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Double aortic arch (DAA) is a rare congenital abnormality characterized by a vascular ring that often requires surgical intervention due to respiratory complications. The DAA and right aortic arch with mirror-image branches (RAA-MB) represent abnormalities in development of the aortic arch. However, prognosis differs significantly, as the DAA forms vascular rings, whereas the RAA-MB typically does not. Distinguishing between the conditions becomes particularly challenging in cases of DAA with closure of the posterior portion of the left aortic arch (LAA) because the postnatal manifestations closely resemble those of RAA-MB. Herein, we present a case of DAA in which longitudinal observation of the LAA and RAA diameters during pregnancy aimed in predicting postnatal closure of the LAA. A 37-year-old female with suspected DAA was referred to our hospital at 26 weeks of gestation. Initial measurements revealed comparable diameters for the LAA and RAA; however, the LAA diameter decreased to approximately half that of the RAA by term owing to growth restrictions. Postnatal contrast computed tomography confirmed the closure of the posterior portion of the LAA and RAA with Kommerell diverticulum. Our findings suggest that careful monitoring of DAA throughout fetal development, especially during the third trimester, may aid in predicting atretic changes in the nondominant arch after birth, allowing an easy distinction between the DAA and RAA-MB after birth.

Here, we report a case of a congenital peribronchial myofibroblastic tumor (CPMT). A 34-year-old primigravida was referred to our hospital at 31 gestation weeks because of suspected congenital pulmonary airway malformation (CPAM). Fetal ultrasonography showed a mass measuring 4.6 × 4.0 × 3.9 cm with mixed high and low echogenicity in the left lung, which was associated with microvascular blood flow in the tumor. Fetal magnetic resonance imaging (MRI) revealed a low-intensity left lobe lung lesion on a T2-weighted image. These findings suggested that the mass was a CPAM with atypical hypointense findings on MRI T2-weighted images or a rare primary pulmonary tumor, such as a CPMT. Unfortunately, the fetus died in utero at 34 gestation weeks due to cardiovascular failure, which could have resulted from direct encasement of the great vessels or cardiac compression due to rapid tumor growth. The autopsy findings confirmed the diagnosis of CPMT. Primary pulmonary tumors, such as CPMT, are extremely rare lung diseases that develop in utero. These tumors often rapidly grow during pregnancy, resulting in intrauterine fetal death. However, if the patient survives surgical mass resection, the prognosis is good. Given the adverse outcomes observed in our case, careful fetal monitoring is required in case of suspected CPMT during the third trimester of pregnancy. Moreover, in case the well-being of the fetus cannot be assured, immediate delivery should be considered, even in the preterm period, followed by surgery.

Contour detection has a rich history in multiple fields such as geography, engineering, and earth science. The predominant approach is based on piecewise planar tessellation and now being challenged concerning the extraction of contour objects for non-linear elevation functions, particularly with respect to bicubic spline functions. A storage-efficient method was developed in previous research, but the detection of the complete set of contour objects is yet to be realized. Although intractable, theoretical underpinnings pertinent to curvature resulted in an approach to realize the complete detection of objects. Given a digital elevation model dataset, in this study, a bicubic spline surface function was first determined. Thereafter, candidate initial points on the edges across the region of interest were identified, and the recursive disaggregation of rectangles was repeated if the non-existence of a solution could not be assured. A developed tracking method was then applied. During advancement, other initial points on the same contour curve were identified and eliminated to circumvent duplicate detection. The completeness of the outlets provides analytical tools for elevation and other geographical assessments. Demonstrative experiments included the development of a three-dimensional contour-based network and slope assessments. The latter application transforms the slope analysis type from raster-based to vector-based. Highlights Detection of a complete set of contour objects amenable to bicubic spline surfaces. Small closure inside a single patch is detectable if size exceeds the standard. Curvature & tolerances central to step length adjustment and tangent angle determination. Redundant initial points are identified and eliminated during the tracking process. Various potential applications in addition to geographical elevations.

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A 76-year-old Japanese man presented with a 6-year history of a sore throat. He was treated at several clinics without any improvement before being referred to us. Physical examination revealed widespread erosions and ulcers from the palate to the larynx. Approximately 25 × 15 mm in size, erosive lesions were present on the retroauricular regions, forearms, and glans penis. Pseudomembranous conjunctivitis was also observed. The skin biopsy revealed a partial cleft formation below the epidermis, suggesting subepidermal bullous disease. Immuno-serological tests were negative for anti-desmoglein 1 (Dsg1), anti-Dsg3, anti-BP180, and anti-BP230 antibodies by ELISAs. A whole-body examination revealed gastric cancer. The possibility of mucous membrane pemphigoid (MMP) or paraneoplastic pemphigus (PNP) was considered. Indirect immunofluorescence using rat bladders showed positive IgG reactivity with cell surfaces on the transitional epithelia. Immunoblotting using recombinant proteins of laminin-332 showed both IgG and IgA reactivities with laminin-α3, and immunoblotting using normal human epidermal extract showed double-positive reactivities with envoplakin and periplakin for both IgG and IgA antibodies. Based on the clinical and histopathological features and results of various immuno-serological tests, our case was diagnosed as anti-laminin-332-type MMP with serological findings of PNP. Twenty days after laparoscopic gastrectomy, treatment with oral methylprednisolone 32 mg/day was initiated, and mucosal and skin lesions improved.

Dermatomyositis (DM) is one of the most common autoimmune rheumatic diseases affecting women of childbearing age. Pregnancy may lead to exacerbation of DM, especially of DM with anti-melanoma differentiation-associated gene (MDA) 5 antibody positivity, leading to a poor obstetric outcome. Here, we report consecutive pregnancies complicated by DM with anti-MDA-5 antibodies. A 32-year-old pregnant woman, gravida 3 para 1, presented with fetal growth restriction. Emergency cesarean section was performed because of non-reassuring fetal status at 28 weeks of gestation. Two days postpartum, the patient's hand eczema had worsened and she was diagnosed with DM with MDA-5 antibody positivity. Immunosuppressive therapy using corticosteroids combined with tacrolimus was immediately started, suppressing the DM symptoms. Eighteen months later, she became pregnant again but was then negative for anti-MDA-5 antibodies while continuing immunosuppressive therapy. During pregnancy, the titer of the antibody gradually increased, peaked in the second trimester and declined to near normal range through the third trimester. A male infant weighing 2418 g was delivered at 38 weeks of gestation. Our case demonstrates that controlling of DM activity using immunosuppressive treatment before and during pregnancy may be beneficial to obstetric outcomes.

Pyoderma gangrenosum (PG) is a relatively rare inflammatory skin disease that progressively causes necrotic ulceration mainly on the lower extremities and trunk. Systemic corticosteroid is considered a first-line treatment for PG as it facilitates wound healing; however, several cases where tumor necrosis factor-α inhibitors, adalimumab and infliximab, were administered showed good response. For intractable PG with a large ulcer or problematic epithelization, chemical or mechanical debridement of necrotic tissue in combination with skin grafting may be necessary to promote wound healing. Our report presents a case of intractable ulcerative PG requiring oral prednisolone and skin grafting. Although mechanical debridement was performed, granulation was poor; therefore, after the PG activity became quiescent, we utilized a vacuum-assisted closure (VAC) system to promote granulation and adaptation of the grafted skin. Although more cases are required for a definitive conclusion, the VAC system may be a choice for PG with large ulcers.

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A common type of scheduling policy includes first-in-first-out (FIFO) and earliest-outset bases. Among many approaches to this, max-plus linear representation is beneficial for event-driven discrete event systems (DESs). The earliest event occurrence times can be represented by linear relations in max-plus algebra, the resultant of which is analogous with the state equation in modern control theory. Methodologies in control theory such as evolution prediction and just-in-time scheduling can thus be utilized. Although useful, the description capability remains confined to FIFO contexts, for which the method would not be capable of producing an efficient solution for systems with two-level priorities. An entity, e.g. a task or token in scheduling contexts, with higher qualification would be prioritized over one with a lower qualification. A framework for overtaking tasks is necessary for this. Motivated by this need, this article is concerned with constructing a two-level priority scheduling methodology in a max-plus linear context. A numerical experiment applied to a simple manufacturing system highlights the significance of the constructed method.

A male infant had the very fragile skin and easily formed bullas by rubbing and scratching from his birth. He was diagnosed with severe recessive dystrophic epidermolysis bullosa (RDEB) due to the lack of type VII collagen by performing an immunofluorescence mapping method from a skin biopsy specimen of the patient’s bulla. We analyzed the skin microbiome using next-generation sequencer. The species from the patient’s skin revealed the dominance of Staphylococcus aureus (S. aureus) similar to the reports from Austria and Chile severe RDEB patients, and these results are same as the pattern isolated from the skin of atopic dermatitis (AD) patients with flares. The interaction of microbiome and skin microenvironment may be similar between RDEB and AD worldwide.

Background: Extramammary Paget's disease (EMPD) is a rare skin cancer and sometimes has fatal prognosis. For progressive cases, therapeutic options are limited. In recent years, treatment with an anti-programmed death-1 (PD-1) antibody has improved the prognosis of various malignancies. In addition, correlations between PD-ligand 1 (PD-L1) expression in tumor cells and favorable responses to anti-PD-1 therapy have been reported for several cancers. There have been a few case series of analysis of PD-L1 expression in patients with EMPD. Aims: The purpose of this study was to investigate the relationship between the EMPD and PD-L1/PD-1 expression in Japanese EMPD patients. Materials and Methods: We investigated 39 patients with EMPD by immunohistochemical staining of PD-L1 and PD-1. We counted the number of tumor cells that were positive for PD-L1 and the number of tumor-infiltrating mononuclear cells (TIMCs) that were positive for PD-L1 and PD-1. We also analyzed correlations between the expression of PD-L1 and PD-1 in EMPD and patients' characteristics. Results: We found that none of the Paget's cells expressed PD-L1. All of the specimens contained TIMCs, and some of the TIMCs expressed PD-L1 and PD-1. However, there was no correlation between the expression of PD-L1/PD-1 in TIMCs and patients' characteristics. Conclusion: Although tumor cells did not express PD-L1 and the expression of PD-L1/PD-1 in TIMCs did not correlate with patients' characteristics, future clinical studies should be carried out to explore another immune escape pathway in EMPD.

Intravesical bacillus Calmette-Guerin (BCG) instillation is an effective treatment for nonmuscle invasive superficial bladder cancer. BCG induces a massive influx of inflammatory cells and production of cytokines in the bladder mucosa and lumen that leads to an immune response against tumor cells, acting as an immunotherapy. Cystitis, bladder ulceration, and bladder contracture are known local genitourinary complications, whereas systemic complications such as miliary pulmonary tuberculosis, mycotic aneurysms, tuberculous spondylodiscitis, and granulomatous hepatitis are very rare. A case of tuberculous spondylodiscitis at the T8 and T9 levels following intravesical BCG instillation for bladder carcinoma is reported. The patient initially underwent decompressive laminectomy for spastic paraparesis. After reporting improvement for few weeks, the patient again presented with similar complaints and was found to have an increased kyphotic deformity, for which he underwent fixation surgery.

Background: A recent clinical trial has shown the efficacy of an anti-programmed death-1 (PD-1) antibody against advanced squamous cell carcinoma (SCC). The expression of PD-ligand 1 (PD-L1) in tumor cells correlates with a favorable response to anti-PD-1 therapy in various malignancies. In recent studies, it has been shown that SCC frequently expresses PD-L1. However, there has been no previous study focusing on the difference in PD-L1 expression between SCC in sun-exposed skin and that in nonsun-exposed areas. Aims: The purpose of this study was to investigate the relationship between sun-exposure status and PD-L1 expression in patients with SCC. Materials and Methods: We investigated 80 patients with SCC (40 patients with SCC in sun-exposed skin and 40 patients with SCC in nonsun-exposed skin) by immunohistochemical staining for PD-L1. Fisher's exact test was used for statistical analyses of the differences between the two groups. Results: Patients with SCC in sun-exposed skin showed a significantly higher expression level of PD-L1 in tumor cells than did patients with SCC in nonsun-exposed skin (P = 0.0133). Conclusions: We found that the expression level of PD-L1 in patients with SCC in sun-exposed skin was higher than in patients with SCC in nonsun-exposed skin. Practical data are needed for appropriate applications of new therapeutic options for SCC.

Abstract is missing (Short communication)

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The pathogenesis of seborrhoeic dermatitis is controversial and remains unclear. Malassezia is considered to be a commensal fungi and is found not only in the stratum corneum but also in hair follicles. It is an important pathogenic factor in seborrhoeic dermatitis. The aim of this study was to clarify the pathogenesis of seborrhoeic dermatitis, morphologically, through comparison with psoriasis vulgaris. Fifteen cases of seborrhoeic dermatitis, 7 of psoriasis, and 6 of normal skin were examined using routine histopathology, immunohistochemistry, and electron microscopy. Macrophages were found to be diffusely distributed in the upper dermis of seborrhoeic dermatitis and psoriasis. In contrast, a significant increase in the number of dendritic cells in the follicular epithelium and dendritic cell clusters in the perifollicular dermis were found only in seborrhoeic dermatitis. Ultrastructural examination of the clusters demonstrated that dendritic cells interacted with lymphocytes, macrophages, and other dendritic cells. In conclusion, folliculotropic distribution of dendritic cells as well as dendritic cell-immune cell clusters play an important role in the pathogenesis of seborrhoeic dermatitis.

Abstract An earthquake of JMA magnitude 6.5 (foreshock) hit Kumamoto Prefecture, Japan, at 21:26 JST on April 14, 2016. Subsequently, an earthquake of JMA magnitude 7.3 (main shock) hit Kumamoto and Oita Prefectures at 1:25 JST on April 16, 2016. The two epicenters were located adjacent to central Mashiki Town, and both events caused significantly strong motions. The heavy damage including collapse of residential houses was concentrated in “Sandwich Area” between Prefectural Route 28 and Akitsu River. During the main shock, we have successfully observed strong motions at TMP03 in Sandwich Area. Simultaneously with installation of the seismograph at TMP03 on April 15, 2016, between the foreshock and the main shock, a microtremor measurement was taken. After the main shock, intermittent measurements of microtremor at TMP03 were also taken within December 6, 2016. As the result, recovery process of shear wave velocities of volcanic soil at TMP03 before/after the main shock was revealed by time history of peak frequencies of the microtremor H/V spectra. Using results of original PS logging tests at proximity site of TMP03 on July 28, 2016, the applicability for the shear wave velocities to TMP03 was then confirmed based on similarity between the theoretical and monitored H/V spectra.Graphical abstract.

A storage-efficient reconstruction framework for cartographic planar contours is developed. With a smaller number of control points, we aim to calculate the area and perimeter as well as to reconstruct a smooth curve. The input data forms an oriented contour, each control point of which consists of three values: the Cartesian coordinates (x, y) and tangent angle θ. Two types of interpolation methods are developed, one of which is based on an arc spline while the other one is on a cubic Hermite spline. The arc spline-based method reconstructs a G1 continuous curve, with which the exact area and perimeter can be calculated. The benefit of using the Hermite spline-based method is that it can achieve G2 continuity on most control points and can obtain the exact area, whereas the resulting perimeter is approximate. In a numerical experiment for analytically defined curves, more accurate computation of the area and perimeter was achieved with a smaller number of control points. In another experiment using a digital elevation model data, the reconstructed contours were smoother than those by a conventional method.

This is the case report of a Scedosporium aurantiacum infection in a subcutaneous abscess. The patient had underlying diabetes and malignant lymphoma. Scedosporium species occur widely in nature and are increasingly recognized as pathologies under specific conditions, such as in immunocompromised hosts. Keywords: Scedosporium aurantiacum, Subcutaneous, Immunocompromised, Diabetes, Malignant lymphoma

The Editor-in-Chief is retracting this article (Hata et al. 2017) because an Investigation Committee established by Osaka University has found that data were fabricated by manipulation, and that theoretical calculation values were falsified to make the fabricated data look more convincing. Masayuki Yoshimi, Hiroyuki Goto, Takashi Hosoya, Hitoshi Morikawa and Takao Kagawa agree with this retraction. Yoshiya Hata is deceased.

A model predictive control-based scheduler for a class of discrete event systems is designed and developed. We focus on repetitive, multiple-input, multiple-output, and directed acyclic graph structured systems on which capacity constraints can be imposed. The target system’s behaviour is described by linear equations in max-plus algebra, referred to as state-space representation. Assuming that the system’s performance can be improved by paying additional cost, we adjust the system parameters and determine control inputs for which the reference output signals can be observed. The main contribution of this research is twofold, 1: For systems with capacity constraints, we derived an output prediction equation as functions of adjustable variables in a recursive form, 2: Regarding the construct for the system’s representation, we improved the structure to accomplish general operations which are essential for adjusting the system parameters. The result of numerical simulation in a later section demonstrates the effectiveness of the developed controller.

We propose a framework for describing the Critical Chain Project Management (CCPM) method based on a Max-Plus Linear (MPL) representation for multiple projects. The framework takes into account time buffers in both a single and multi-project environments which play a role for controlling undesirable state change and protecting the completion time for the entire system. The appropriate position and size of these buffers are determined for a large scale multi-project system. Furthermore, the MPL system with the CCPM method applied is redefined to easily comprehend the structure of the system. Finally, we confirm the proposed framework through a numerical example.

Hydraulic systems have high-power density because its oil transmitting power has high rigidity. However, when air bubbles are mixed into oil, they reduce oil stiffness and decrease system efficiency. This study mitigates this problem by removing air bubbles from the oil using an active bubble elimination device that uses a swirl flow to eliminate air bubbles from a hydraulic fluid. We focus on the relationship between the change in the bulk modulus and elimination of air bubbles from the hydraulic fluid and experimentally measure the bulk modulus of the hydraulic oil with and without air bubbles. Moreover, to clarify the relationship between the amount of air bubbles and the effective bulk modulus of oil, we propose a mathematical model of the bulk modulus of oil containing air bubbles. The experimental results indicate that the effective bulk modulus of oil increases by eliminating the air bubbles in oil, and the curve of the bulk modulus with the bubble eliminator turned off has a small hysteresis depending on whether it is pressurized or depressurized. We investigate the calculation method of the effective bulk modulus by considering the amount of air bubbles and the amount of air being dissolved and released. Finally, we confirm that the effective bulk modulus calculated using the mathematical model agrees well with the experimental results. We conclude that the volume of air contained in the oil and the differences due to the process of dissolving and releasing air significantly influence the bulk modulus of the hydraulic fluid.

Byline: Goto. Hiroyuki, Yoshida. Yuichi Sir, An 86-year-old woman was referred to our clinic with a complaint of a nodule on her right cheek. The tumor had gradually enlarged over [...]

In seismic hazard assessment, generating a source rupture process consistent with the physics of natural earthquakes is an important issue. This study focuses on the source model with hierarchical patches of slip-weakening distance DC proposed by Ide and Aochi (2005), which can satisfy the Gutenberg-Richter law. To investigate how the model works, characteristics of the simulated dynamic rupture process in a homogeneous full-space medium and for a vertical strike-slip fault in a half-space medium with a seismogenic zone are analyzed, considering varying dynamic rupture parameters. The source spectrum of the simulated rupture process using the hierarchical patch model generally follows the Brune model. However, the source spectrum underestimates the Brune model near the corner frequencies when the event size grows over MW 5.5. This spectral shape is consistent with the JA19_2 model (Ji and Archuleta, 2021) of the double-corner-frequency source spectrum. The obtained relationship between the simulated rupture length and magnitude is consistent with the empirical model of Leonard (2010). It confirms that if the event ruptures over the whole seismogenic zone width, the rupture length does not scale linearly with the rupture width, indicating that the seismogenic zone contributes to the relationship between rupture length and magnitude. [ABSTRACT FROM AUTHOR]