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Background: Mycoplasma pneumoniae pneumonia (MPP) is generally a self-limiting disease, but it may become refractory. It is thought that refractory MPP is linked to the excessive immunologic responses of the host. Consequently, the use of adjunctive systemic corticosteroids may have beneficial effects. In this study, we compared the effects of high- and low-dose corticosteroid therapy in a pediatric population with refractory MPP. Methods: We retrospectively collected data from 91 pediatric MPP patients treated with adjunctive systemic corticosteroids between April 2014 and October 2016. The patients were divided into the following two groups: high-dose corticosteroid group (2 mg/kg/day or more of prednisolone equivalents; n = 38) and low-dose corticosteroid group (, ファイル公開：2020-05-01

In this paper, we investigate the effectiveness of training data expansion methods to distinguish between normal and abnormal lung sounds. Acoustic characteristics of lung sounds vary according to auscultation points. In conventional classification methods, acoustic models were usually trained using only lung sounds recorded at the same auscultation points to that of evaluation data. This results in a small amount of training data and, thus, hinders the achievement of a high classification rate. To overcome this problem, we performed training data expansion by selecting the lung sounds, which are expected to be useful for generating acoustic models with higher classification performance, among sound samples recorded at other auscultation points. We investigated the two types of selection approach: selection based on the similarity of acoustic features in sound samples and selection based on the confidence measure represented by the difference between the acoustic likelihood for a normal or abnormal respiratory candidate. Our experiments showed that both selection types have the potential to increase the classification performance between normal and abnormal lung sounds, as well as the classification performance between healthy and unhealthy subjects.

Background/aim The neurokinin 3 receptor (NK-3R) is differentially expressed in the central nervous system including cases of human oral squamous cell carcinoma. However, the role of NK-3R signaling in oral squamous cell carcinoma is not well known. Materials and methods NK-3R expression in surgically resected oral squamous cell carcinoma was examined immunohistochemically and the strength of the expression was quantified. We evaluated the function of NK-3R signaling using NK-3R antagonist in human oral squamous cell carcinoma bone invasion mouse model. Results NK-3R was significantly expressed in tumor cells that had invaded the bone matrix compared to the oral side tumor cells. SB222200, a selective antagonist of NK-3R, significantly suppressed the radiographic osteolytic lesion and tumorigenesis. Conclusion NK-3R signaling is a potential target for the treatment of oral squamous cell carcinoma in cases of bone destruction.

Admission control is a procedure to guarantee a given level of Quality of Service (QoS) by accepting or rejecting arrival connection requests. There are many studies on backlog or loss rate evaluation formulas for admission control at a single node. However, there are few studies on end-to-end evaluation formulas suitable for admission control. In a previous paper, the authors proposed a new stochastic network calculus for many flows using an approach taken from large deviations techniques and obtained asymptotic end-to-end evaluation formulas for output burstiness and backlog. In this paper, we apply this stochastic network calculus to a heterogeneous tandem network with many forwarding flows and cross traffic flows constrained by leaky buckets, and obtain a simple evaluation formula for the end-to-end backlog. In this formula, the end-to-end backlog can be evaluated by the traffic load at the bottle neck node. This result leads us to a natural extension of the evaluation formula for a single node., IEICE Transactions on Communications, E94-B(5), pp.1288-1294; 2011

Because of their compactness and possibility of attaining high efficiency, laser-diode-pumped Nd:YAG lasers are expected to be applied to laser-based processes such as welding, cutting, drilling and marking. In the “Advanced Photon Processing and Measurement Technologies” project, we have developed and designed a high-power laser-diode-pumped Nd:YAG laser using simulation techniques such as a ray tracing, thermal analysis, and so on. We have successfully obtained a maximum output power of 12 kW with an efficiency of 23%, which to the best of our knowledge are the highest values for an Nd:YAG laser.

BACKGROUND AND PURPOSE: Developmental and seizure outcomes in patients with cryptogenic West syndrome are variable. Our aim was to clarify the relationship between FDG-PET findings in infancy and long-term seizure and developmental outcome in cryptogenic West syndrome. MATERIALS AND METHODS: From 1991 to 1999, we prospectively performed FDG-PET from the onset of cryptogenic West syndrome in 27 patients. PET was performed at onset and at 10 months of age. In 2012, we evaluated the educational status, psychomotor development, and seizure outcome in 23 of the 27 patients (13–22 years of age). The correlation between PET findings and outcome was evaluated. RESULTS: At onset, PET showed hypometabolism in 13 patients (57%). The second PET after the initial treatment revealed cortical hypometabolism in 7 patients (30%). While hypometabolism at onset disappeared on the second PET in 9 patients, it was newly revealed in 3 patients on the second PET. In 2012, seven patients had persistent or recurrent seizures. Eight patients had intellectual impairment. The first PET did not correlate with seizure or developmental outcome. Five of 7 patients (71%) with hypometabolism seen on the second PET had persistent or recurrent seizures, while 14 of 16 (88%) patients with normal findings on the second PET were free of seizures. Five of 7 patients (71%) showing hypometabolism on the second PET had intellectual impairment. Thirteen of 16 (81%) patients with normal findings on the second PET showed normal intelligence. A significant correlation was found between the second PET and long-term seizure ( P = .01) or developmental outcome ( P = .03). CONCLUSIONS: Cortical hypometabolism is not permanent; it changes with clinical symptoms. Hypometabolism after initial treatment predicts long-term seizures and poor developmental outcome.

Summary: Purpose: A large number of children had fits while watching the animated cartoon television (TV) program “Pocket Monster.” To elucidate the seizures associated with the TV program, we administered a questionnaire survey in Aichi Prefecture, Japan. Methods: The questionnaires were sent to 75 hospitals located in and around Aichi prefecture. The presence of epileptic seizures and the types of seizures were determined by three pediatric neurologists. Results: Sixty-one hospitals responded to the questionnaire survey. Among 95 patients living in Aichi prefecture for whom enough information on seizure manifestations and EEG was available, ≤93 patients were considered to have epileptic seizures while watching the TV program. Most seizures occurred at a scene in which red and blue frames alternated at 12 Hz. Sixty-nine (74%) patients had no history of epilepsy. Thirty-nine patients had generalized seizures, and 49 patients had partial seizures. Partial seizures occurred more frequently in the younger age group than did generalized seizures. The EEG revealed a photoparoxysmal response (PPR) in 43% of patients. PPR was present not only in patients with a history of epilepsy (54%) but also in those with no history of epilepsy (38%). Conclusions: Almost all seizures induced by the TV program “Pocket Monster” were epileptic, and partial seizures were induced more frequently than generalized seizures. The incidence of this “Pocket Monster”-induced seizures was roughly estimated as ≥1 in 4,923 individuals aged 6–18 years.

We report video-EEG findings and a long-term follow-up study in 10 patients with benign myoclonic epilepsy in infants (BMEI). A high incidence of a past and family history of febrile convulsions was noted. Six of the 10 patients manifested characteristic vocalization associated with myoclonic seizures. It consisted of a sudden, brief expiratory noise and is considered to be characteristic of BMEI. Afebrile convulsions occurred before the onset of myoclonic seizures or during the clinical course in six patients, but the accurate type of these seizures remains to be clarified. Monotherapy with valproatic acid (VPA) was very effective, but plasma VPA levels over 100 micrograms/ml were initially necessary in most of the cases, although they did not need to be maintained for further seizure control. All patients showed a favorable long-term seizure outcome, although one showed moderate mental retardation.

Summary: Background: We conducted a 5-year follow-up study in patients with a seizure induced by animated cartoon “Pocket Monster.” Methods: A recurrence of seizures was observed in 25 of 91 patients with a Pocket Monster seizure. The patients were divided into two groups: Epilepsy group of 12 patients with a history of epilepsy and Nonepilepsy group of 13 patients without a history of epilepsy. Results: Age below 12 years and generalized seizures were more often in Nonepilepsy group than in Epilepsy group. Seizure recurrence was earlier in Epilepsy group than in Nonepilepsy group. Photoparoxysmal response was relatively infrequent in Epilepsy group. The majority of patients were classified into idiopathic generalized epilepsies in Nonepilepsy group, whereas most patients were categorized into localization-related epilepsies in Epilepsy group. Conclusions: Epilepsies after Pocket Monster seizures were different according to the presence or absence of a history of epilepsy. These results will be useful in order to determine the treatment of a patient with a visually induced seizure.

In the 3 cases of intravenous leiomyomatosis presented here, the retroperitoneal, pelvic, and vaginal veins were completely removed. Two of the cases were diagnosed by a gynecologist at surgery, and 1 was diagnosed by the pathologist performing a histological examination on excised tissue. These 3 cases were asymptomatic in spite of the intravenous invasive leiomyomatosis.

We report histopathological findings in a 2-year-old boy with Charcot-Marie-Tooth (CMT) 1A, which had some similarities to those of chronic inflammatory demyelinating polyneuropathy. These findings are unusual in adult CMT patients but are reported in some patients with corticosteroid-responsive hereditary motor and sensory neuropathy (HMSN) that are characterized by rapid worsening of symptoms. We administered betamethasone based on the inflammatory pathological features but no improvement was seen. Active demyelination is also reported as an early morphological feature in HMSN. It is probable that edema, active demyelination and a few onion bulb formations, which were recognized in this patient, are characteristic early histological changes of HMSN rather than those of corticosteroid-responsive HMSN.

This paper is based on work done to establish the validity of a simple engineering approach to assess plastic collapse for a vessel with a local thin area (LTA). The approach is based on a recently developed p-M (internal pressure ratio and external bending moment ratio) diagram, which is an easy way to visualize the status of a vessel with a LTA simultaneously subjected to internal pressure, p and external bending moment, M due to earthquake, etc. If the assessment point (Mr,pr) lies inside the p-M line, the vessel with the LTA is judged to be safe. Numerous experiments and finite element analyses for a cylinder with an external flaw were conducted under (1) pure internal pressure, (2) pure external bending moment, and (3) subjected simultaneously to both internal pressure and external bending moment, in order to determine the plastic initiation load and plastic collapse load by applying the twice-elastic slope (TES) as recommended by ASME. It has been clarified that the collapse (TES) loads are similar to those calculated under the proposed p-M line based on the measured yield stress. The p-M line adopted in the Ibaraki fitness for service (FFS) rule based on the specified minimum yield stress with a safety factor of 1.5 indicates that the safety margin for the plastic initiation loads at LTA is about 1.0–3.0, about 1.5–4.0 for the TES loads at LTA, and 2.5–6.5 for the plastic instability (break) loads.

To identify the short-term outcome of patients who had seizures while watching an animated cartoon TV program, "Pocket Monster," on December 16, 1997.One and three years after the incident, questionnaires were sent to physicians of each patient about seizure recurrence, EEGs, and medication.Among 103 patients in whom epileptic seizures occurred during the TV program and information on the outcomes was available, 25 (24%) patients had a history of unprovoked seizures before the incident (Epilepsy Group), and 78 (76%) did not (Non-Epilepsy Group). Twenty-three (22%) patients were reported to have seizures after the incident, and 15 of them had visually induced seizures. Patients of the Epilepsy Group had more seizure recurrence than did those of the Non-Epilepsy Group (56% vs. 9%; p0.0001), either for unprovoked (44% vs. 4%; p0.0001) or visually induced seizures (28% vs. 9%; p0.05). Of nine patients of the Non-Epilepsy Group who had seizures after the incident, only three developed recurrent unprovoked seizures. In the Non-Epilepsy Group, no difference was found in seizure recurrence between patients in whom valproate (VPA) was prescribed immediately after the incident and in those without medication (one of five (20%) vs. seven of 73 (10%); p0.05). EEG was performed at least once in 98 patients after the incident. Photoparoxysmal response (PPR) was present in 45 (46%) patients, and spontaneous epileptiform discharges, in 49 (50%). PPR did not have any correlation with recurrence of seizures, neither spontaneous nor visually induced seizures, whereas spontaneous epileptiform discharges showed a good correlation with seizure recurrence (34% vs. 8%; p0.01), including visually induced seizures (24% vs. 2%; p0.01).Short-term outcomes showed that 70 (68%) of 103 patients who had a seizure during the incident had no seizures before and duringor = 3 years of follow-up.

As a tool for high speed and high precision material processing such as cutting and welding, we developed a rod-type all-solid-state laser with an average power of more than 10 kW, an electrical-optical efficiency of more than 20%, and a laser head volume of less than 0.05 m 3 . We developed a highly efficient diode pumped module, and successfully obtained electrical-optical efficiencies of 22% in CW operation and 26% in QCW operation at multi-kW output powers. We also succeeded to reduce the laser head volume, and obtained the output power of 12 kW with an efficiency of 23%, and laser head volume of 0.045 m 3 . We transferred the technology to SHIBAURA mechatronics corp., who started to provide the LD pumped Nd:YAG laser system with output power up to 4.5 kW. We are now continuing development for further high power laser equipment.

The relationship between positron emission tomography (PET) findings and developmental or seizure outcome was examined in 17 infants (11 males, six females; mean age at onset of spasms 7 months, range 3 to 26 months) with newly diagnosed cryptogenic West syndrome. The predictive value of PET in these infants was assessed. PET was performed in the infants at the onset of spasms and 3 months after initial therapy using 18F-labelled 2-deoxy-2-fluoro-D-glucose. A third PET was performed at 18 months of age if the second scan was abnormal. All infants were followed up until at least 3 years of age. Cortical hypometabolism was detected in 11 infants on the first PET and in five infants on the second. Rate of developmental delay at the last follow-up was significantly higher in infants with hypometabolism on the second PET than in those without PET abnormalities (p

We demonstrated average powers of 12 kW with CW operation and 7.2 kW with combined mode of CW and QCW operation with the multi-head configuration. The electrical- optical efficiencies are more than 22% in both modes.

In a review of 145 children with partial onset epilepsy, the authors were able to determine a focus of children whose complex partial seizures (CPS) ran a benign course, who had no identifiable lesion on scanning and whose EEG focus was not fixed, but tended to shift. The authors suggest that a benign form of CPS in children can be recognised.

For the practical application of end-point detection of etching using plasma-impedance monitoring, the factors determining the impedance were clarified using an electric circuit model of a reaction chamber. In the model, plasma is approximated by a conductor, and the floating capacitance and wafer of a powered electrode, as well as the powered-electrode sheath (the sheath formed between the plasma and powered electrode), are approximated by capacitors. Calculated values obtained using the model agree well with measured values obtained by an impedance monitor installed between the powered electrode and the matching network. Based on this result, it was inferred that the impedance depends on the powered-electrode sheath-voltage and electron density, as well as on the floating capacitance and area of the powered electrode, the dielectric constant and thickness of the wafer, and the electron temperature. Next, the end-point detection method of etching by impedance monitoring was applied to reactive ion etching of SiO2 films, and the following finding was confirmed: the change in the impedance significantly depends on the RF power and the exposed area ratio (the ratio of etched area to wafer area) on the wafer. In addition, the feasibility of detecting the point of change of the exposed area ratio on the wafer, where the area size varies during etching, by detecting microchanges in the impedance, was demonstrated. As a result, the possibility of highly accurate end-point detection of etching by impedance monitoring was confirmed.

A z-pinch experiment is carried out with a hollow-shaped Ar gas puff. Three types of discharge are found depending on the delay time of discharge from gas-puff detection, and the pinch time is compared with the measured gas pressure profile. Strong X-ray radiation is emitted from spots, a cloud and the anode surface. The number of spikes in the X-ray signal is correlated with spot images of the X-ray photograph. An X-ray burst is sometimes observed in the short-delay-time operation.

Segmental wall motion abnormalities are common in patients with myocarditis. Left ventricular (LV) regional wall motion was assessed in six patients with myocarditis by two-dimensional echocardiography. Some of our patients demonstrated regional thinning of the wall, similar to myocardial infarction. Therefore, segmental wall motion abnormalities with or without regional wall thinning detected by two-dimensional echocardiography cannot be used to differentiate myocarditis from coronary artery disease. Nevertheless, echocardiography can be performed repeatedly and is useful for evaluating the severity of myocarditis by assessing LV regional wall motion abnormalities, changes in LV wall thickness and cardiac pump function during the course of the disease.