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Summary Background Satralizumab, a humanised monoclonal antibody targeting the interleukin-6 receptor, reduced the risk of relapse in patients with neuromyelitis optica spectrum disorder (NMOSD) when added to immunosuppressant therapy. This study assessed the safety and efficacy of satralizumab monotherapy in patients with the disorder. Methods In this phase 3, double-blind, placebo-controlled, parallel-group trial, we enrolled adults aged 18–74 years with aquaporin-4 antibody seropositive or seronegative NMOSD at 44 investigational sites in 13 countries. Eligible participants had experienced at least one documented NMOSD attack or relapse in the past 12 months and had a score of 6·5 or less on the Expanded Disability Status Scale. Exclusion criteria included clinical relapse 30 days or fewer before baseline. Participants were randomly assigned (2:1) to receive satralizumab 120 mg or visually matched placebo subcutaneously at weeks 0, 2, 4, and every 4 weeks thereafter. Taking immunosuppressants concomitantly was prohibited. The primary endpoint was time to the first protocol-defined relapse, based on the intention-to-treat population and analysed with stratification for two randomisation factors (previous therapy for prevention of attacks and nature of the most recent attack). Safety was assessed in all participants who received at least one dose of satralizumab or placebo. The double-blind phase was due to last until 44 protocol-defined relapses occurred or 1·5 years after random assignment of the last patient enrolled, whichever occurred first; participants could enter an open-label phase after the occurrence of a protocol-defined relapse or at the end of the double-blind phase. The study is registered with ClinicalTrials.gov , NCT02073279 . Findings 95 (57%) of 168 screened participants were randomly assigned to treatment (63 to satralizumab; 32 to placebo) between Aug 5, 2014, and April 2, 2017. Protocol-defined relapses occurred in 19 (30%) patients receiving satralizumab and 16 (50%) receiving placebo (hazard ratio 0·45, 95% CI 0·23–0·89; p=0·018). 473·9 adverse events per 100 patient-years occurred in the satralizumab group, as did 495·2 per 100 patient-years in the placebo group; the incidence of serious adverse events and adverse events leading to withdrawal was similar between groups. Interpretation Satralizumab monotherapy reduced the rate of NMOSD relapse compared with placebo in the overall trial population, with a favourable safety profile. The patient population included a ratio of aquaporin-4 antibody seropositive and seronegative patients that was reflective of clinical practice. Satralizumab has the potential to become a valuable treatment option for patients with NMOSD. Funding Chugai Pharmaceutical (Roche).

We report current status of developing Soft X-ray Imager (SXI), the X-ray CCD camera onboard X-Ray Imaging and Spectroscopy Mission (XRISM). Four flight model (FM) CCDs have been selected considering several items including energy resolution at 5.9keV, CTI, dark current, etc. We have also completed calibration campaign for all the FM CCDs. Initial analyses show that the response function for monochromatic X-rays is basically the same as that of Hitomi CCDs. The focal plane including the single-stage Stirling cooler has been assembled. Production of key parts in SXI sensor body such as contamination blocking filter and onboard calibration source has been finished and they are waiting for assemble. The digitized signals of the CCD are corrected step by step before conversion to X-ray energy. We are preparing calibration database for the correction such as CTI, gain, and line redistribution function.

Over four thousands of exoplanets have been found to date. To understand the formation mechanisms of these diverse exoplanets, it is essential to unveil the detailed physical properties of these exoplanets by various methods, including high-precision transit photometry from the ground. So far two observing techniques have succeeded in achieving high-precision photometry from the ground; one is defocusing and the other is using optical diffusers. Diffusers spread light from stars over many pixels and stabilize the top-hat like point spread function (PSF), reducing systematic noises in photometric observations. In addition to it, diffusers enable us to use longer exposure times, which reduces atmospheric scintillation noises. We have developed diffuser units and installed them to the optical three-band imager MuSCAT. Each diffuser unit can store two types of diffusers with different opening angles, which allows us to change the strength of scatter of light from stars. We installed the diffuser units to MuSCAT in July 2019 and carried out on-sky examination. We observed out of transit (oot) phase of 11 planet-hosting stars alternatively with the following three configurations: with diffusers, without diffusers and with onfocus, and without diffusers and with defocus. From these observations, we confirmed that diffusers stabilized PSF and peak counts of stars. Throughput of the diffusers are measured to be about 93%. In addition, with diffusers, we succeeded in observing 55 Cnc, which is too bright (V=5.4) to observe without diffusers. We achieved the photometric precisions of 426, 641, and 783 ppm per 1 minute, or 188, 221, and 196 ppm per 5 minutes, in g', r', and zs-band, respectively.

We have been developing P-channel Charge-Coupled Devices (CCDs) for the upcoming X-ray Astronomy Satellite XRISM, planned to be launched in 2021. While the basic design of the CCD camera (Soft X-ray Imager: SXI) is almost the same as that of the lost Hitomi (ASTRO-H) observatory, we are planning to reduce the "light leakages" that is one of the largest problems recognized in Hitomi data. We adopted a double-layer optical blocking layer on the XRISM CCDs and also added an extra aluminum layer on the backside of them. We develop a newly designed test sample CCD and irradiate it with optical light to evaluate the optical blocking performance. As a result, light leakages are effectively reduced compared with that of the Hitomi CCDs. We thus conclude that the issue is solved by the new design and that the XRISM CCDs satisfy the mission requirement for the SXI., 6 pages, 4 figures, accepted for publication in NIMA, proceedings of the 12th International "Hiroshima" Symposium on the Development and Application of Semiconductor Tracking Detector (HSTD12)

Patients diagnosed with an endometrial cancer precursor lesion on biopsy may be found to have endometrial cancer at the time of subsequent surgery. The current study seeks to identify patients with endometrial intraepithelial neoplasia (EIN) on biopsy that may be harboring an occult carcinoma. Immunohistochemical stains for gene loss of expression (LOE) for 6 genes, PTEN, ARID1A, MSH6, MSH2, MLH1, and PMS2, were performed on 113 biopsy specimens with EIN. For the 95 patients with follow-up histology, 40 patients had cancer, 41 had EIN, and 14 had normal endometrium. PTEN LOE was found frequently in both EIN and endometrial cancer, and therefore had low positive predictive value. All specimens with ARID1A, MSH6, MSH2, MLH1, or PMS2 LOE on biopsy were subsequently found to have cancer. LOE of any gene was associated with modest sensitivity (0.78) in identifying patients with endometrial cancer who had EIN on biopsy. Further investigation is warranted to determine if gene LOE is a useful clinical tool when evaluating patients with EIN on biopsy., Highlights • PTEN, ARID1A, MSH6, MSH2, MLH1, and PMS2 were analyzed on patients with EIN. • Loss of expression was associated with the subsequent finding of endometrial cancer. • Sensitivity was 0.78 for loss of expression of any gene and the finding of cancer.

Highlights • Endometrial and cervical adenocarcinomas may demonstrate morphologic overlap. • Distinction between these is important as it dictates treatment and prognosis. • This diagnostic dilemma can be approached with a panel of stains., In a biopsy specimen, adenocarcinomas of the endometrium and uterine cervix may demonstrate significant morphologic overlap. The distinction between these two entities prior to surgical resection is clinically significant as assigning the primary site dictates treatment and prognosis. This diagnostic dilemma is approached by the application of a panel of immunohistochemical stains, traditionally composed of CEA, vimentin, p16, ER, and PR. Most cases are successfully managed with this panel; however, in difficult cases additional tools are needed to suggest a more definitive diagnosis. In this study, we reviewed the efficacy of the customary panel of stains, as well as the added value of new stains in the diagnosis of endocervical adenocarcinoma. Our cohort included biopsy samples of 90 patients (81 endometrial and 9 endocervical adenocarcinomas) with a subsequent hysterectomy for confirmation of diagnosis. This study validated the customary panel of stains and suggests additional markers to aid in the differential diagnosis (PAX8 and CAIX). The addition of PAX8 to the traditional panel increases PPV from 85.71% to 100%. A PPV of 100% may also be attained with fewer stains (five total), with the application of a proposed new panel, which includes PAX8, CAIX, CEA, p16 and ER. This is the first-time differential expression of CAIX has been suggested in the distinction between endocervical and endometrial adenocarcinomas.

ObjectiveThe aim of this study was to determine the histopathologic characteristics of patients with endometrial carcinoma with low-volume metastases (micrometastases and isolated tumor cells) compared with macrometastases.MethodsWe performed a retrospective review of patients with endometrial carcinoma.ResultsAmong 350 robotic-assisted hysterectomies for endometrial cancer, 187 (53%) underwent attempted sentinel lymph node (SLN) biopsy. At least 1 SLN was detected in 185, a 99% overall detection rate; 108 (58%) also had non-SLNs removed. Among 91 patients with SLNs and non-SLNs from the ipsilateral hemipelvis, both were negative in 74 (81%) and positive in 7 (8%), and 10 (11%) had a positive SLN with negative non-SLNs. Among 17 patients with SLNs and non-SLNs from the contralateral hemipelvis, both were negative in 12 (71%), both were positive in 3 (18%), and 2 patients (12%) had negative SLNs with contralateral positive non-SLNs. Among 79 patients with only a SLN dissection, 4 (5%) were positive; among 69 patients with only a non-SLN dissection, 14 (20%) had positive lymph nodes. Among 24 patients with metastatic SLNs, 9 (38%) had isolated tumor cells, 3 (13%) had micrometastases, and 12 (50%) had macrometastases. Among the 40 total patients with metastatic lymph nodes, low-volume metastases represented the largest metastatic deposit in one third of patients, all of which had SLN dissection. All 12 with low-volume metastases had endometrioid histology compared with less than half (46%) of those with macrometastases (P < 0.01). Grade 1 carcinoma was present in 7 (58%) of the patients with low-volume metastases compared with 4 (14%) of those with macrometastases (P < 0.01) Furthermore, significantly more patients with low-volume metastases versus macrometastases had less than 50% myometrial invasion (67% vs 4%, P < 0.001).ConclusionsLow-volume disease was present in one third of patients with nodal metastases, the largest metastatic deposit only in patients who had SLN dissection; these patients were significantly more likely to have grade 1 endometrioid carcinoma with less than 50% myometrial invasion, traditional “low-risk” features.

Background Relapsing polychondritis (RP) is a rare systemic inflammatory disorder and might often be refractory. Therefore, the discover of imaging modality would be required on diagnosis and treatment of RP. Objectives To assess the clinical implications of ultrasonography (US) in monitoring disease activity of relapsing polychondritis (RP). Methods Three cases of a 78-year-old man with RP, a 74-year-old woman with RP associated with optic perineuritis and a 42-year-old woman with RP associated with uveitis were assessed by US before and after treatments. Results Ultrasonography (US) of the auricle before treatment showed low-echoic swollen auricular cartilage with increased power Doppler signals (PDS) in all cases. US findings corresponded to the above-mentioned biopsy findings. After treatment with prednisolone combined with methotrexate, the auricular swelling completely resolved in all cases. Then, US findings also showed dramatic reductions in swelling of cartilage with the decrease in PDS. Conclusions US imaging can be used to differentiate between inflammation, vascular lesions, and tumors in the ear pinna. RP could be differentiated from the damage of repeated trauma (i.e. rugby) with producing subperichondrial serous effusion. As in the present cases, US imaging of the external ear and auricular cartilage in RP also facilitates evaluation of auricular lesions and monitoring of disease activity, especially when we consider the treatment response and the timing of drug tapering. Disclosure of Interest None declared

Patients with Lynch Syndrome are at an increased risk for a variety of malignancies, including ovarian cancer. Ovarian cancers associated with Lynch Syndrome are predominantly clear cell or endometrioid in histology. Lynch Syndrome is characterized by germline mutations in mismatch repair (MMR) genes. The current study aims to assess the prevalence of loss of MMR expression in patients with endometrioid and clear cell ovarian carcinoma.A retrospective review identified 90 patients with endometrioid and/or clear cell carcinomas. Slides made from tumor tissue microarray blocks were evaluated using immunohistochemical stains with antibodies against MLH1, PMS2, MSH2, and MSH6. Statistical analysis was performed.Seven of the 90 cases (7.8%) had loss of MMR expression. The mean age of patients with loss of MMR expression (47 years) was significantly younger than those with retained MMR expression (p=0.014). Loss of MMR expression was present in 20% of patients under the age of 53 with clear cell or endometrioid cancers. Genetic studies found that 3 of the 5 patients with loss of MMR expression carried mutations consistent with Lynch Syndrome; acquired hypermethylation of MLH1 was noted in one patient. Six of 7 patients (86%) whose tumors lacked MMR expression had synchronous or metachronous primary malignancies, a significantly greater prevalence than those with retained MMR expression (p0.001).Patients under the age of 53 with clear cell or endometrioid ovarian carcinomas are at a clinically significant risk for loss of MMR expression and Lynch Syndrome; routine screening with immunohistochemical staining should be considered.

OBJECTIVE The benefit of evaluating the precursor of endometrial carcinoma, endometrial hyperplasia (intraepithelial neoplasia [EIN]), for loss of mismatch repair (MMR) protein expression and Lynch syndrome has yet to be determined. The present study aims to establish the incidence and type of loss of MMR protein expression in unselected premalignant lesions of endometrial adenocarcinoma, as well as the agreement of immunohistochemical staining in pretreatment endometrial biopsy (EMB) specimens with subsequent uterine resections. METHODS A retrospective review identified 112 endometrial biopsies meeting criteria for endometrial EIN. Slides made from tissue microarray blocks were evaluated using antibodies against MLH1, PMS2, MSH2, and MSH6. Cases with a deficit in MLH1 were evaluated for gene promoter hypermethylation by polymerase chain reaction analysis. Fifty-four subsequent hysterectomy specimens were retrieved and assessed for MMR protein expression. RESULTS Of the 112 endometrial biopsies with EIN, 4.5% (5/112) exhibited loss of MMR protein expression. The majority (4/5) demonstrated a deficit of MLH1, of which all exhibited inactivation via promoter hypermethylation. A single case displayed an absence of MSH6. Age was not significantly associated with MMR deficiency. There was no significant association between MMR status in the EMB and a subsequent diagnosis of cancer. Immunohistochemical staining in all successive hysterectomy cases was concordant with the pattern observed in the EMB specimen. CONCLUSIONS Sporadic hypermethylation of MLH1 seems to be the primary mechanism underlying defective MMR protein expression in EIN. Among our cohort, only 1 patient (

Background The aim of this study was to clarify the outcomes of lung resection for lung cancer in patients with cardiac disease, especially coronary artery disease, in a large-scale multi-institutional cohort. Methods We retrospectively analyzed the data on 1,254 patients who underwent major lung resection for lung cancer and had been diagnosed with coronary stenosis, atrial fibrillation, or both, in 58 institutions in Japan between January 2009 and December 2011. The primary outcome was 90-day postoperative mortality or in-hospital death. Results Among the 1,254 patients, 902 (71.9%) and 452 patients (36.0%) were preoperatively diagnosed with coronary stenosis and atrial fibrillation, respectively, and 951 patients (75.8%) received antiplatelet therapy. Among the patients with coronary stents (n = 532; 42.4%), 204 (16.3%) received drug-eluting stents. The 90-mortality or in-hospital death rate was 2.6% (n = 32), including stent thrombosis (n = 1), thromboembolic events without stent thrombosis (n = 2), and bleeding events (n = 2). In the multivariate analyses, blood transfusion, history of cerebrovascular disease, amount of bleeding, and history of congestive heart failure were associated with a higher independent risk of 90-day mortality or in-hospital death (odds ratio, 9.400, 3.574, 2.827, and 2.945, respectively). Preoperative discontinuation of antiplatelet therapy was not associated with an independent risk of 90-day mortality or in-hospital death on univariate analysis. Conclusions Major lung resection for lung cancer in patients with coronary artery disease is feasible. Our study suggests that discontinuation of antiplatelet therapy may not increase postoperative complications in patients with coronary artery disease.

Objective This study examines premenopausal and early menopause patients in a unique population with endometrial cancer and loss of mismatch repair (MMR) gene expression. The purpose is to compare clinical and pathologic differences in patients with loss of expression (LOE) to those with normal expression (NE). Methods Endometrial cancer patients under age 60 in-between 1998 and 2008 were identified from a single tumor registry. Clinical and pathologic data were abstracted from records. Staining for expression of MSH6, MSH2, MLH1, and PMS2 were performed on archived tissue blocks. Statistical analysis was performed. Results 158 patients were analyzed; 58% Asian, 34% Pacific Islander, and 8% Caucasian. 31 demonstrated LOE of at least one MMR gene; 127 retained NE. 50% Caucasian, 21.9% Asian, and 12.5% Pacific Island populations had LOE of one or more MMR genes. LOE was found to have a higher incidence of Grade III (p = 0.0013) and stage 3–4 tumors (p = 0.0079), mean depth of myometrial invasion (p = 0.0019), lymphovascular space invasion (p = 0.0020), nodal metastases (p = 0.0157), and a lower incidence of Grade I (p = 0.0020) and stage 1A tumors (p = 0.0085). LOE had a significantly lower mean BMI (p = 0.0001). 35% of patients in the NE vs zero in the LOE group had a BMI greater than 40. Conclusion Younger patients with LOE endometrial cancer appear to represent a clinically significant subgroup of patients without features characteristically found in classic type 1 endometrial cancer generally demonstrating lower BMI and tumors associated with poor prognostic characteristics. It is unclear if the distinctive ethnicity found in Hawaii has a significant impact on outcome. Further investigation is necessary to identify appropriate treatment strategies.

Objective: To investigate the role of previous gynecologic surgery, hormone use, and use of non-steroidal anti-inflammatory drugs on the risk of type 1 and type 2 ovarian cancer. Methods: We utilized data collected for the Prostate, Lung, Colorectal, and Ovarian cancer screening trial. All diagnosed ovarian cancers were divided into three groups: type 1, endometrioid, clear cell, mucinous, low grade serous, and low grade adenocarcinoma/not otherwise specified (NOS); type 2, high grade serous, undifferentiated, carcinosarcoma, and high grade adenocarcinoma/NOS; and other: adenocarcinoma with grade or histology not specified, borderline tumors, granulosa cell tumors. The odds ratios for type 1, type 2, and other ovarian cancers were assessed with regard to historical information for specific risk factors. Results: Ibuprofen use was associated with a decrease in risk for type 1 ovarian cancer. Tubal ligation and oral contraceptive use were associated with a decrease in risk for type 2 ovarian cancer. A history of ectopic pregnancy was associated with a decreased risk for all ovarian cancers by almost 70%. Conclusion: These findings support the hypothesis that carcinogenic pathways for type 1 and type 2 ovarian cancer are different and distinct. The marked reduction in all ovarian cancer risk noted with a history of ectopic pregnancy and salpingectomy implies that the fallopian tube plays a key role in carcinogenesis for both type 1 and type 2 ovarian cancer.

By monitoring the temperature inside cryogenic equipment such as superconducting magnet, we can detect the indication of failures and prevent the equipment suffered from damage. It is possible to measure the multipoint temperature by one optical fiber sensor. This sensor is suitable to measure the temperature at cryogenic temperatures because of low heat invasion and high voltage insulation. In this study, as for Fiber Bragg Grating as abbreviated FBG system of multipoint type, we investigated the reproducibility by measuring the temperature repeatedly, and multipoint measurement characteristics by measuring the temperature inside a cryogenic equipment with temperature gradient. We also investigated the improvement of the sensitivity for temperature at cryogenic temperatures by enhancing the thermal expansion coefficient using the coated optical fiber sensor.

e13516Background: Loss of expression of p53, ARID1a, MLH1, PMS2, MSH2, and MSH2 are commonly seen in endometrial adenocarcinomas. The objective of our study is to delineate the incidence of loss of...

This paper proposes a vibrator gyroscope made of a piezoelectric tube, which has the same configuration as that used for the tri-axial sensors and actuators developed in our previous paper. The gyroscopic operation is the same as a circular rod, but the polarization (in thickness direction of the shell) and, accordingly, the electrode arrangement are much simpler. Wireless LAN arrangement is devised for remote data access with which the measurement is possible for the gyroscope under rotation. The experimental results are compared with the numerical simulation with three-dimensional finite-element calculation. The discrepancy between the measured and the experimental is found to depend on the asymmetrical deformation of the structure, and the cause is clearly demonstrated via simulation. This shows the usefulness of the numerical modeling to investigate the cause, in which the parameters of dimensions and boundary conditions can easily change.

This paper provides an outline of a new animatronic system, based on the technology of the flexible oscillating fin. The oscillating fin propulsion system was designed and constructed to be combined with a ship model. The system's feasibility has been confirmed by tank tests using the ship model. As a result, several advantages of the oscillating fin system have been found. A neural network was successfully applied for an identification of the ship model dynamics with the oscillating fin and its effectiveness was confirmed. The animatronic system is a computer-controlled biomechanically engineered model, rapidly gaining popularity throughout the world. We have developed aquatic robots with oscillating fins for the animatronics system to build a virtual aquarium. We have proposed an exhibition system for enhancing event spaces that includes an animatronic system for modern-day fish, coelacanths, and Cambrian-world creatures, able to swim under their own electric power.

The least-square method is applied to the identification of the stop model in order to improve its hysteretic representation. It is shown that the height difference of stop hysterons should not be smaller than the amplitude difference of the hysteretic loops used for the identification. The effective magnetic field is used for the play model. It successfully improves the hysteretic representation by the play model. The comparison of both models shows that the play model using the effective magnetic field represents the hysteretic characteristics more precisely than the stop model.

The study investigated the relationship between the circadian variation of salivary melatonin and the amount of light received during the day and night. Forty one females served as subjects. An illuminance meter worn on the wrist of the non-dominant arm measured the amount of light which subjects leading a diurnal lifestyle received during two consecutive days. Light received from the time of rising to 18:00h was defined as ‘daytime light’, and that from 18:00h to the time of retiring as ‘nighttime light’. The average amount of light over the two days was 48 × 10 4 lx during the daytime and 11 × 10 4 lx during the nighttime. Saliva was collected every 4h in order to measure melatonin secretion. Peaks of melatonin secretion were observed at 14:00h and 18:00h in the subjects who had received lesser amounts of light during the daytime and nighttime. Melatonin secretion was high around 22:00h and peaked around 02:00h in the subjects who had received greater amounts of light during the daytime and lesser amoun...

To determine if an abnormal CA-125 level in a menopausal female without ovarian cancer is associated with an increase in mortality.The Prostate, Lung, Colorectal, and Ovarian Cancer Screening Randomized Controlled (PLCO) Trial is a large multicenter prospective trial conducted by the National Cancer Institute (NCI). Over 78,000 healthy women aged 55-74 were randomized to a screening arm versus a usual medical care arm to evaluate the efficacy of screening in reducing mortality due to ovarian cancer. Women in the screening arm underwent annual screening for ovarian cancer with transvaginal ultrasound and CA-125 levels. There were 38,818 patients without ovarian cancer that had at least one CA-125 level drawn; 1201 (3.09%) had at least one abnormal level. The current study compares mortality in patients that had one or more abnormal CA-125 levels without ovarian cancer versus those with all normal levels.Patients with one or more abnormal CA-125 levels, without ovarian cancer, had a significantly higher mortality than patients with all normal CA-125 levels in the PLCO screening trial (p0.0001). This increased risk extended throughout the follow-up period. Analysis of cause of death listed on the death certificate showed an excess mortality attributable to lung cancer, digestive disease, and endocrine, nutritional, and metabolic disease.Menopausal females with an elevated CA-125 and without ovarian cancer are exposed to an increased risk of premature mortality.

Nippon Steel Yawata Works operates with only one blast furnace in service. BF No. 1 (inner volume : 4407 m3 ) was blown off on January 31, 1998 after operating for thirteen years. The third campaign of BF No. 4 (inner volume : 4250 m3 ) was started the following day and productivity reached 2.0 t/d.m3 IV after fifteen days of operation. This paper describes the characteristics of the relining of No. 4 furnace. Also presented is the background of the speedy switchover of large blast furnace operation and the rapid increase in productivity without any reduction in output.

High-frequency extracellular unitary activity was recorded mainly in the ventral caudal nucleus of the thalamus in chronic-pain patients. These high-frequency discharge (hyperactive) neurons shows thr

Strong optical confinement to the low-index slot, such as ErxY2-xSiO5, is expected for TM mode in Si slot waveguide. The confinement effect causes the optical mode density modification, resulting in the enhancement of radiative transition. We have fabricated slab Si-slot waveguides with Er2SiO5 slot layers in order to demonstrate the dependence of radiative emission on the guided waveguide modes. The PL fine structure particular to Er2SiO5 crystal has been observed through the waveguide structure. We confirmed the enhancement of the TM mode edge emission.

To describe the first reported case of non-islet cell tumor hypoglycemia (NICTH) associated with carcinosarcoma of the ovary.We report the clinical course, imaging, and pathologic findings of our patient and review relevant literature.A 48-year-old woman had a surgery to remove ovarian masses, which turned out to be carcinosarcoma of the ovary, stage IIIc; however, she declined postoperative adjuvant chemotherapy. Six months later, she became unconscious with severe hypoglycemia. A large pelvic mass was found and thought to represent a recurrence. Serum insulin and C-peptide were undetectable. Morning cortisol was mildly elevated. Thyroid stimulating hormone, amylase, lipase, and renal and hepatic functions were normal. While insulin-like growth factor (IGF)-I was low, IGF-II was inappropriately elevated. Increased IGF-II/IGF-I ratio was suggestive of NICTH in light of the large pelvic tumor. She required frequent meals, dextrose boluses, and continuous infusions, oral prednisone, and glucagon continuous infusion to prevent recurrent hypoglycemic attacks. Chemotherapy with carboplatin and paclitaxel was initiated, and glucose control started to improve. After 4 cycles of the chemotherapy, the tumor regressed substantially and was surgically removed. She had 3 more cycles of postoperative chemotherapy. Although the reported median survival of this aggressive neoplasm is less than 2 years, this patient has been free of recurrent disease and hypoglycemia for 6 years.This is the first study to report NICTH in a patient with carcinosarcoma of the ovary. Clinicians should be aware of NICTH as a cause of hypoglycemia especially in a patient with a tumor or history of tumor.

Free vibrations of a fully clamped symmetrically laminated skew plate are analyzed by a numerical approach in which the Green function for a static bending problem is used. As a numerical example, results are presented for a three-layered symmetrically laminated skew plate. The effects of the skew angle and the fiber orientation angle on natural frequencies and mode shapes are discussed.

e17073Background: ARID1a is thought to function as a tumor suppressor; mutations in this gene have been associated with many cancers. Recent studies have found ARID1a mutations in atypical endometr...

The purpose of this paper is to describe the feasibility research on an oscillating fin propulsion control system as a vehicle actuator. The system is designed and constructed in order to be combined with ship models. Tank cruising tests are conducted to confirm the system's feasibility. As a result, several advantages of the oscillating fin system are found. A neural network is successfully applied for an identification of the ship model with the oscillating fin, and its effectiveness is confirmed. >

The application of exhaust gas recirculation technology which can drastically decrease the volume of exhaust gas from the stack was studied at Tobata No. 3 sinter plant as basic technology to respond to environmental control which will become more and more strict in the future. This report describes the specification of the exhaust gas recirculation equipment installed at the Tobata No. 3 sinter plant and the operating resuit before and after the installation of the equipment.

CANINE superficial pyoderma is a common skin disease in dogs ([Scott and others 2001][1]). It is mainly treated with systemic antimicrobials, particularly oral cefalexin ([Lloyd and others 1996][2]). However, the emergence of multiresistant mecA -positive Staphylococcus intermedius was reported by [

An x‐ray microprobe system with total‐reflection mirror optics for trace element analysis has been developed at beamline 37XU of SPring‐8. To achieve sub‐microprobe, a spatial filter has been installed downstream of a monochromator. Focusing tests have been performed in the x‐ray energy range of 6–14 keV. A focused beam size of 0.83 μm(V)×1.35 μm(H) has been obtained at an x‐ray energy of 10 keV, and using a spatial filter in the horizontal direction, the beam size is down to 0.84 μm. Micro‐x‐ray absorption fine structure (XAFS) spectroscopy of submicrometer particles has been done by utilizing the total‐reflection mirror optics. It was clearly observed from the nickel K‐edge XAFS spectra that the oxidation state of nickel was a mixture of metal and oxide even in the single submicrometer particle.

A twelve-year follow-up study was carried out with 98 consecutive patients operated on for pure mitral stenosis with open mitral commissurotomy (OMC) or valve replacement with porcine valves (MVR). Each patient had the extent of valve distortion diagnosed preoperatively by two-dimensional echocardiography as either grade I of the dome-formation type, grade II of the intermediate type, or grade III of the mass-formation type. Thirty grade I patients and 24 grade II patients underwent OMC and 44 grade III patients received MVR. The long-term survival and reoperation rates were significantly poorer with grade II than grade I patients and there was no statistical significance between grades II and III. However, the clinical conditions set by NYHA are significantly worse in grade II than in grade III. This can be clearly explained by the fact that the left atrial volume decreasing ratio (LAVDR) in the latest period, which was measured in patients with more than 7 years survival, remained nearly at the early postoperative value in grade III, while the LAVDR of grade II at the latest period grew worse and became insignificantly different from the preoperative values. This study clearly shows that when OMC is applied to grade II patients, frequent reoperations might be necessary because of poor hemodynamic conditions. Thus, it might be better to adopt MVR rather than OMC with grade II patients with moderately distorted mitral valves.

The 3rd interplanetary network (IPN), which has been in operation since 1990, presently consists of 9 spacecraft: AGILE, RHESSI, Suzaku, and Swift, in low Earth orbit; INTEGRAL, in eccentric Earth orbit with apogee 0.5 light‐seconds; Wind, up to ∼7 light‐seconds from Earth; MESSENGER, en route to Mercury; and Mars Odyssey, in orbit around Mars. Ulysses and HETE have ceased operations, and the Fermi GBM is being incorporated into the network. The IPN operates as a full‐time, all‐sky monitor for transients down to a threshold of about 6 × 10^(−7) erg cm^(−2) or 1 photon cm^(−2) s^(−1). It detects about 275 cosmic gamma‐ray bursts per year. These events are generally not the same ones detected by narrower field of view imaging instruments such as Swift, INTEGRAL IBIS, and SuperAGILE; the localization accuracy is in the several arcminute and above range.

Laboratorio Fleury is a reference clinical laboratory performing more than 1,200 different laboratory tests, with a workload of 3.5 million tests in 1998. With 60% of this workload directed to our clinical chemistry section, we started a project three years ago to evaluate the possibility of an automation system to fulfill our needs of quality, increased productivity, and as a base for further increases in workload. A workforce was assembled, and after detailed studies of our necessities and possibilities as well as an extensive program of visits and contacts in the U.S., Europe, and Japan, a final solution was settled.The system is being manufactured by IDS, Japan, and will be delivered by April 1999. It includes an inlet unit, an error lane, a decapper, a waiting line, a retrieve unit, a sorting table, a recapper unit, and an outlet unit. One of the main characteristics of our system is that it can be easily upgraded in order to receive more machines and/or more samples. © 1999 John Wiley & Sons, Inc. Lab Robotics and Automation 11: 335–337, 1999

AlGaN/GaN Schottky barrier diodes (SBDs) using a low-temperature- (LT-) GaN cap layer to provide edge termination, thus increasing the breakdown voltage and suppressing current collapse, were developed and fabricated on cost-effective, 100-mm-diameter Si (111) substrates. The SBDs fabricated with the LT-GaN/AlGaN/GaN heterostructure had a reverse leakage current three orders lower than that of conventional AlGaN/GaN SBDs and a high breakdown voltage of 1000 V. The effect of the LT-GaN cap layer on current collapse in the fabricated SBDs was also studied. Even under a pulse-mode bias stress of -200 V, no significant current collapse was observed.

Counting of passing people in passage or corridor is considered important for security or various investigations. This paper proposes a method for automatic counting of moving people with the different movement ways in the horizontal view. Each gravitational center of motion detection blocks is plotted in the plotting space, and the movement of people can be detected by Hough Transform without motion tracking. The intercept and the slope of a detected line represent the starting time when a person came into the scene and the moving speed of the target. The movement ways also can be recognized by using the difference of moving speed of detected persons. The experimental results showed that reliable detection and counting of passing people were realized by the proposed method.