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BACKGROUND In adolescence, physical symptoms may develop due to psychosocial problems, but such problems are not fully evaluated in school medical checkups. The aim of the study was to compare the characteristics of students with high and low scores on the Questionnaire for Triage and Assessment with 30 items (QTA30) in a school health checkup. METHODS The QTA30 (a self-completed questionnaire) was used in checkups for 3,414 students from the 5th grade of primary schools to the 3rd grade of junior high schools in south Wakayama Prefecture. The students were divided into groups with high (QTA30 ≥ 37) and low (QTA30 < 37) risk for psychosomatic disorder. Eleven items, including gender, grade, lifestyle habits, and life events, were compared between these groups, and in subgroups with and without recent absence from school. RESULTS The QTA30 response rate was 87.9%. The high-risk group had significantly more 3rd grade students (P< 0.001), females (P< 0.001), problems with teachers or friends (P< 0.001), and experience of bullying (P< 0.001), in addition to game playing for ≥2 h (P< 0.001), late bedtime (P< 0.001), and many absences (P< 0.001). Students in the high-risk group with no absences for 1 month regardless of age still had a late bedtime and problems with friends, and 76.4% of the high-risk students had not visited a medical institution. CONCLUSIONS Use of the QTA30 facilitated detection of psychosomatic stress in school medical checkups, with latent risks of truancy detectable at an early phase. The QTA30 may thus be useful in early intervention for psychosomatic stress of adolescents.

Pulmonary tumor thrombotic microangiopathy (PTTM) is an acute, progressive, and fatal disease. PTTM manifests as subacute respiratory failure with pulmonary hypertension, progressive right-sided heart failure, and sudden death. An antemortem diagnosis of PTTM is very difficult to obtain, and many patients die within several weeks. We herein report a case of PTTM diagnosed based on a transbronchial lung biopsy. In this case, we finally diagnosed PTTM due to gastric cancer because of its histological identity. The patient was administered chemotherapy, including angiogenesis inhibitors, against gastric cancer at an early age and survived for a long time.

The Space Infrared Telescope for Cosmology and Astrophysics (SPICA) mission is to be launched into orbit around the second Lagrangian point (L2) in the Sun-Earth system. Taking advantage of the thermal environment in L2, a 2.5m-class large IR telescope is cooled below 8K in combination with effective radiant cooling and a mechanical cooling system. SPICA adopts a cryogen-free system to prevent the mission operation lifetime being limited by the amount of cryogen as a refrigerant. Currently, the mechanical cooler system with the feasible solution giving a proper margin is proposed. As a baseline design, 4K / 1K-class Joule-Thomson coolers are used to cool the telescope and thermal interface for Focal Plane Instruments (FPIs). Additionally, two sets of double stage stirling coolers (2STs) are used to cool the telescope shield. In this design, nominal operation of FPIs can be kept when one mechanical cooler is in failure. In this paper, current baseline configuration of the mechanical cooler system and current status of mechanical coolers developments which need to satisfy the specific requirements of SPICA cryogenic system are presented.

著者人数: 35名, 形態: カラー図版あり, Number of authors: 35, Physical characteristics: Original contains color illustrations, Accepted: 2018-01-22, 資料番号: PA1810022000

Following increasing awareness of aircraft emissions and demand for technologies to reduce NOx emissions, experimental research has been conducted to develop a combustor for a small aircraft engine in the TechCLEAN of Japan Aerospace Exploration Agency project. The combustor was tuned to produce rich–lean combustion behavior through combustion tests, including full annular combustion experiments, under atmospheric and actual operating conditions of the target engine. Excellent combustion performance was observed. The final, optimized full annular combustor achieved a reduction of NOx emissions below 40% of the standard regulated by Committee on Aviation Environmental Protection/4 of International Civil Aviation Organization while maintaining low CO and total hydrocarbon emissions and showing superior exit temperature profiles and lean blow-out performance. Through the combustor development process, the dependence of combustion characteristics on combustor configuration was also clarified.

形態: カラー図版あり, Physical characteristics: Original contains color illustrations, Accepted: 2020-04-24, 資料番号: PA2120002000

The X-ray Imaging and Spectroscopy Mission (XRISM) is a recovery mission of ASTRO-H (Hitomi) launched in 2016. The Resolve instrument on the XRISM is an 6 × 6 array of silicon-thermistor microcalorimeters cooled down to 50 mK combined with a 5.6 m focal length X-ray telescope. Its design inherits that of the Soft X-ray Spectrometer (SXS) onboard ASTRO-H that demonstrated high resolution spectroscopy of the X-ray microcalorimeters by observing astronomical objects and providing superb resolution spectra. The cooling chain of the Resolve consists of a 3-stage adiabatic demagnetization refrigerator (ADR), a Joule-Thomson cooler, ~ 30 L superfluid helium, four Stirling coolers and a vacuum vessel or a dewar. Design of the Resolve cooling system is basically the same as that in the SXS but several changes are adopted based on lessons learned. This paper describes mainly the cooling system from room temperature to about 1 K providing the ADR heat sink. Major changes include an aperture baffle for micrometeoroid and orbital debris protection and optical light reduction, an eddy current damper to slow a gate valve opening, a new vibration isolation system with launch-locks.

Background Postural tachycardia syndrome (POTS) manifests as marked tachycardia while standing. We noticed two forms of circulatory response to orthostatic stress in POTS. We investigated cardiovascular and autonomic nervous response to orthostatic stress in the two forms. Methods We studied 79 patients with POTS and 38 healthy control subjects (Ct). Beat-to-beat blood pressure (BP) and heart rate (HR) were non-invasively and continuously measured in the supine and standing positions. Autonomic nervous function was evaluated on power spectral analysis of HR variability and diastolic BP variability. We divided the subjects into two groups: standing-induced tachycardia (SI group; increase in HR ≥35 beats/min) and supine tachycardia (Su group; standing HR ≥115 beats/min with standing-induced HR increase

Accepted: 2019-09-16, 資料番号: SA1190202000

Background Migraine is a common and disabling neurological disorder. Studies attempting to determine a relationship between migraine and the autonomic nervous system (ANS) have been inconclusive. Moreover, pediatric studies are extremely limited. Therefore, the present study investigated interictal ANS function in adolescent migraineurs. Methods We studied 21 patients with migraine and 26 healthy controls. Beat-to-beat blood pressure (BP) and heart rate (HR) were noninvasively and continuously measured in the supine and standing positions. ANS function was evaluated by power spectral analysis of HR variability and diastolic BP (DBP) variability. Results HR and systolic BP were not different between the two groups in either the supine or standing position. DBP did not differ between groups in the standing position, but was significantly higher in migraineurs in the supine position. The vasoconstrictor index was significantly higher in migraineurs. High-frequency (HF) RR interval variability (RR-HF) and the ratio of the low-frequency (LF) to HF component of RR interval variability (RR-LF/HF) were not different between the two groups in both position. The LF component of DBP variability (DBP-LF) in the supine position was significantly lower in migraineurs, while DBP- LF during standing in migraineurs was significantly higher than that in controls. Conclusion We found that migraineurs have significantly lower sympathetic vasomotor activity in the supine position and sympathetic vasomotor activity was hyperresponsive during standing. This article is protected by copyright. All rights reserved.

Suppression of super fluid helium flow is critical for the Soft X-ray Spectrometer onboard ASTRO-H (Hitomi). In nominal operation, a small helium gas flow of ~30 μg/s must be safely vented and a super fluid film flow must be sufficiently small

Soft X-ray Spectrometer (SXS) onboard ASTRO-H (named Hitomi after launch) is a microcalorimeter-type spectrometer, installed in a dewar to be cooled at 50 mK. The energy resolution of the SXS engineering model suffered from micro-vibration from cryocoolers mounted on the dewar. This is mitigated for the flight model by introducing vibration isolation systems between the cryocoolers and the dewar. The detector performance of the flight model was verified before launch of the spacecraft in both ambient condition and thermal-vac condition, showing no detectable degradation in energy resolution. The in-orbit performance was also consistent with that on ground, indicating that the cryocoolers were not damaged by launch environment. The design and performance of the vibration isolation system along with the mechanism of how the micro-vibration could degrade the cryogenic detector is shown.

The calorimeter array of the JAXA Astro-H (renamed Hitomi) Soft X-ray Spectrometer (SXS) was designed to provide unprecedented spectral resolution of spatially extended cosmic x-ray sources and of all cosmic x-ray sources in the Fe-K band around 6 keV. The properties that make the SXS a powerful x-ray spectrometer also make it sensitive to the entire electromagnetic band. If characterized as a bolometer, it would have a noise equivalent power (NEP) of < 4x10(exp -18) W/(Hz)0.5. Thus it was imperative to shield the detector from thermal radiation from the instrument and optical and UV photons from the sky. Additionally, it was necessary to shield the coldest stages of the instrument from the thermal radiation emanating from the warmer stages. These needs are addressed by a series of five thin-film radiation blocking filters that block long-wavelength radiation while minimizing x-ray attenuation. The SXS aperture assembly is a system of barriers, baffles, filter carriers, and filter mounts that supports the filters and inhibits their potential contamination. The three warmer filters also were equipped with thermometers and heaters for decontamination.

International audience; In this paper, experimental results obtained with laser-induced plasma spectroscopy to retrieve local compositions are presented for an ambient pressure up to 5.0 MPa in a still cell. Well-controlled mixtures of gases are introduced and plasma is obtained with the fundamental emission of a pulsed Nd:YAG laser. Simultaneously, plasma shape and spectrally resolved data are taken with a temporal resolution down to 2 ns. First, the temporal evolutions of a high-pressure nitrogen plasma are analyzed as function of spark energy. It is shown that plasma changes orientation from an elongated shape parallel to the laser line to a perpendicular one in a very short time. Results are reported for both spatial and spectral variations. Afterward, the effects of increased carbon concentration are discussed in both shape and spectra. It is seen that strong intensity due to the atomic carbon emissions appear for the high-pressure case. From those experiments, calibration strategies are proposed to get equivalence ratio under high-pressure conditions with a ratio of carbon versus nitrogen and oxygen. The delay between plasma and measurements is set to 2,000 ns and the signal is integrated for 5,000 ns, so as to yield a good signal to noise ratio and a good sensitivity of the technique to changes in mixture fraction. Calibration curves are reported for equivalence ratio up to 1.00 and for pressure from 1.0 to 5.0 MPa. It is shown that typical uncertainties are limited to 7.5% regardless the equivalence ratio in a single shot approach using a spectral fit procedure, whereas it accounts to two times more in a more classical peak ratio approach. Increasing the pressure tends to increase the precision as lower pressure had higher uncertainties.

MIRIS is the main payload of the STSAT-3 (Science and Technology Satellite 3) and the first infrared space telescope for astronomical observation in Korea. MIRIS space observation camera (SOC) covers the observation wavelength from to with a wide field of view . The PICNIC HgCdTe detector in a cold box is cooled down below 100K by a micro Stirling cooler of which cooling capacity is 220mW at 77K. MIRIS SOC adopts passive cooling technique to chill the telescope below 200 K by pointing to the deep space (3K). The cooling mechanism employs a radiator, a Winston cone baffle, a thermal shield, MLI (Multi Layer Insulation) of 30 layers, and GFRP (Glass Fiber Reinforced Plastic) pipe support in the system. Optomechanical analysis was made in order to estimate and compensate possible stresses from the thermal contraction of mounting parts at cryogenic temperatures. Finite Element Analysis (FEA) of mechanical structure was also conducted to ensure safety and stability in launching environments and in orbit. MIRIS SOC will mainly perform Galactic plane survey with narrow band filters (Pa and Pa continuum) and CIB (Cosmic Infrared Background) observation with wide band filters (I and H) driven by a cryogenic stepping motor.

The AKARI satellite (formerly known as ASTRO-F) is Japan’s first infrared astronomical satellite. AKARI is equipped with the infrared camera (IRC) and the far-infrared surveyor (FIS), which are cooled below 7 K. The AKARI’s 68.5 cm telescope, which is made of SiC, is also cooled below 7 K. A unique feature of the AKARI cryostat is that it uses both cryogen and mechanical coolers. Using mechanical coolers, the helium lifetime can be greater than one year with 170 L of liquid helium. AKARI was launched on February 21, 2006 (UT), from the Uchinoura Space Center (USC). It has been performing successfully in orbit.

A 51-year-old man was admitted to our hospital because of fever and diarrhea. Chest X-ray revealed consolidation in the left lower lung field. Ceftriaxone and minocycline were given empirically, under the suspicion of bacterial or atypical pneumonia. In spite of treatment with antibiotics, the disease rapidly progressed to systemic inflammatory response syndrome. The diagnosis of acute respiratory distress syndrome (ARDS) accompanied with influenza (H1N1) 2009 was made because of positive findings of real-time polymerase chain reaction. While multidisciplinary treatment was performed, his condition was further deteriorated suggesting the excessive pro-inflammatory mediators. To remove them, we conducted polymyxin-B immobilized column-direct hemoperfusion (PMX-DHP), and his general condition recovered successfully. PMX-DHP may be a useful treatment choice for ARDS accompanied with influenza.

A case of collision tumor in the left maxillary sinus composed of adenoid cystic carcinoma (ACC) and metastatic hepatocellular carcinoma (HCC) is reported. Radiographic examination revealed masses in the liver and bilateral lung metastases. Histologically, proliferation of tumor cells with resemblance to HCC was observed, in addition to the ACC. For this reason, differential diagnosis between a second primary tumor and metastasis was made. The metastatic lesion immunohistochemically showed positivity for hepatocyte antigen (OCH1E5) and protein induced by vitamin K absence or antagonist II (PIVKA-II), sustaining the HCC diagnosis. Primary ACC and metastatic HCC in the maxillary sinus are rare, and this may therefore be the first case of maxillary sinus tumor with both these elements.

Experiments were conducted to determine whether the medial amygdala could control hemodynamics through the GABA receptor in anesthetized rats. Bicuculline (10-100pmol), a GABA(A) antagonist, injected into the anterior basomedial amygdala (medial amygdala) produced dose-related increases in blood pressure (BP) and heart rate (HR). Following microinjection of a 100pmol dose, plasma norepinephrine and epinephrine also rose significantly. In a group that had undergone bilateral adrenalectomy, the same dose of bicuculline into the same region of the amygdala caused similar increases in BP and HR to those produced in normal rats. Pretreatment with an intraperitoneal injection of hexamethonium prevented these responses. When bicuculline was given intravenously (100pmol) it failed to effect these cardiovascular changes. Bicuculline-induced hypertension and tachycardia were inhibited by microinjection of muscimol, a GABA agonist, into the anterior basomedial amygdala. The results thus demonstrate that the influence of bicuculline on BP and HR is through action on the anterior basomedial amygdala and direct sympathetic outflow to heart and vascular smooth muscle. There is tonic GABAergic inhibition of sympathetic outflow in the medial amygdala that plays a part in regulating hemodynamics in the limbic system.

An NMR-based metabolomic approach in aquatic ecosystems is valuable for studying the environmental effects of pharmaceuticals and other chemicals on fish. This technique has also contributed to new information in numerous research areas, such as basic physiology and development, disease, and water pollution. We evaluated the microbial diversity in various fish species collected from Japan’s coastal waters using next-generation sequencing, followed by evaluation of the effects of feed type on co-metabolic modulations in fish-microbial symbiotic ecosystems in laboratory-scale experiments. Intestinal bacteria of fish in their natural environment were characterized (using 16S rRNA genes) for trophic level using pyrosequencing and noninvasive sampling procedures developed to study the metabolism of intestinal symbiotic ecosystems in fish reared in their environment. Metabolites in feces were compared, and intestinal contents and feed were annotated based on HSQC and TOCSY using SpinAssign and network analysis. Feces were characterized by species and varied greatly depending on the feeding types. In addition, feces samples demonstrated a response to changes in the time series of feeding. The potential of this approach as a non-invasive inspection technique in aquaculture is suggested.

Chromomycosis usually occurs in cutaneous or subcutaneous tissue. Many case reports are found in dermatology. Rarely does it occur in deep soft tissue.We report a case of granuloma caused by Phialophora Verrucosa between the left Achilles tendon and tibia. Magnetic Resonance Imaging disclosed a low intensity signal on T1-and T2-weighted images, and high intensity on Gd-enhanced, otherwise known as the dark ring sign. We believe that MRI is useful for the diagnosis of chromomycosis.

Giant cell tumors (GCT) are primary benign tumors, which arise from long bone epiphysis commonly. We report a rare case of GCT that occurred in the calcaneus. A 22-year-old woman was suffered from developing pain and swelling in the right lateral heel. On physical examination, hard mass with tenderness was palpated in the lateral calcaneus lesion. Results from laboratory tests were within normal limits. Plain radiography revealed osteolytic lesion in the calcaneus, and lateral cortex was disrupted. CT showed a mass lesion in the calcaneus, and periosteal reaction was not found. On MR imaging, bone tumor of the calcaneus was identified. The lesion was low-and iso-intense on T1-weighted sequence and inhomogeneous on T2-weighted imaged images. After administration of Gd-DTPA, inhomogeneous enhancement was seen in the tumor. The pathologic diagnosis was GCT of bone. The tumor was reseated, and cryosurgery utilizing nitrogen liquid was added, in order to remove tumor cells completely. Allo-bone graft was performed, and bone defect of the calcaneus was occupied with grafted bone. There was no evidence of recurrence 4 months following surgery.

We performed subtotal sacrectomy for squamous cell carcinoma on the sacral area of a 48-year-old man suffering paralysis of lower extremities for 28 years. Although the resection of the total mass of carcinoma including most part of sacrum (S2-5) was successfully performed, the patient suffered from protracted bacterial infection of the pelvic cavity and osteomyelitis of iliac bone. He died of respiratory failure due to distant metastasis of the tumor to the lung 248 days after surgery. [Skin Cancer (Japan) 2001; 16: 265-2691]

PURPOSE: To evaluate the efficacy of macular buckling surgery using a special exoplant. METHODS: The authors reviewed 33 cases of patients with retinal detachment due to macular hole with posterior staphyloma who underwent a macular bucking procedure and 11 cases of patients with the same condition due to macular hole without posterior staphyloma or due to a hole along the edge of the posterior staphyloma who underwent gas injection or vitrectomy. The reattachment rate, visual acuity (VA), and area size (V-4, I-4 isopter) by Goldmann perimetry were calculated. RESULTS: Reattachment rate for the macular buckling procedure was 94% (initial) and 100% (final), and that for the gas injection or vitrectomy was 100% (both initial and final). Twenty of the 33 eyes (60.6%) had VA of 20/400 or better, and none of these 33 eyes had a VA at the level of finger counting or poorer following macular buckling. Nine of the 11 eyes (81.8%) had VA of 20/400 or better, and none of these 11 eyes had a VA at the level of finger counting or poorer following the gas injection or vitrectomy. The area size of V-4 isopter in the macular buckling group was significantly larger than that in the gas injection or vitrectomy group (P = 0.017). CONCLUSION: The macular buckling procedure is effective when considered both from an anatomic and a functional perspective for retinal detachment due to macular hole with posterior staphyloma.

In solitary bone cysts (SBC), the level of intra-cystic alkaline phosphatase (ALP) has been reported to be obviously high compared with that of serum in the past, however, only a few reports on its origin and effectiveness are available. We report the results of a comparative study of the roentgenographic appearance and levels of serum/intra-cystic ALP in 12 patients operated for primary SBC. All patients were classified into the Non-sclerotic (NS) group (7 cases) and Sclerotic (S) group (5 cases) based on the marginal sclerosis and clear definition on plain roentgenograms. In the NS group, the level of the intra-cystic ALP was extremely high compared with that of serum, and also with intra-cystic ALP in S group. Histologically, osteoid formation with numerous osteoblasts rimmings and marked calcification on the osteoid and amorphas fibrin were recognized, and this is suggested to bo the origin of the elevation of the intra-cystic ALP in SBC.

It is important to give weight control advice to obese female with gonarthritis to prevent ischemic heat diseases as well as in the conservative treatment of gonarthritis.In our study, we compared the changes of blood sugar and lipid metabolism by comparing the result before, right after, and one hour after bicycle rowing exercise with the load shift lever set to load I and load II.We compared the results for six female patients. Three hours after their breakfast, we asked them to contine the bicycle rowing exercise for ten minutes three times, with an interval of five minutes in between. Comparison of the results for load I and load II showed no difference in the blood pressure, heart rate, blood sugar, T-cho, and HDL-cho. We however found an obvious increase in the blood density of FFA for load II.We realized that even the aged can increase their FFA by raising the load shift level one level higher. The bicycle rowing exercise did not produce any effects on the heart rate.

Transtrochanteric anterior rotaional osteotomy was performed on 7hips in 7 patients with steroid-induced osteonecrosis of the femoral head. Bipolar endoprosthesis arthroplasty was performed on 3 hips and collapse was progressive in 1 hip after osteotomy.In steroid-induced osteonecrosis of the femoral head, since it is difficuls to determine the width of hecrotic lesion the often resulting in the misjudgment of the indication for osteotomy.Steroid induced osteoporosis and reduced repair ability for osteonecrosis. In addition, continuous dose of steroid after osteotomy induced reccurent necrosis. These reasons cause postosteotomy conditions to worsen.

It is well known that hydroxyapatite is a useful biomaterial with biocompatibility and nontoxicity in the reconstructive field of orthopedic surgery.We report a case with suspected pes anserinus bursitis or enthesopathy caused by hydroxyapatite. A 56-year-old woman suffering from renal sarcoidosis with bone defect of the left medial tibial condyle underwent operation for hydroxyapatite 3 years ago. At this time, though the hydroxyapatite spilt and fell in the operation field, no symptoms were seen for 3 years.Because of recurring sharp pain in the same area, we thought that this pain was caused by hydroxyapatite, and we removed the hydroxyapatite, after which the sharp pain disappeared.Histologically, foreign body gaint cells around the hydroxyapatite particle were observed, but no inflammatory reaction and calcification were seen.

We reported a case of Brodie's abscess which developed unusual patterns with penetration of the epiphyseal plate of the distal tibia. A thirteen-year-old boy was referred to our hospital complaining of mild pain and swelling of the left ankle.The roentgenography of the left tibia disclosed a radio-lucent lesion which was surrounded by a clear osteosclerotic margin. The lesion existed in the metaphysis and epiphysis with penetration of the epiphyseal plate of the distal tibia. The C-reactive protein value and erythrocyte sedimentation rate were normal.The diagnosis was made by a needle biopsy of the lesion with aspiration of pus. The bacteriological examination revealed staphylococcus aureus. Surgery with curettage and bone graft including the epiphyseal plate resulted in it healing and no deformity nor limb length-discrepancy was recognized.

Seven hands of 7 patients with thumb polydactyly underwent surgery were followed-up. The mean age of the patients at operation was 8 months (range; 3-15 months).According to Wassel's classification, 1 patient was Type II, 4 were Type IV, 1 was Type V and 1 was Type VII. Radial hypoplastic thumb was resected in all patients. Angulation of the phalanx and matacarpal bone was treated with osteotomy in 3 patients.The average follow-up period was 7 years and 2 months (range; 7 months-15 years). According to Tada's evaluation, 5 hands were evaluated as good, 2 hands were fair, and none was poor.As a subjective evaluation, patients and their parents were satisfied with the results in 6 patients (86%).

We evaluated the results of the rotational acetabular osteotomy using an allogeneic heat-treated or freeze-dired bone graft clinically and radiographically. The average age of the patients at the time of the osteotomy was thirty one years old. The average duration of follow-up was two years. We preserved the power of abduction of the hip joint without stripping procedure of gluteus medius. There are no obvious absoaption or collapsing of the grafted bone radiographically. The results of the rotational acetabular osteotomy using an allogeneic bone graft is better as compared with the rotational acetabular osteotomy using an autogenous bone graft.We reported the utility of heat-treated or freeze-dried bone graft at the time of the rotational acetabular osteotomy.

We experienced a case of tuberculous sacroiliitis. The patient was a 70-year-old woman. She suffered from general fatigue and febrile, but complained of no pain of the sacroiliac (SI) joint. She had slight tenderness over the right SI joint. Gaenslen test was negative. Roentgenogram revealed diffuse destruction with calcificated masses on the right SI joint. Laboratory on admittance showed no leukocytosis, elevation of erythrocyte sedimentation rate (125mm/hr) and C-reactive protein (3.79mg/dl). Results of the Mantoux test were positive. Needle biopsy from the right SI joint was performed, but the culture of specimens was negative and the pathological findings were not the specific results. We performed curettage and irrigation, and got the specimen of the bone involved. Histologic examination revealed granulomatous inflammation with infiltration of epitheloid cells, tubercle formation, caseous necrosis, and Langhans' giant cells. She was treated with three combined antituberculosis drugs (isoniazid, ethambutol, and rifampicin). At present 6 months after surgery, she has no pain, no fever and feels no fatigue.Sacroiliac joint involvement has been reported in 3-10 percent of patients with skeletal tuberculosis. Lack of awareness of this rare disease now often leads to diagnotic delay and increased morbidity. The direct sampling of the SI joint is necessary to establish the diagnosis. It is important to obtain the specimen involving oteoarticular fragments for the diagnosis.

Purpose: The authors evaluated the effectiveness of ultrasound biomicroscopy to determine the condition of the ciliary body during perioperative examinations of patients with atopic dermatitis and retinal detachment. Methods: The authors compared two groups of patients with atopic dermatitis and retinal detachment. Parameters included patient age, gender, eye, cataract, type and location of breaks, macular involvement, detachment of the ciliary epithelium, and preoperative and postoperative best-corrected visual acuities. Group 1 included six patients (nine eyes) who were examined before surgery and after surgery using ultrasound biomicroscopy, with which the authors also measured the maximum height of the detachment of the ciliary epithelium. Group 2 included 10 patients (13 eyes) who did not undergo ultrasound biomicroscopy. Results: In group 1, ultrasound biomicroscopy showed ciliary epithelium detachment in all eyes before surgery and in eight of nine eyes after successful retinal reattachment. The height of the ciliary detachment, however, decreased dramatically after surgery. Although almost all the parameters between groups 1 and 2 were similar, the authors observed a significant difference in the incidence of preoperative diagnosis of ciliary detachment ( P = 0.023). Conclusion: Ultrasound biomicroscopy is beneficial in detecting detachment of the ciliary epithelium. The residual shallow detachment that remains after successful surgery suggests the fragility of the ciliary body.

The margins of intramuscular hemangiomas are usually obscure making extensive resection, including normal muscle necessary. Such resections can at times result in impairment of function.To reduce the post-operative functional impairment, we performed preoperative embolization to intramuscular hemangioma by percutaneous tumor puncture with n-butyl cyanoacrylate (Histoacryl®) for clarifing the tumor margins. Consolidated tumor margins were easily identified at the time of surgery. After five months follow-up, there was no signs of recurrence and the patient has no impairment of function. Preoperative percutaneous embolization with n-butyl cyanoacrylate was useful to clearly delineate the range of tumor resection needed.

Malignant Rhabdoid Tumor (MRT) is a rare neoplasm which usually arises from the kidney of infants. Extrarenal MRT is also known to occur in other organs or soft tissue. We report a case of retroperitoneal MRT which developed in the paravertebral region and invaded into the intrathecal sac through the intervertebral foramen. A twenty seven year old female who had developed severe sciatica ten months earlier was referred to our hospital. MR imaging disclosed no evidence of spinal tumor. Three months later, a mass in intrathecal sac at the level of L4/5 vertebra was seen. Postmyelogram CT scan revealed an intradural mass at the same level. Surgical treatment was performed to the intrathecal region. Histological and immunohistochemical examinations revealed is as MRT.

The incidence of chronic tophaceous gout has been decreasing with the availability of a precise diagnostic test and effecttive urate lowering medications. This article presents two cases of chronic to phaceous gout with bony destruction in the knee. Case 1: a 51 year-old male disclosed enlarging soft tissue masses in his right prepatellar burs a and along the left patella tendon. Plain radiogram of both patellae demonstrated cloudy soft tissue masses with cortical erosion of the patella. Case 2: a 53 year-old male had suffered from severe pain of both knees for a month. Plain radiograms showed a number of cloudy, slightly calcified, soft tissue masses in the left knee and also cortical destruction of the right femur. MR imaging of left knee demonstrated intra-articular tophi which appeared as low intense areas on the T1-weighted image and high intensity on T2-weighted images. Although most intra-articular tophi increased in intensity on T1-weighted images with Gd-DTPA enhancement, there were some tophi which did not change in brightness.

Deep infection remains one of the most common complications following total knee arthroplasty reportedly occurring in 1%-3% of cases. Various treatments of infected total knee arthroplasties have been performed. Irrigation and debridement combined with intravenous administration of antibiotics and retention of the prosthesis remains complex and controversial. One or two-stage reimplantation for salvage of the infected prosthesis produces a successful clinical result, compared to arthrodesis, resection arthroplasty and amputation. However there are some problems associated with reimplantation, such as diagnosis of eradication of infection, correct time-interval between removal of the prosthesis and reimplantation, and contracture of soft tissue due to delayed reimplantation.We experienced a case treated by a two-stage reimplantation process in an 86-year-old man. The problems of reimplantation in the infected total knee arthroplasty are discussed in this paper.

NOx emissions from aircraft engines cause atmospheric pollution near airports. In addition, in the troposphere, NOx reacts with hydrocarbons in the presence of sunlight to form ozone, which is a powerful greenhouse gas, and thus NOx is a secondary greenhouse gas [1]. There is a trend of increasing the pressure ratio in aircraft engines, since this trend reduces the fuel consumption and emission of the most important greenhouse gas, CO2. However, NOx increases with pressure ratio, thereby making the reduction in NOx in future aircraft engines more difficult. Air transportation volume will increase in the future. Therefore, the development of technologies to reduce NOx emissions from aircraft engines is very important. ICAO CAEP has tightened the NOx emission standard, as shown in Fig. ​Fig.1.1. Engine data were taken from the ICAO Aircraft Engine Emissions Databank [2]. Engine manufacturers and national research institutes are actively working on low-NOx technologies to meet lower NOx emission standards. In Japan, research and development of environmentally compatible engines for small aircraft (ECO engine project) [3] is being conducted. The thrust range of the engine is 8000–12,000 pounds. For this project, IHI, Kawasaki Heavy Industries, and Mitsubishi Heavy Industries developed three low-NOx combustors using different combustion types that were aimed at a 50% reduction over the CAEP/4 standard. Fig. 1 ICAO NOx standard and target of TechCLEAN Rolls-Royce Deutschland is developing a core engine with a 65% reduction over the CAEP/2 NOx standard and proved a 70% reduction in a full annular combustor in the Engine 3E (Environment, Economy, and Efficiency) program [4]. Advisory Council for Aeronautics Research in Europe (ACARE) aims at an 80% reduction in NOx emission in its vision for aeronautics in the year 2020, Vision 2020. In the United States, the NASA Environmentally Responsible Aviation (ERA) project is also underway [5]. It aims at a 75% reduction over the CAEP/6 NOx standard. General Electric developed a lean-staged combustor, namely twin annular premixing swirler (TAPS) combustor, and applied it to a new practical engine, GEnx. The Japan Aerospace Exploration Agency (JAXA) started TechCLEAN [6] in October 2003 for conducting research and development of aircraft engine technologies to reduce environmental impact. In this project, technologies for noise, NOx and CO2 reduction are being developed. The target for NOx emissions is an 80% reduction over the ICAO CAEP/4 standard. For this drastic reduction in NOx emissions, a fuel nozzle based on the lean-staged combustion concept was designed. It has a pilot fuel injector for diffusion combustion at the center of the fuel nozzle and a main fuel–air mixer for lean premixed combustion around the pilot. Geometric variations of the main swirler were investigated in a single-sector combustor rig under four conditions of the LTO cycle of ECO engine [7]. A fuel nozzle, so-called model E, which was characterized by a triple contrary swirler, showed the best low-NOx performance. The test results showed that the NOx emission of the fuel nozzle was a 72% reduction over the ICAO CAEP/4 standard. This fuel nozzle was also tested in a multisector combustor under the same conditions [8]. The combustor is 3/16th the size of a small annular combustor and has three fuel nozzles. The test results showed that the combustor had combustion characteristics equivalent to a 70% reduction over the CAEP/4 NOx standard, which was almost the same as that of the single-sector combustor. For improvement of combustion efficiency (CE) under the middle power conditions of the engine, fuel staging among the main fuel mixers was investigated. The results showed that fuel staging was effective in improving the CE of the annular combustor. As a next step, the fuel nozzle was tested in the single-sector combustor rig under the four conditions of the LTO cycle of an assumed engine [9]. The engine has a rated output of 40 kN and an overall pressure ration (OPR) of 25.8. Test results showed that the combustor has a NOx emission, which is a 77% reduction over CAEP/4. However, a reduction in smoke emissions under thrust conditions higher than the 30% MTO condition and a reduction in CO emissions under thrust conditions lower than the 85% MTO condition are necessary. In this study, an additional fuel nozzle, called the emissions control fuel nozzle (ECF), was designed to reduce NOx, smoke, and CO emissions. The single-sector combustor with the lean-staged fuel nozzle (LSF) and the additional fuel nozzle was tested.

Histological features of the synovial membrane in eighty one knee and hip joints of rheumatoid arthritis patients were studied. The histological findings were then compared to radiographic changes.Each synovial membrane was classified histologically according to the degree of inflammatory cell infiltration and synovial lining cell proliferation.Radiographic changes in the same joint were evaluated independently using the Larsen system.Results showed that radiographic joint destruction is associated with a sparsity of inflammatory cells and synovial lining cell proliferation.

Lesser toe abnormalities, which can result in significant pain and discomfort, are caused by several intrinsic or extrinsic factors including inflammatory arthritis, trauma, congenital abnormalities, neuromuscular disorders, or poorly fitting shoe wear. Identification of the etiology of the deformity is necessary to determine whether conservative or surgical treatment is warranted and to possibly halt progression of the deformity.