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The wettability of a surface of channels filtering liquids and gases under natural conditions of oil and gas reservoirs is one of the parameters that largely determines the filtration. A nature of the filtration channel surface wettability determines a phase permeability, capillary forces and intensity of adsorption at the interface. An ability of the filtration channel surface to be wet by the polar or nonpolar phases of formation fluid and process liquids affects the filtration-capacitive parameters of oil and gas saturated rocks. In this regard, in the development of oil and gas fields, much attention is paid to the study of physicochemical phenomena and processes occurring at the interfaces. An article presents the results of a set of laboratory experiments to study the surface activity of the colloidal system in the form of an emulsion with supercharged nanoparticles. A set of filtration experiments was carried out using the United States Bureau of Mines (USBM) method in order to assess an effect of the emulsion system with nanoparticles on wettability of the surface of oil and gas reservoir rock filtration channels. The research was conducted on rock cores of two oil and gas fields in the Ural-Volga region of the Russian Federation. According to the applied experimental procedure, rock cores were preliminarily maintained under reservoir conditions to give a surface of pore channels the properties close to the natural conditions. After that, the wettability of rocks was assessed by measuring the USBM wettability index before and after filtering the emulsion system with nanoparticles. Analysis of the research results showed that filtration of the emulsion system with high surface activity led to a change in the wettability of rocks from completely hydrophilic (USBM index – 0.60) to completely hydrophobic (USBM index – minus 0.32). The research results allowed to conclude that there is a high potential for application of emulsion systems with supercharged nanoparticles to control the filtration of formation fluids and process liquids in natural oil and gas reservoirs.

An invented method of making nanoparticle-based emulsion system allows to create the water-in-oil type emulsion system with improved surface-activity and stability properties provided by presence of silicon dioxide nanoparticles with modified surface. Improved physical and chemical properties of the invented emulsion system provide the extremely high thermal stability (more than 140 C), unique rheology, selectivity of the effect, and make it possible to change the wettability of rocks surface. These properties allow to apply the nanoparticle-based emulsion system effectively in form of water-blocking agent widely applied for IOR methods. Based on the results reached during deep R&D work the oilfield pilot tests have been done successfully. The pilot test results showed high efficiency of the new water-blocking agent application for intensification of oil production in high heterogenous carbonate reservoirs and in the reservoirs with water break-through. The results confirm the huge potential of the method for the new water-blocking agent expansion to other directions of the IOR area. As a result of the laboratory tests carried out during R&D stage the optimal concentration and most effective types of the silicon dioxide nanoparticles with modified surface were determined. The thermal stability was measured by using thermal oven for heating the samples for 90 and 140 C. The rheology tests were carried out, and unique properties revealed. Results of the optical rheology tests visually show a structure of the emulsion systems with nanoparticles and gives a basic data for comparative analysis of the differences in the structure of the classical emulsions and improved emulsion systems with nanoparticles. Core flooding tests of new emulsion system with nanoparticles showed unique combination of water-blocking effect with selectivity of impact onto oil saturated intervals. All carried out tests are comparative, and the results confirm advantages of the new method for emulsion system generation. It was revealed that the presence of nanoparticle gives to the emulsion system unique physicochemical properties and the application of the new emulsion system as a water-blocking agent significantly increase the efficiency of the IOR methods in technological, economics and environmental aspects.

In this research, thermal desorption characteristics of deuterium retained at trap sites of W created by irradiation of 300 keV hydrogen ions have been studied. With 10 hours of annealing, about 85...

Naturally arising CD4+CD25+ regulatory T (TR) cells have been shown to prevent and cure murine T cell-mediated colitis. However, their exact mechanism of controlling colitogenic memory CD4+ T cells in in vivo systems excluding the initial process of naive T cell activation and differentiation has not been examined to date. Using the colitogenic effector memory (TEM) CD4+ cell-mediated colitis model induced by adoptive transfer of colitogenic CD4+CD44highCD62L− lamina propria (LP) T cells obtained from colitic CD4+CD45RBhigh T cell-transferred mice, we have shown in the present study that CD4+CD25+ TR cells are able not only to suppress the development of colitis, Th1 cytokine production, and the expansion of colitogenic LP CD4+ TEM cells but also to expand these cells by themselves extensively in vivo. An in vitro coculture assay revealed that CD4+CD25+ TR cells proliferated in the presence of IL-2-producing colitogenic LP CD4+ TEM cells at the early time point (48 h after culture), followed by the acquisition of suppressive activity at the late time point (96 h after culture). Collectively, these data suggest the distinct timing of the IL-2-dependent expansion of CD4+CD25+ TR cells and the their suppressive activity on colitogenic LP CD4+ TEM cells.

Multitask and multifunctional tools can process alternative operations, for example, LPCVD depositions of both Poly Si and SiN films with good repeatability and few particulates. Using those tools, we can reduce the total number of tools and the number of "only-one" tools which exist for a type of tool in the fab. We have also evaluated mini-fab availabilities using both a full calculation method and an approximate calculation method. The results show that tool reduction is more effective in obtaining good fab availability and uptime. The reduction of "only-one" tools is very important to improving mini-fab availability. The approximate calculation is simple for estimating the fab availability and offers the possibility to extend mega-fab estimations. It is also possible to use in the case that there are variations of MTTR, MTBF, and excess tool numbers.

The quality of a wound roll is highly dependent upon the in-roll stress distribution, which is controlled by the operating parameters of the center-wind torque, nip and tension. With increasing demands for higher performance of paper winding systems in terms of higher winding speeds, wider web widths and larger wound roll diameters, it becomes of vital importance to determine and understand the optimum operating conditions of these machines. In this paper, a numerical formulation for estimating the in-roll stress of a wound roll is proposed with taking account of the effect of nonlinearity in web compressibility, air-entrainment and permeance. The in-roll stress is calculated as the superposition of the stress increments caused by each winding. The theory of elasto-hydrodynamic lubrication with the compressibility of air is introduced to evaluate the effect of air-entrainment at the roll-inlet. Permeance of air is newly incorporated into the winding model, which is expressed under the assumption that permeance is proportional to the pressure difference of both sides of a web. In order to assure the applicability of the proposed theory, winding tests were conducted using the dry-end section of the paper-making pilot machine. The numerical analysis and experimental observation show the significant effect of the air-entrainment and permeance upon the in-roll stress.

Several reports have suggested that sclerotic changes in cancellous bone of the jaw and thickening of the lamina dura are characteristic radiographic changes of an early silent stage of bisphosphonate (BP)-related osteonecrosis of the jaw. No quantitative evaluation has been reported to support this hypothesis. Emago® software (Oral Diagnostic Systems, Amsterdam, Netherlands) can perform digital subtraction on intraoral radiographs even if they were obtained by non-standardized radiography, provided the dimensional error is within a certain limit. The purpose of this study was to evaluate whether sclerotic changes of alveolar bone or thickening of lamina dura in patients using BP can be detected using the subtraction function of Emago.The authors selected 46 pairs of intraoral radiographs of the mandibular molar area in dental patients. All radiographs were obtained at intervals of 6 months or more. Among the 46 pairs, 7 pairs were from patients who were being treated with BP (study subjects), and 39 pairs were from patients who had not been using BP (controls). All pairs of radiographs underwent digital subtraction by Emago. The number of pixels of the sclerotic areas was counted and compared between subjects and controls.The sclerotic changes were significantly distinguishable in two of the seven subjects (28.6%) using BP.Digital subtraction function of Emago was able to detect sclerotic changes in alveolar bone. Therefore, it is suggested that the subtraction function of Emago is a useful tool for quantitatively detecting sclerotic changes that are observed at an early, silent stage of BP-related osteonecrosis of the jaw.

The levels of macrophage migration inhibitory factor (MIF), a proinflammatory and carcinogenic cytokine, were significantly higher in the sera from patients with hepatocellular carcinoma (HCC; 25.6+/-15.3 ng/ml, n=55) and liver cirrhosis (LC; 18.9+/-10.7 ng/ml, n=26) compared with sera from patients with gastrointestinal cancer (6.8+/-7.5 ng/ml, n=29) and normal controls (5.6+/-1.2 ng/ml, n=45; P

Although defective functions of peripheral blood or splenic antigen-presenting cells (APCs) are implicated in the pathogenesis of persistent infection in murine and human hepatitis B virus (HBV) and hepatitis C virus (HCV)-carriers, little is known regarding liver-infiltrating APCs in patients with chronic liver diseases. Using immunohistochemical methodology and antigen retrieval technique, we have detected APCs such as HLA DR-positive cells, interdigitating cells (IDCs) and CD83-positive mature and activated dendritic cells (DCs) at the liver specimens from 39 patients with chronic hepatitis (CH) and 10 patients with liver cirrhosis (LC). All 3 types of APCs were detected at the portal areas in both CH and LC, the most abundant being the HLA DR-positive APCs. CD83-positive, mature and activated DCs were detected in patients with CH around the areas of focal and confluent necrosis at the liver parenchyma in close association with T cells. The localization of CD83-positive mature and activated DCs at the liver tissues from patients with CH warrants further study about the role of these DCs in the induction of hepatocellular damage. This may also help to design DC-based therapy for patients with chronic liver diseases.

Mature and activated dendritic cells (CD83-positive DCs) are essential for the recruitment and survival of activated tumor-specific lymphocytes during carcinogenesis. The frequencies of CD83 positive DCs were almost same in peripheral blood from patients with hepatocellular carcinoma (HCC) and cirrhosis of liver (LC). However, the numbers of CD83 positive DCs in liver tissues were significant lower in HCC compared with LC (6.6+/-10.9 vs. 33.3+/-24 DCs/specimen, P

Background Traditional herbal medicine, sho-saiko-to (TJ-9), improves subjective symptoms, and a recently developed vaccine therapy reduces the viral replication in some chronic hepatitis B virus (HBV)-carriers. The study presented here considers the impact of a combination of vaccine therapy and TJ-9 and the mechanism underlying the therapeutic effect of TJ-9. Materials and methods HBV-transgenic mice (HBV-Tg) expressing similar levels of HBV-related antigens and HBV DNA were used as an animal model of HBV-carrier state, and were assigned to receive either a TJ-9-enriched diet or a monthly injection of vaccine containing hepatitis B surface antigen (HBsAg), or both, for 12 consecutive months. Results Twelve months after starting the therapy, 9% (1 of 11), 61% (11 of 18), and 100% (10 of 10) of HBV-Tg receiving only the TJ-9-treatment, only the monthly vaccine, and both the TJ-9 and vaccine, respectively, responded to therapy and became completely negative for HBsAg. Spleen lymphocytes and antigen presenting cells (APC) from TJ-9-treated HBV-Tg produced significantly higher levels of IgM, IgG and antibodies to keyhole limpet hemocyanin (KLH) and showed significantly higher stimulatory capacity in allogenic mixed leukocyte reaction (MLR) compared with the spleen cells and APC from HBV-Tg receiving normal diet without TJ-9 (P

Background/Aims: Treatment of hepatitis B virus carriers by vaccine containing hepatitis B surface antigen with Pre-S protein and HBsAg/ anti-HBs complex has been reported and these studies have constituted a new and promising concept for the treatment of HBV-carriers. The present communication, a placebo-controlled trial of vaccination in HBV-transgenic mice, was designed to examine the impact of vaccination using a high dose of HBsAg for a duration of 12 months to achieve further insights about the dose, duration and effectiveness of vaccine therapy. Another aim of this study was to analyse the mechanism underlying the antiviral and immunomodulatory potentiality of vaccine therapy in HBV-transgenic mice. Methods: HBV-transgenic mice positive for HBV DNA, hepatitis B surface antigen and hepatitis B e antigen in sera received either HBV-vaccine containing HBsAg in complete Freunds' adjuvant (CFA), intraperitoneally, once a month for 12 consecutive months (vaccine recipients), or only CFA, intraperitoneally once in a month for 12 consecutive months (placebo recipients). Thirty-two vaccine-recipient and 16 placebo-recipient HBV-transgenic mice were injected, checked and followed on a monthly basis for the entire duration of 12 months. Results: Of the 32 transgenic mice from the vaccine-recipient group, 25 became completely negative for HBsAg and 30 for HBeAg. Five mice developed anti-HBs in sera after the observation period of 12 months. Semiquantitative estimation of HBV DNA by polymerase chain reaction showed that vaccination resulted in a decrease of HBV DNA in sera. Placebo-recipient transgenic mice did not show any significant change in the titres of HBV markers after receiving 12 monthly injections of CFA. Interleukin-2 could be detected in sera from vaccine-recipient transgenic mice, but not in placebo-recipient transgenic mice. Conclusions: Vaccination with a high dose of HBsAg in adjuvant over a long period had a significant antiviral as well as immunomodulatory potential in HBV-transgenic mice. This inspires optimism that vaccine alone or in combination with antiviral agents can be used successfully for the treatment of human HBV-carriers.

We have been developing a high-speed simulator and micro-grid emulator for real-time energy management system. In this paper, we describe our new fast simulation model for PV system that will allow us to simulate 24-hour data in less than 5 sec. We use this simulator to make estimations and verify our management strategies. We have proposed a hybrid DC/AC micro-grid system in our previous work. The proposed system consists of several renewable energy supply sources and a secondary battery connected to the DC bus line while load and utility-grid are connected to the AC bus line. When the renewable energy power becomes lower than the demand, additional power is supplied from the secondary battery and the utility-grid. To optimally control the state of energy balance, it is necessary to develop a simulator for operational analysis. In addition, verification of simulation and emulation using real devices is essential. As for realization of emulator, a high-speed simulator is effective in predicting and analyzing system that incorporate energy usage patterns, running cost, and other factors. The proposed micro-grid emulator can realize seamless operation between simulation and emulation by using our revolutionary model. The verification results show that the proposed simulator and emulator are effective in the energy management strategies and to draw up optimum control operation of micro-grid system.

Orcein staining was used to detect copper-binding protein as orcein-positive granules in liver tissue with hepatocellular carcinoma (HCC) and in small HCC (up to 2 cm in diameter). These granules were found in 36 out of 80 patients with HCC. Morever, we found the granules in 1228 patients with small HCC. The frequency of orcein-positive granules in HCC and small HCC was significantly higher than that in patients with liver cirrhosis (LC) without HCC (HCC with LC vs. LC without HCC, 45.0% vs. 6.7%, P < 0.01; small HCC vs. LC without HCC, 42.9% vs. 6.7%, P < 0.01). The granules were distributed in both the malignant cells and the surrounding non-malignant cells. Structures forming pseudo-glandular patterns in HCC and liver-cell rosettes in non-malignant areas displayed numerous granules. The granules were also positive for copper by the rhodanine staining. The accumulation of histologically demonstrable copper-binding protein and copper in hepatocytes may be one of the characteristics of HCC, including small HCC.

Recently updated nanocrystalline soft magnetic Fe-Co-Si-B-P-Cu alloys “NANOMET®” exhibit high saturation magnetic flux density (Bs > 1.8 T), low coercivity (Hc < 10 A/m) and low core loss (W1.7/50 ∼ 0.4 W/kg) even in a ribbon form with a thickness of up to 40 μm. By utilize excellent magnetic softness, several products such as motors or transformers for electrical appliances are now under developing by industry-academia collaboration. In particular, it is found that a brushless DC motor using NANOMET® core exhibited remarkable improvement in energy consumption. The prototype motor with an outer core diameter of 70 mm and a core thickness of 50 mm was constructed using laminated nano-crystallized NANOMET® ribbons. Core-loss for the constructed motor was improved from 1.4 W to 0.4 W only by replacing the non-oriented Si-steel core with NANOMET® one. The overall motor efficiency is evaluated to be 3% improvement. In this work, the relation between processing and resulting magnetic properties will be presented. In addition, feasibility for commercialization will also be discussed.

Cleidocranial dysplasia (CCD, MIM#119600), for which the responsible gene is RUNX2, is a genetic disorder characterized by hypoplasia or aplasia of the clavicles, patent fontanelles, and a short stature. Supernumerary teeth and delayed eruption and impaction of permanent teeth are frequently associated with CCD. Our previous study reported wide intrafamilial variation in supernumerary tooth formation associated with a mutation in the RUNT-domain of RUNX2, suggesting a low correlation between the genotype and supernumerary tooth formation. To further clarify this point, a more precise evaluation was performed.Gene mutational analysis of nine Japanese individuals with CCD was performed. Dental and skeletal characteristics were examined based on patient examinations and radiographs.Four different gene mutations, including one novel mutation in RUNX2 gene (NM_001024630), were identified. Among them, four individuals had the R225Q mutation, three siblings had the P224S mutation, and the other two individuals had different frame-shift mutations. Wide variations in supernumerary tooth formation were observed in individuals with identical gene mutations, and discordance was seen between monozygotic twins. Asymmetric supernumerary tooth formation was noted in five out of the nine individuals.Individuals with identical gene mutations showed a wide variation in the supernumerary tooth formation. Not only the genotype but also environmental factors and a complex system including epigenetics and copy number variation might regulate supernumerary tooth formation in CCD.

This paper describes a study on acoustic emission in soils, continued from previous research, by the method of triaxial compression test, to explore a possibility of establishing correlation between the characteristics of acoustic emission in soils subjected to shear stress and deformation properties of the soils. From the results of tests conducted under strain-controlled and stress-controlled conditions, it has been made obvious that the characteristics of acoustic emission are closely connected with the rate of axial strain, the sign of dilatancy, and work done by external stresses during shear process. (Authors)

The SSRM in vacuum is proven to have sufficiently high spatial resolution for 2D profiling of ultra-shallow junctions of ~10 nm. An extremely small effective probe radius of 0.5 nm has been shown to be available with our SSRM systems. Halo distribution influence on roll-off characteristics has been directly observed. SSRM has been shown to have great potential for 2D characterization of next-generation CMOS devices and other nanostructures.

Adult T-cell leukaemia/lymphoma (ATLL) is a highly aggressive haematological malignancy. More than 40 cases of ATLL treated by allogeneic bone marrow transplantation (BMT) from sibling donors have been reported, while there have been only a few cases of unrelated BMT for treatment of this disease. We began performing allogeneic BMT from unrelated donors in 1999 to improve the outcome of ATLL patients with no suitable sibling donors. Eight ATLL patients underwent unrelated BMT; five received the conventional conditioning regimen consisting of cyclophosphamide and total body irradiation, while three received a reduced-intensity preparative regimen. Two patients died due to encephalopathy of unknown aetiology on days 10 and 35, and one patient died due to progression of ATLL 25 months after BMT. Five patients are currently alive and disease-free at a median of 20 months after BMT. Proviral human T-lymphotropic virus type-I (HTLV-I) DNA load in peripheral blood mononuclear cells (PBMCs) was assessed in four cases before and after BMT. HTLV-I proviral DNA load was reduced significantly after transplantation. Unrelated BMT is feasible for treatment of ATLL. Further studies in a larger number of cases are required to determine the optimal conditioning regimen and stem cell source.

A novel contact recording slider design for HDD, which continuously contacts a disk surface, was investigated. The design of the slider, which has a wide air bearing surface in the front and a contact portion in the rear, enables precise division of suspension load between hydrodynamic force and contact force under certain tolerances. Therefore, stable contact between the slider and the disk is accomplished with small contact force, and the wear of the slider can be reduced. Experiment shows the small spacing fluctuation (

Publisher Summary This chapter aims to evaluate the reduction of the lifecycle cost (LCC) of both preventive maintenance (PM) and corrective maintenance in the case of the water transmission system in Kobe. A Markov decision process model is developed to derive the maintenance policy and the LCC under the policy. As a result, the reduction of the LCC by preventive maintenance in this case is not negligible. It suggests that cost reduction only by corrective maintenance, which can be easily evaluated in practice, may be an underestimate of the total cost reductions. The model in the chapter should be further extended in terms of PM and by considering the number of the components of system. Although it is assumed that PM is only a replacement, the manager can make repairs which lead the state to a better state but not necessarily to state 0. Considering that the manager takes on repairs in the evaluation, this may actually reduce the LCC. In addition, the manager does not always replace or repair the whole system but only a part of the system. The evaluation when assuming the system consists of multi-unit components is the work to be studied.

The overexpression of estrogen receptor alpha (ERalpha) is frequently observed in the early stage of breast cancer. We previously reported that the specific promoter of the ERalpha gene is responsible for this enhanced transcription of the gene, and identified the cis-acting elements which play an important role in its transcription. Furthermore, methylation of the ERalpha gene promoters also contribute to the regulation of gene transcription. Elucidation of these mechanisms of ERalpha gene expression may provide useful information for the early detection and chemoprevention of breast cancer. On the other hand, the expression of ERbeta has been reported in breast cancer. We have also assessed the significance and function of ERbeta and its variant types in breast cancer, and suggest that ERbeta and ERbetacx specifically suppress the function of ERalpha through different mechanisms. ERbeta isoforms may be important functional modulators of the estrogen-signaling pathway in breast cancer cells, and might affect the clinical outcome of patients. Moreover, to address the role of these ERs on the estrogen-dependent growth of breast cancer cells and to develop a diagnostic tool, we have analyzed the gene expression profiles of estrogen-responsive genes using cDNA microarray. Based on these results, the expression of several candidate genes in breast cancer tissues were analyzed by real-time RT-PCR and by immunohistochemical techniques, in order to discover new predictive factors for the endocrine therapy of patients with breast cancer. These studies could provide new clues for the elucidation of the estrogen-dependent mechanisms of cancer and the clinical benefits for patients.

The contribution of CTLA-4 alleles to the pathogenesis of systemic sclerosis (SSc) was studied in Japanese patients.CTLA-4 typing in 2 dimorphic sites, +49 A/G and -308 C/T, was carried out in 62 SSc patients and 107 normal subjects by the PCR-RFLP (restriction fragment length polymorphism) method. HLA-DRB1*15 and *08 genotyping were carried out by the PCR-SSCP (simple-stranded DNA conformation polymorphism) method.In SSc the frequency of the +49A allele increased slightly (40.3%), but was not significant. In SSc with diffuse scleroderma and SSc with anti-topoisomerase I antibody, the +49A also increased (43.8%, and 48.0%, respectively) but again was not significant. A significant increase in the +49A was not observed in SSc with HLA-DRB1*1502 or ORB1*0802. In contrast, the +49A had significantly increased in SSc with the anti-RNP antibody [52.9%, p = 0.0337, Odds ratio (OR) = 2.27 (95% confidential interval (CI) = 1.09-4.71)]. HLA-DRB1*1502 and *0802 had no influence on the association of anti-RNP antibody with the +49A. The +49AA genotype increased significantly in SSc without lung fibrosis [31.8%, p = 0.0456, OR = 3.37 (CI = 1.16-9.87)], especially in limited SSc without lung fibrosis [33.3%, p = 0.0319, OR = 3.62 (CI = 1.16-11.29)]. The dimorphism at -308 did not associate with SSc.In Japanese scleroderma, the +49A allele of CTLA-4 increased in the presence of SSc with the anti-RNP antibody.

In multipurpose reservoir developments, conflicts arise when joint costs must be allocated amongst uses (such as flood control, municipal and industrial water supply, irrigation and hydroelectric power) participating in the development. To resolve such conflicts, called the cost allocation problem, the allocation should satisfy the conditions of economical efficiency and fairness among the participating uses. In addition, it is necessary for a cost allocation method to be as simple as possible in terms of application. Namely, ease of use and ease of calculation are considered significant and are the basis for conventional allocation methods. In this paper, we claim that the conventional cost allocation methods should continue to be used in practice. However, they should be reexamined by use of cooperative game theory as a measure to analyze the extent to which the methods hold logical reasoning. Specifically, we note the presence of coincidence between the allocation by the conventional cost allocation methods and by game-theory based-methods. As long as coincidence holds, the conventional methods are endorsed on the grounds of its fairness and equity by the corresponding game theory.

After the Hanshin-Awaji Earthquake, researchers have generally agreed that a disaster prevention plan should take into account a strong seismic motion which exceeds the maximum past level and destroys the city or region. However, many of the issues discussed remain on the methodology of how to determine the reasonable level. This study proposes a methodology to determine the level from a socio-economic viewpoint by focusing the level of remaining functions for reconstruction. Through numerical examinations on the model performance under several kinds of utility functions and loss functions, the usefulness of the proposed model is confirmed. The proposed model gives a framework for further detailed discussion, including an introduction of a policy mix of seismic improvement and inter-regional seismic insurance.

To determine how experts would classify 10 early-arthritis cases (7 atypical) and to study discrepancies in diagnoses relative to ACR criteria for rheumatoid arthritis (RA) or ESSG criteria for spondyloarthropathy (SpA).Ten real cases (5 met ACR criteria for RA, 6 ESSG criteria for SpA, 3 both and 2 neither) followed for 28.5 +/- 4.8 months were sent as paper cases to 20 international and 12 French experts. Each expert selected a diagnosis among 8 possible choices and rated it on a 0-10 confidence scale. For each case, 3 analog scales (0-100 mm) were used to indicate the probability of RA, SpA or undifferentiated arthritis (UA).Experts often disagreed about diagnoses (up to 5 different diagnoses for a given case, with a mean of 3.9 per case). Similarly, expert opinions on probabilities for RA and SpA differed widely, with great overlap between confidence for RA, SpA and UA. Fulfilment of ACR or ESSG criteria was poorly related to the experts' diagnosis and evaluation of probabilities for RA and SpA. However, UA was a relatively infrequent choice (19%).There was no general consensus about the nosology of early RA and SpA. Classification of atypical early arthritis was not resolved by currently available criteria for RA and SpA. This may have implications for therapy in early disease.

We report the case of a 29-year old female who developed a fixed drug eruption due to ephedrine hydrochloride administered intravenously during the cesarean section. On the day of the operation a palm-sized dark brown macula with half egg-sized erosion appeared on her right lower thigh. We diagnosed her disease as fixed drug eruption and examined the causative agent among all the 14 drugs used from admission to the appearance of fixed drug eruption. Each of systemic challenge, patch test on the lesion, intradermal and subcutaneous injection on the lesion with ephedrine hydrochloride showed positive reaction. As far as we have been able to search, our case is the first one of fixed drug eruption due to ephedrine hydrochloride.