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La bronquiolitis eosinofílica es un trastorno alérgico poco frecuente causado por inflamación eosinofílica en los bronquiolos pulmonares. Se requiere una estrategia de tratamiento eficaz en los casos resistentes a los esteroides. Sin embargo, su fisiopatología sigue sin estar clara debido al escaso número de casos. Presentamos aquí el caso de un hombre de 31 años que experimentó bronquiolitis eosinofílica con ETosis por eosinófilos (EETosis) en los tapones de moco. El paciente fue diagnosticado con asma. Los síntomas respiratorios empeoraron con eosinofilia cuando recibió el tratamiento estándar para el asma, que incluía corticosteroides inhalados, agonistas β2 de acción prolongada, antagonistas muscarínicos de acción prolongada y antagonistas de los receptores de leucotrienos. La tomografía computarizada torácica reveló engrosamiento de la pared bronquial y nódulos centrilobulares en los lóbulos inferiores de ambos pulmones. La broncoscopía mostró obstrucción del bronquio subsegmentario con tapones de moco. El análisis histológico demostró la presencia de abundantes eosinófilos en los tapones mucosos. También se observaron eosinófilos citolíticos junto con formaciones de cristales de Charcot-Leyden y la deposición de proteína básica mayor, lo que indicó la aparición de EETosis. La introducción de benralizumab, un anticuerpo contra el receptor α de la interleucina 5, controló con éxito el estado del paciente y redujo la cantidad de corticosteroides sistémicos administrados. Nuestros resultados confirman que este anticuerpo disminuye notablemente el número de eosinófilos en las vías respiratorias de pacientes con asma grave. Así pues, el benralizumab podría ser un agente terapéutico óptimo para el tratamiento de las enfermedades pulmonares eosinofílicas formadoras de tapones de moco o de EETosis, incluida la bronquiolitis eosinofílica.

Federated learning (FL) is a method used for training artificial intelligence models with data from multiple sources while maintaining data anonymity, thus removing many barriers to data sharing. Here we used data from 20 institutes across the globe to train a FL model, called EXAM (electronic medical record (EMR) chest X-ray AI model), that predicts the future oxygen requirements of symptomatic patients with COVID-19 using inputs of vital signs, laboratory data and chest X-rays. EXAM achieved an average area under the curve (AUC) >0.92 for predicting outcomes at 24 and 72 h from the time of initial presentation to the emergency room, and it provided 16% improvement in average AUC measured across all participating sites and an average increase in generalizability of 38% when compared with models trained at a single site using that site’s data. For prediction of mechanical ventilation treatment or death at 24 h at the largest independent test site, EXAM achieved a sensitivity of 0.950 and specificity of 0.882. In this study, FL facilitated rapid data science collaboration without data exchange and generated a model that generalized across heterogeneous, unharmonized datasets for prediction of clinical outcomes in patients with COVID-19, setting the stage for the broader use of FL in healthcare. Federated learning, a method for training artificial intelligence algorithms that protects data privacy, was used to predict future oxygen requirements of symptomatic patients with COVID-19 using data from 20 different institutes across the globe.

Hepatitis A virus (HAV) commonly causes acute hepatitis in humans and is transmitted through the fecal-oral route or by ingestion of contaminated food or water. HAV infection generally follows a self-limiting course; it can seldom cause fulminant hepatitis that increases the risk of mortality. To the best of our knowledge, this is the first reported fatal case of fulminant hepatitis caused by HAV in a 40-year-old male with human immunodeficiency virus (HIV) infection. The HAV genotype in this case was IA, which has recently become common globally among people living with HIV (PLWHIV), intravenous drug users, and homeless people especially in developed countries. His HIV infection was stabilized by antiretroviral drugs and his CD4 values were stable. He developed acute hepatic encephalopathy, did not respond to repeated plasma exchange therapy, and died rapidly. It is known that HIV co-infection sometimes leads to fulminant non-HAV hepatitis, although evidence supporting a correlation between fulminant hepatitis A risk and HIV infection is still lacking. This case demonstrated the fatal risk of HAV infection in PLWHIV; it was suggested that education about appropriate preventive measures and vaccination are important for preventing HAV infections among PLWHIV.

Objective Severe acute respiratory syndrome coronavirus 2 has spread globally, and it is important to utilize medical resources properly, especially in critically ill patients. We investigated the validity of chest radiography as a tool for predicting aggravation in coronavirus disease (COVID-19) cases. Methods A total of 104 laboratory-confirmed COVID-19 cases were referred from the cruise ship "Diamond Princess" to the Self-Defense Forces Central Hospital in Japan from February 11 to 25, 2020. Fifty-nine symptomatic patients were selected. Chest radiography was performed upon hospitalization; subsequently, patients were categorized into the positive radiograph (Group A) and negative radiograph (Group B) groups. Radiographic findings were analyzed with a six-point semiquantitative score. Group A was further classified into two additional subgroups: patients who required oxygen therapy during their clinical courses (Group C) and patients who did not (Group D). Clinical records, laboratory data, and radiological findings were collected for an analysis. Results Among 59 patients, 34 were men with a median age of 60 years old. Groups A, B, C, and D consisted of 33, 26, 12, and 21 patients, respectively. The number of patients requiring oxygen administration was significantly larger in Group A than in Group B. The consolidation score on chest radiographs was significantly higher in Group C than in Group D. When chest radiographs showed consolidation in more than two lung fields, the positive likelihood ratio of deterioration was 10.6. Conclusions Chest radiography is a simple and easy-to-use clinic-level triage tool for predicting the severity of COVID-19 and may contribute to the allocation of medical resources.

Dasatinib-related chylothorax is a rare adverse event, and the mechanism underlying its occurrence is still not fully understood. We herein report the case of a 73-year-old woman with chronic myeloid leukemia (CML) who developed dasatinib-related chylothorax refractory to conventional treatments, except for steroids. To the best of our knowledge, this is the first case of dasatinib-related chylothorax which was successfully controlled by combining diuretics with the Japanese herbal medicine “Goreisan.” “Goreisan” is known to inhibit aquaporin channels and regulate the water flow. Our findings showed that “Goreisan” is an effective treatment option for uncontrollable dasatinib-related chylothorax.

Allergic bronchopulmonary aspergillosis (ABPA) is an eosinophilic inflammatory condition characterized by exaggerated immune responses to the fungal genus Aspergillus. Pulmonary manifestations in patients with Crohn's disease (CD) are frequent comorbidities. A 66-year-old man with CD treated with an anti-tumor necrosis factor-α antibody presented with dyspnea. Laboratory findings of elevated blood eosinophils and total serum IgE and positive aspergillus-specific antibodies as well as imaging findings of central bronchiectasis and mucoid impaction indicated a diagnosis of ABPA. To our knowledge, this is the first report of ABPA arising in a patient with CD. We discuss the pathophysiological mechanism of this rare complication.

The push and slide method is a method of endoscopic bronchial occlusion using an endobronchial Watanabe spigot that facilitates occlusion of the target bronchus rapidly and accurately using a guidewire. We herein report the case of a man who was diagnosed with empyema forming bronchopulmonary fistulae that was successfully treated by endoscopic bronchial occlusion. Because of the multiple fistulae, balloon occlusion was not a favorable therapeutic approach. Instead, the push and slide method was used in order to detect the fistulae. Endoscopic occlusion, particularly that using the push and slide method, may be a valid treatment option for empyema with multiple bronchopulmonary fistulae.

Introduction In patients with severe coronavirus disease 2019 (COVID-19), respiratory failure is a major complication and its symptoms occur around one week after onset. The CURB-65, A-DROP and expanded CURB-65 tools are known to predict the risk of mortality in patients with community-acquired pneumonia. In this retrospective single-center retrospective study, we aimed to assess the correlations of the A-DROP, CURB-65, and expanded CURB-65 scores on admission with an increase in oxygen requirement in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. Methods We retrospectively analyzed 207 patients who were hospitalized with SARS-CoV-2 pneumonia at the Self-Defense Forces Central Hospital in Tokyo, Japan. Performance of A-DROP, CURB-65, and the expanded CURB-65 scores were validated. In addition, we assessed whether there were any associations between an increase in oxygen requirement and known risk factors for critical illness in COVID-19, including elevation of liver enzymes and C-reactive protein (CRP), lymphocytopenia, high D-dimer levels and the chest computed tomography (CT) score. Results The areas under the curve for the ability of CURB-65, A-DROP, and the expanded CURB-65 scores to predict an increase in oxygen requirement were 0.6961, 0.6980 and 0.8327, respectively, and the differences between the three groups were statistically significant (p

Background Zosteriform skin metastasis (ZSM) is rare, and its etiology is not well understood. ZSM is possibly derived from the retrograde movement of cancer cells through the lymphatic vessels during disease development. However, it has been difficult to demonstrate it, as no specific findings have been observed. Case presentation A 68-year-old man presented to our department with neck lymphadenopathy. After detailed examinations, squamous cell lung carcinoma (cT2aN3M1c) was diagnosed. Although cisplatin combined with gemcitabine was administered, his cancerous lymphangiopathy was exacerbated, and ZSM was observed on his right chest. Pembrolizumab was initiated as a second-line chemotherapy; however, the patient died 7 months after the initial presentation. In this case, fluorodeoxyglucose-positron emission tomography indicated the presence of skin metastasis and cancerous lymphangiopathy. Similarly, after performing an autopsy, tumor-cell filled lymph ducts were observed in the right subclavian and the cutaneous lymphatic vessel from the right hilar lymph nodes. Conclusions To the best of our knowledge, this is the first study to demonstrate that the localization of ZSM in the cutaneous lymphatics was caused by the retrograde movement of cancer cells through the lymphatic vessels, using radiographical and pathological analysis. In addition, fluorodeoxyglucose-positron emission tomography may help predict skin metastasis induced by cancerous lymphangiopathy.

Objectives The symptoms of Coronavirus disease 2019 (COVID-19) vary among patients. The aim of this study was to investigate the clinical manifestation and disease duration in young versus elderly patients. Methods We retrospectively analyzed 187 patients (87 elderly and 100 young patients) with confirmed COVID-19. The clinical characteristics and chest computed tomography (CT) extent as defined by a score were compared between the two groups. Results The numbers of asymptomatic cases and severe cases were significantly higher in the elderly group (elderly group vs. young group; asymptomatic cases, 31 [35.6%] vs. 10 [10%], p

Federated learning (FL) is a method used for training artificial intelligence models with data from multiple sources while maintaining data anonymity, thus removing many barriers to data sharing. Here we used data from 20 institutes across the globe to train a FL model, called EXAM (electronic medical record (EMR) chest X-ray AI model), that predicts the future oxygen requirements of symptomatic patients with COVID-19 using inputs of vital signs, laboratory data and chest X-rays. EXAM achieved an average area under the curve (AUC)0.92 for predicting outcomes at 24 and 72 h from the time of initial presentation to the emergency room, and it provided 16% improvement in average AUC measured across all participating sites and an average increase in generalizability of 38% when compared with models trained at a single site using that site's data. For prediction of mechanical ventilation treatment or death at 24 h at the largest independent test site, EXAM achieved a sensitivity of 0.950 and specificity of 0.882. In this study, FL facilitated rapid data science collaboration without data exchange and generated a model that generalized across heterogeneous, unharmonized datasets for prediction of clinical outcomes in patients with COVID-19, setting the stage for the broader use of FL in healthcare.

The destruction caused by ballistic ejecta from the phreatic eruptions of Mt. Ontake in 2014 and Mt. Kusatsu-Shirane (Mt. Moto-Shirane) in 2018 in Japan, which resulted in numerous casualties, highlighted the need for better evacuation facilities. In response, some mountain huts were reinforced with aramid fabric to convert them into shelters. However, a number of decisions must be made when working to increase the number of shelters, which depend on the location where they are to be built. In this study, we propose a method of using high-strength steel to reinforce wooden buildings for use as shelters. More specifically, assuming that ballistic ejecta has an impact energy of 9 kJ or more, as in previous studies, we developed a method that utilizes SUS304 and SS400 unprocessed steel plates based on existing impact test data. We found that SUS304 is particularly suitable for use as a reinforcing material because it has excellent impact energy absorption characteristics due to its high ductility as well as excellent corrosion resistance. With the aim of increasing the structural strength of steel shelters, we also conducted an impact test on a shelter fabricated from SS400 deck plates (i.e., steel with improved flexural strength provided by work-hardened trapezoidal corrugated plates). The results show that the shelter could withstand impact with an energy of 13.5 kJ (2.66 kg of simulated ballistic ejecta at 101 m/s on impact). In addition, from the result of the impact test using the roof-simulating structure, it was confirmed the impact absorption energy is further increased when artificial pumice as an additional protective layer installed on this structure. Observations of the shelter after the impact test show that there is still some allowance for deformation caused by projectile impact, which means that the proposed steel shelter holds promise, not only structurally, but also from the aspects of transportation and assembly. Hence, the usefulness of shelters that use steel was shown experimentally. However, shelter construction should be suitable for the target environment.

The mechanisms underlying interstitial lung disease (ILD) are characterized by variable inflammation or fibrosis of the pulmonary interstitium. A negative heart sign (NHS) on 67Ga scintigrams of patients with ILD is due to considerably increased inflammatory activity in the lungs. We retrospectively analyzed relationships between NHS and established biomarkers of disease severity in patients with ILD. Among 81 consecutive non-smoking patients with ILD (mean age, 63 years) who had been hospitalized between April 2009 and October 2011, we selected 52 who had been assessed by 67Ga scintigraphy. We then evaluated relationships between NHS and blood biomarkers, pulmonary function and high-resolution computed tomography (HRCT). Among these 52 patients, 10 showed idiopathic pulmonary fibrosis and 42 had other ILD. Multivariate analysis with stepwise variable selection, serum surfactant protein (SP)-A (OR (odds ratio), 1.026; 95%CI (confidence interval), 1.003–1.050; P = 0.024) and inflammation index calculated from HRCT findings (OR, 1.358; 95%CI, 1.079–1.709; P = 0.009) were significant predictors of an NHS. Serum SP-A offered 85% sensitivity and 75% specificity for predicting NHS at an optimal cut-off of 45.8 ng/mL. Serum SP-A concentrations correlated positively with inflammation index (r = 0.344, P = 0.015). In conclusion, serum SP-A might serve as a surrogate biomarker for predicting an NHS in patients with ILD.

The occurrence of endotracheal/endobronchial metastasis (EEM) after complete resection of a primary lung cancer is rare. Here, we report the case of an 86‐year‐old woman in whom EEM occurred twice over a 20‐year period following complete resection of a primary adenocarcinoma localized to the left main bronchus and trachea. The presence of EEM was confirmed by establishing immunohistochemical homology of the metastases with the primary tumor. To the best of our knowledge, this is the first reported case of repetitive EEM of primary lung adenocarcinoma. Lymphatic invasion in the primary lesion suggested that a possible route for EEM was the peripheral lymphatic tract, explaining the slow recurrence rate. We conclude that observation of the trachea/bronchus over a long period post operation could be important in monitoring for EEM, particularly if lymphatic invasion is confirmed in the primary tumor., This is the first reported case of repetitive localized endotracheal/endobronchial metastasis of primary lung adenocarcinoma with mild lymphatic invasion that occurred twice over a 20‐year period after complete resection. Observation of the trachea/bronchus over a long period post operation could be important in monitoring for endotracheal/endobronchial metastasis, particularly if lymphatic invasion is confirmed in the primary tumor.

Coronavirus disease 2019 (COVID-19) is spreading worldwide and poses an imminent threat to public health. We encountered 2 cases of COVID-19 with progression resulting in severe respiratory failure and improvement without any specific treatment. To examine the course of infection, we performed reverse-transcription (RT) polymerase chain reaction assay with serum specimens, and serum SARS-CoV-2 RNA was detected in both cases when body temperature increased and respiratory status deteriorated. We, then examined, retrospectively and prospectively, the clinical course during hospitalization by performing serial examinations of serum SARS-CoV-2 RNA status. The findings from our cases suggest that not only is detection of viremia useful as a predictive marker of severity, but also serial serum SARS-CoV-2 RNA results can be helpful for predicting the clinical course.

Many of the casualties in the phreatic eruption of Mt. Ontake, which is located in central Japan, on September 27, 2014, were climbers near the summit. The main cause of death was injury by lapilli and block ejecta (ballistic ejecta). The absence of shelters at the summit and along the climbing trails may be a major factor in the large number of casualties attributable to ballistic ejecta, and establishing and improving shelters on active volcanoes is an urgent need. The climbers who evacuated to wooden mountain huts survived the 2014 Mt. Ontake eruption, this research focuses on the impact characteristics of wooden materials. We therefore performed an experimental investigation into the safety of wooden materials under impact by simulated ballistic ejecta with a mass of 2.66 kg (equivalent to a diameter of 128 mm) as by assembling cylindrical abrasive travelling at up to 300 km/h (approximately 83 m/s). With abrasives acting as ballistic ejecta, the simulated shelter facility components serving as targets were wooden structures composed of Japanese cedar, which found on volcanoes at high elevations in Japan. The components of the fabricated roof were Japanese cedar with a thickness of 15 mm as roofboard installed on the surface waterproof sheet and 0.4 mm thick Galvalume® steel sheet with an additional rafter installed. The impact absorption energy of the fabricated roof increased with simulated ballistic ejecta impact velocity because the localization of bending deformation progressed at the impact part and the frequency of splitting failure increased with increasing impact velocity. This is attributable to variation in the mode of splitting failure of cedar boards and the dependence of the material strength on projectile velocity. We also experimentally investigated simple reinforcement methods in order to obtain basic data on conversion of mountain huts to shelters. The reinforced wooden structure could withstand simulated ballistic ejecta impacts of up to approximately 13 kJ by incorporating two layers of aramid fabric between a waterproof sheet and a cedar board. Review of the roof structures of existing wooden buildings based on these results promises further advances in safe impact-resistant design.

Pazopanib, a multityrosine kinase inhibitor used for treating malignant soft tissue tumors, rarely causes adverse events associated with the respiratory system. We report a case of a 73-year-old male with leiomyosarcoma treated with pazopanib. Four months after treatment initiation, chest computed tomography showed bilateral patchy consolidation and ground-glass opacities. Bronchoscopy revealed increased lymphocytes in the bronchoalveolar lavage fluid. Histological analysis of lung tissue demonstrated intraluminal fibrotic changes in alveolar spaces. According to these findings, we diagnosed the patient with pazopanib-induced organizing pneumonia. To best of our knowledge, this is the first report of such a case., Highlights • Pazopanib is a multityrosine kinase inhibitor used for treating soft tissue tumors. • Pazopanib rarely causes adverse events associated with the respiratory system. • This is the first report of a patient with pazopanib-induced organizing pneumonia.

Mount Ontake erupted at 11:52 am on September 27, 2014, which generated pyroclastic density currents, ballistic projectiles, ash falls, and a small-scale lahar that spouted directly from craters formed by the eruption. Because this lahar may have been generated by water released from within these craters, we refer to this lahar as a “syneruptive-spouted type lahar” in this study. The lahar of the 2014 eruption was small relative to the other syneruptive type lahars reported in the past that were snowmelt type or crater lake breakout type lahars. Nevertheless, in the 2014 event, the syneruptive-spouted type lahar extended approximately 5 km downstream from the Jigokudani crater via the Akagawa River, with an estimated total volume of ~1.2 × 105 m3. We have reviewed other representative syneruptive-spouted type lahars that have been reported in Japan. The syneruptive-spouted type lahar attributed to the September 2014 eruption had the longest runout distance and largest volume of all cases studied. The mineral assemblage identified from samples of the lahar deposits is similar to that of ash-fall deposits from the same eruption. Previous workers deduced that the ash was derived mainly from shallow depths (within 2 km of the surface). The syneruptive-spouted type lahar deposits are therefore also considered to have originated from shallow depths. A syneruptive-spouted type lahar is a small-scale phenomenon that causes little direct damage to infrastructure, but has long-term influence on water quality. Increases in turbidity and decreases in pH are expected to occur in the Mount Ontake area downstream of Nigorisawa after heavy rainfall events in the future. Therefore, the potential indirect (but long term) damage of syneruptive-spouted type lahars should be considered for hazard mapping and planning volcanic disaster prevention measures.

浅間火山2004年9月1日噴火（以下，9/1噴火と略す）について未解明であった火口西側地域を中心に現地踏査を行った．さらに，高分解能衛星画像の判読結果や室内分析および火山監視画像の解析から9/1噴火による本質物（パン皮状火山弾）を特定し，それらの分布を明らかにした．地層を形成しにくいブルカノ式噴火噴出物の分布を現地で把握するために，高分解能衛星画像が有効であった．現地踏査単独ではブルカノ式噴火噴出物の把握は難しいため，平常時より高分解能衛星画像や空中写真の整備など，噴火前後の微地形変化を比較できる準備が必要である．特定した本質物（パン皮状火山弾）を用いて，9/1噴火をもたらしたマグマの実態を推定した．含水量測定の結果より算出されたマグマ深度の差から，マグマ柱は鉛直方向に少なくとも180 m程度の高さであったと考えられる．

The memory compression algorithm CCC-LCP (color-count-controlled local color palette) reduces flicker in the liquid crystal display (LCD) overdrive. Its compression ratio is 1:5.4 for 10-bit images, with a 33 dB PSNR peak signal-to-noise ratio and with five times flicker reduction compared with the block truncation coding. The authors’ two-alternative forced choice subjective tests proposed two new soundness properties, the ‘CMP harmlessness’ and ‘OD non-lost (or OD liveliness)’, to clarify the functional interaction between the overdrive functionality OD and the compression functionality CMP. The tests verified that CCC-LCP is practically applicable (at a 1.2H viewing distance threshold) for 42” 37-ppi WXGA TVs.

Influence of metal catalyst (Fe) surface condition was investigated for the growth of carbon nanotubes (CNTs). Surface condition of 5 nm thick Fe coated on Si substrate was changed by varying substrate temperature during the CNTs synthesis in a thermal CVD method. Acetylene and argon were used as precursor and carrier gas, respectively, for the synthesis of CNTs. After the growth, the CNTs were removed from the substrate and the post-growth condition of the substrate surface was studied by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), and atomic force microscopy (AFM). Unlike the case of untreated Fe-coated Si substrate, XPS analysis shows Si peaks from the thermal treated substrate/samples, which indicates the formation of Fe nanoparticles. AFM results indicate that 750 degrees C is optimum temperature for the nanoparticle formation. Moreover, SEM results show that 700 degrees C is optimum temperature for the CNTs synthesis. The results of this study clarify that the optimum temperature for nanoparticle formation and CNT synthesis are different.

( R )-(+)-Cibenzoline (95% ee) was synthesized in two steps from (+)-2,2-diphenylcyclopropylmethanol 3a (98% ee), which was oxidized with IBX in DMSO, followed by treatment with ethylenediamine in the presence of I 2 and K 2 CO 3 in t BuOH. Compound ( R )-(+)- 3a (98% ee) was prepared by cyclopropanation of 3,3-diphenyl-2-propen-1-ol 1 with Et 2 Zn and CH 2 I 2 in the presence of a catalytic amount of ( S )-2-(methanesulfonyl)amino-1-( p -toluenesulfonyl)amino-3-phenylpropane 2 , followed by esterification with 3,5-dinitorobenzoyl chloride, recrystallization, and hydrolysis.

We propose a method of bit depth analysis that promotes a deeper understanding of the "45dB curse": a widely accepted but usually misunderstood 45dB PSNR criterion for image compression. Our analysis illustrates useful guidelines to further investigate lowering the cost of high-quality display peripheral devices. The Barten model accurately predicts our 2AFC experimental results.

地形再現性の高いデジタル地形データである航空機レーザスキャナDEM (ALSDEM) を用いて, 傾斜量図に高度段彩図を重ね合わせた新しい地形表現手法である「カラー標高傾斜図 (ELSAMAP) 」を開発し, 地形の判読性について検討した. ELSAMAPは標高と地形の情報を同時に表現するため, 両者の特徴を活かした直感的な地形判読が可能である. ELSAMAPを用いて十勝平野断層帯の2地区についてその有効性の検討を行った. その結果, 段丘面の区分および段丘面上の浸食・堆積地形を詳細に把握することができた. 十勝平野断層帯の北部においては稲穂断層に対応する断層変位地形が認められないこと, 広尾町上野塚の光地園断層においては, 丘陵地内の断片的な地形面が確認でき, 変位量を従来よりも精度よく判読できることがわかった. ELSAMAPは, 標高の微妙な変化を判読するような地形, 例えば低地の微地形, 段丘地形, 火山地形などの地形判読にとくに有効な地形表現であり, さまざまな地形発達史を考えるうえでの重要な基礎データを提供することが可能である.

Background In liver surgery, the hepatic pedicle often is clamped to reduce blood loss, and later unclamped, representing hepatic ischemia and reperfusion (I/R) with induction of hypoxia. Vascular endothelial growth factor (VEGF) expression reportedly is induced by hypoxia; further, some cancer cells express the VEGF receptor (flt-1, flk-1/KDR). We hypothesized that I/R-induced VEGF expression could enhance growth of microscopic tumor via VEGF receptors on tumor cells, thus promoting liver metastasis in a rat model. Materials and methods Time-dependent VEGF expression in liver and plasma was determined by enzyme-linked immunosorbent assay in rats subjected to 60 min of 70% hepatic I/R (I/R group). Other rats given an intrasplenic inoculation of a rat colon adenocarcinoma cell line (RCH-H4) were divided 3 days later into three groups: group A, untreated; group B, sham operation; group C, 70% I/R for 60 min. Liver metastasis was evaluated on day 14. Expression of flt-1 and flk-1/KDR was examined in RCN-H4 cells, and effects of exogenous VEGF on RCN-H4 cell proliferation were determined by MTT assays. Results Hepatic VEGF expression increased significantly in the I/R group compared to the control group. Liver metastasis was more extensive in group C than in groups A and B. RCN-H4 cells expressed flt-1 and flk-1/KDR, while exogenous VEGF increased RCN-H4 cell proliferation. Conclusion Hepatic ischemia reperfusion leads to induction of VEGF and this is associated with increased tumor burden in an animal model of colon cancer metastasis.

The Hakkoda-Towada caldera cluster (HTCC) is a typical Late Cenozoic caldera cluster located in the northern part of the Northeast Japan Arc. The HTCC consists of five caldera volcanoes, active between 3.5 Ma and present time. The felsic magmas can be classified into high-K (HK-) type and medium- to low-K (MLK-) type based on their whole-rock chemistry. The HK-type magmas are characterized by higher K2O and Rb contents and higher 87Sr/86Sr ratios than MLK-type magmas. Both magmas cannot be derived from fractional crystallization of any basaltic magma in the HTCC. Assimilation-fractional crystallization model calculations show that crustal assimilation is necessary for producing the felsic magmas, and HK-type magmas are produced by higher degree of crustal assimilation with fractional crystallization than MLK-type magmas. Although MLK-type magmas were erupted throughout HTCC activity, HK-type magmas were erupted only during the initial stage. The temporal variations of magma types suggest the large contribution of crustal components in the initial stage. A major volcanic hiatus of 3 my before the HTCC activity suggests a relatively cold crust in the initial stage. The cold crust probably promoted crustal assimilation and fractional crystallization, and caused the initial generation of HK-type magmas. Subsequently, the repeated supply of mantle-derived magmas raised temperature in the crust and formed relatively stable magma pathways. Such a later system produced MLK-type magmas with lesser crustal components. The MLK-type magmas are common and HK-type magmas are exceptional during the Pliocene–Quaternary volcanism in the Northeast Japan Arc. This fact suggests that exceptional conditions are necessary for the production of HK-type magmas. A relatively cold crust caused by a long volcanic hiatus (several million years) is considered as one of the probable conditions. Intensive crustal assimilation and fractional crystallization promoted by the cold crust may be necessary for the generation of highly evolved HK-type felsic magmas.

Towada volcano is an active caldera volcano located at the northern part of the Northeast Japan arc. We re-examined the tephra stratigraphy of the post-caldera stage (15 ka to present) of Towada volcano, and carried out AMS radiocarbon dating of six soil samples taken from directly below the tephra layers. The most suitable ages of eruptive episodes A, B, C, D, D', E, F, G and Ninokura Scoria are estimated to be 1.1, 2.8, 6.2, 7.6, 8.3, 9.4, 10.1, 10.6, and 11-15 ka, respectively, on the basis of the thickness of soil layers between tephras and the radiocarbon ages determined by present and previous studies. This result shows that the eruption intervals have become longer with time, and the frequency of eruptions has decreased with time. Although the cause of this change is not known as yet, these are important data for predicting long-term eruptive activity of Towada volcano.

We developed mobile multi-level adaptive block truncation coding (BTC) that reduces the size of the mobile source driver's embedded RAM by 3/4 (for VGA screen with QVGA-size memory). The BTC suppresses border artifacts,especially in images shown in windows of PCs,and it corrects jagged edges in natural images. It also improves the PSNR by approximately 6.6 dB compared with that of conventional quad decimation for natural images. Our BTC enables the suppression of artifacts using: (1) trimmed averaging for three-level representative values and (2) adaptive scheme selection (two- or three-level).

症例は77歳,男性.腹痛と発熱を認め,前医で腹腔内膿瘍の経皮的ドレナージ術を施行された後,精査目的に当科入院となった.腹部CTで腹部大動脈瘤とその腹側に4cm大の膿瘍があり, 1カ月後腹部CTで膿瘍は2.5cmに縮小していたが,腹痛の症状が改善しないため手術を行った.径約1cmの回腸腫瘍と約4cmの腫大リンパ節および回腸の虚血による狭窄を認めた.組織学的にカルチノイド腫瘍と,そのリンパ節転移と診断された.術後1年現在,無再発で外来通院中である.今回われわれは,腹腔内膿瘍が発見の契機となった小腸カルチノイドの1例を経験したので文献的考察を加え報告する.

This study shows the stratigraphy, petrography, whole-rock chemistry and paleomagnetic polarity of pyroclastic flow deposits during the latest Pliocene to Middle Pleistocene in the southeastern foot area of the Hakkoda Caldera, Northeast Japan. Six pyroclastic flow deposits are identified in this area : Kumanosawa Pyroclastic Flow Deposits (Ks), Takatoge Pyroclastic Flow Deposits (Tk), Osegawa Pyroclastic Flow Deposits (Os), Hakkoda-Ose Pyroclastic Flow Deposits (Hto), Hakkoda 1st-stage Pyroclastic Flow Deposits (Ht1) and Hakkoda 2nd-stage Pyroclastic Flow Deposits (Ht2), in order of decreasing age. These pyroclastic flow deposits have dacitic to rhyolitic compositions, and show distinct modal compositions and whole-rock major element chemistry in each. Based on stratigraphy, topography and paleomagnetic polarity, eruptive ages of the pyroclastic flow deposits are estimated to be as follows : Ks, 1.95-1.77 Ma; Tk, 1.77-1.07 Ma ; Os and Hto, 0.99-0.78 Ma ; Ht1, 0.76 Ma ; Ht2, 0.40 Ma. The source calderas of the Ks, Tk, Os, and Hto can be estimated from petrological features. The source of the Ks is neither the Hakkoda Caldera nor Okiura Caldera, and is probably an unidentified caldera. The source of the Tk may be a low gravity anomaly area “Nenokuchi Caldera” located northeast of Towada Caldera. The source of the Os is not the Okiura Caldera. The source of the Hto is the Hakkoda Caldera. This study suggests that the two large-scale pyroclastic flow deposits during 1-2 Ma erupted from previously unidentified calderas (one is possibly Nenokuchi Caldera). This proposes a revised volcanic history in which the activities of caldera volcanoes overlap each other in the Hakkoda-Towada Volcanic Region.