1日の入力回数の中央値は4.5回で, 質問項目の「入力しようと思った時は毎回入力した」「グラフを見た頻度」「グラフをもとに医師と話し合った」「他の患者にも勧めたい」「治療に参加しているという実感がある」と相関した. また, 医療スタッフは入力回数が多い患者に対し, 「痛み計のデータは疼痛アセスメトに役立った」「疼痛コントロールに関する患者の満足度は向上した」を高く評価した. 以上, がん性疼痛マネジメントを促進する痛み計の効果が示唆された. Palliat Care Res 2007;2(2):223-230

An intermittent wireless communication system has been developed for low-power sensor networks that improves sensor network efficiency by promoting cooperative optimization among the hardware architecture, communication protocol, and multiple access scheme. The intermittent communication protocol together with hardware for intermittent function contributed to reduce power consumption and extended sensor-node battery lifetime. A multiple access scheme based on the R-ALOHA protocol is used for the wireless link; it works efficiently with the protocol and hardware. Due to its inter-layer optimization, the system has low power consumption regardless of the traffic load and is thus flexible enough to support a wide range of sensor network applications.

本研究の目的は, 患者が簡便な操作で随時, 主観的な痛みの強さを記録できる「痛み計」を開発し, 臨床における有用性を確認することである. 「痛み計」(23cm x 6cm x 2cm,160g)は, 0-10 Numeric Rating Scale (NRS)を採用した11個の押しボタンを有し, 患者が疼痛に相当する数値のボタンを押すとその数値と日時を記憶する. 「痛み計」をパソコンに接続すると, 痛みの強さをグラフとして印刷できる. 研究方法は事例検討である. 大学病院に入院中でがん性疼痛のある患者1例に14日間, 痛み計の使用を依頼した. 印刷したグラフは患者と医療スタッフに渡した. その結果, 以下の点が示唆された. 1.0-10NRSを用いたことにより, 患者は痛みを円滑に表現できた. 2.操作を簡便にしたことにより, 患者は随時, 入力できた. 3.1日の痛みの推移をグラフで出力したことは, 疼痛アセスメントに有効であった.

Primary lung involvement in Waldenstrom's macroglobulinemia (WM) is rare. The present case had lymphoplasmacytic lymphoma, secreting monoclonal IgM, localized to the lung. WM is also of great interest with regard to the pathogenesis of amyloidosis. The nodular, parenchymal amyloid lesions of the lung are presented with CXR observations of more than 20 years.