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Evidence exists that escalating melanoma incidence is due in part to overdiagnosis, the diagnosis of lesions that will not lead to symptoms or death. The authors aimed to characterize subsets of melanoma patients with very-low risk of death that may be contributing to overdiagnosis.Melanoma patients diagnosed in 2010 and 2011 with stage I lesions ≤1.0 mm thick and negative clinical lymph nodes from the Surveillance, Epidemiology, and End Results database were selected. Classification and regression tree and logistic regression models were developed and validated to identify patients with very-low risk of death from melanoma within 7 years. Logistic models were also used to identify patients at higher risk of death among this group of stage I patients.Compared to an overall 7-year mortality from melanoma of 2.5% in these patients, a subset comprising 25% had a risk below 1%. Younger age at diagnosis and Clark level II were associated with low risk of death in all models. Breslow thickness below 0.4 mm, absence of mitogenicity, absence of ulceration, and female sex were also associated with lower mortality. A small subset of high-risk patients with20% risk of death was also identified.Patients with very-low risk of dying from melanoma within 7 years of diagnosis were identified. Such cases warrant further study and consensus discussion to develop classification criteria, with the potential to be categorized using an alternative term such as "melanocytic neoplasms of low malignant potential."Although melanoma is the most serious skin cancer, most melanoma patients have high chances of survival. There is evidence that some lesions diagnosed as melanoma would never have caused symptoms or death, a phenomenon known as overdiagnosis. In this study, we used cancer registry data to identify a subset of early-stage melanoma patients with almost no melanoma deaths. Using two statistical approaches, we identified patients with1% risk of dying from melanoma in 7 years. Such patients tended to be younger with minimal invasion into the skin. We also identified a very small patient subset with higher mortality risk.

ImportanceMedical second opinions are common, although little is known about the best processes for obtaining them. This study assesses whether knowledge of a prior physician’s diagnosis influences consulting physicians’ diagnoses.ObjectiveTo measure the extent to which dermatopathologists’ diagnoses are influenced by prior diagnostic information from another dermatopathologist.Design, Setting, and ParticipantsDermatopathologists were randomly assigned to interpret 1 slide set of 18 melanocytic skin biopsy specimens in 2 phases (5 slide sets totaling 90 cases). Phase 1 interpretations were conducted without prior diagnostic information. After a washout period of 12 or more months, dermatopathologists’ phase 2 interpretations were conducted with their identical slide set; for a random subset of cases in phase 2, participants were shown prior diagnoses by other dermatopathologists that were either more or less severe than their own phase 1 diagnosis of the case. Using the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis tool, cases ranged from class I (benign) to class V (≥pT1b invasive melanoma). Data collection took place from August 2018 to March 2021, and data analysis was performed from March to December 2021.InterventionPrior diagnoses were actual diagnoses from board-certified and/or fellowship-trained dermatopathologists. A prior diagnosis was always in a more severe or less severe diagnostic class than the participant’s phase 1 interpretation; more or less severe was determined by the randomization scheme. In the control condition of no prior diagnostic information, the participants were told that a prior diagnosis was not available.Main Outcomes and MeasuresWhen exposure was to a prior diagnosis in a higher diagnostic class, the primary study outcome was whether a participant’s diagnosis in phase 2 was in a higher diagnostic class than the participant’s diagnosis in phase 1. When exposure was to a prior diagnosis in a lower diagnostic class, the primary study outcome was whether a participant’s diagnosis in phase 2 was in a lower diagnostic class than the participant’s diagnosis in phase 1. The effect of prior diagnostic information was measured using the relative risk (RR) of each outcome relative to the control condition of no prior diagnostic information, adjusted for the diagnostic class of the phase 1 diagnosis. Prior to data collection, it was hypothesized that participants would be swayed in the direction of prior diagnostic information.ResultsA total of 149 dermatopathologists (median [range] age, 47 years [34-76] years; 101 [68%] were male) provided 5322 interpretations of study cases. Participants were more likely to increase the severity of their diagnosis when the prior diagnosis was of greater severity compared with when no prior diagnosis was provided (RR, 1.52; 95% CI, 1.34-1.73); likewise, participants gave less severe diagnoses when prior diagnoses were of lesser severity (RR, 1.38; 95% CI, 1.19-1.59). Trends were similar among dermatopathologists who had previously stated they were “not at all influenced” by prior diagnoses. Prior diagnoses also swayed dermatopathologists away from correct diagnoses.Conclusions and RelevanceIn this randomized controlled trial, despite the preference of most dermatopathologists to receive prior diagnoses when providing second opinions, this information swayed them away from a correct diagnosis to an incorrect diagnosis.

BackgroundA standardized pathology management tool for melanocytic skin lesions may improve patient care by simplifying interpretation and categorization of the diverse terminology currently extant.ObjectiveTo assess an online educational intervention that teaches dermatopathologists to use the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx), a schema collapsing multiple diagnostic terms into 5 classes ranging from benign to invasive melanoma.MethodsPracticing dermatopathologists (N = 149) from 40 US states participated in a 2-year educational intervention study (71% response rate). The intervention involved a brief tutorial followed by practice on 28 melanocytic lesions, with the goal of teaching pathologists how to correctly use the MPATH-Dx schema; competence using the MPATH-Dx tool 12-24months postintervention was assessed. Participants' self-reported confidence using the MPATH-Dx tool was assessed preintervention and postintervention.ResultsAt preintervention, confidence using the MPATH-Dx tool was already high, despite 68% lacking prior familiarity with it, and confidence increased postintervention (P = .0003). During the intervention, participants used the MPATH-Dx tool correctly for 90% of their interpretations; postintervention, participants used the MPATH-Dx tool correctly for 88% of their interpretations.LimitationsFuture research should examine implementing a standardized pathology assessment schema in actual clinical practice.ConclusionDermatopathologists can be taught to confidently and competently use the MPATH-Dx schema with a simple educational tutorial followed by practice.

Previous studies of second opinions in the diagnosis of melanocytic skin lesions have examined blinded second opinions, which do not reflect usual clinical practice. The current study, conducted in the USA, investigated both blinded and nonblinded second opinions for their impact on diagnostic accuracy.In total, 100 melanocytic skin biopsy cases, ranging from benign to invasive melanoma, were interpreted by 74 dermatopathologists. Subsequently, 151 dermatopathologists performed nonblinded second and third reviews. We compared the accuracy of single reviewers, second opinions obtained from independent, blinded reviewers and second opinions obtained from sequential, nonblinded reviewers. Accuracy was defined with respect to a consensus reference diagnosis.The mean case-level diagnostic accuracy of single reviewers was 65.3% (95% CI 63.4-67.2%). Second opinions arising from sequential, nonblinded reviewers significantly improved accuracy to 69.9% (95% CI 68.0-71.7%; P 0.001). Similarly, second opinions arising from blinded reviewers improved upon the accuracy of single reviewers (69.2%; 95% CI 68.0-71.7%). Nonblinded reviewers were more likely than blinded reviewers to give diagnoses in the same diagnostic classes as the first diagnosis. Nonblinded reviewers tended to be more confident when they agreed with previous reviewers, even with inaccurate diagnoses.We found that both blinded and nonblinded second reviewers offered a similar modest improvement in diagnostic accuracy compared with single reviewers. Obtaining second opinions with knowledge of previous reviews tends to generate agreement among reviews, and may generate unwarranted confidence in an inaccurate diagnosis. Combining aspects of both blinded and nonblinded review in practice may leverage the advantages while mitigating the disadvantages of each approach. Specifically, a second pathologist could give an initial diagnosis blinded to the results of the first pathologist, with subsequent nonblinded discussion between the two pathologists if their diagnoses differ.

ImportanceA standardized pathology classification system for melanocytic lesions is needed to aid both pathologists and clinicians in cataloging currently existing diverse terminologies and in the diagnosis and treatment of patients. The Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx) has been developed for this purpose.ObjectiveTo revise the MPATH-Dx version 1.0 classification tool, using feedback from dermatopathologists participating in the National Institutes of Health–funded Reducing Errors in Melanocytic Interpretations (REMI) Study and from members of the International Melanoma Pathology Study Group (IMPSG).Evidence ReviewPracticing dermatopathologists recruited from 40 US states participated in the 2-year REMI study and provided feedback on the MPATH-Dx version 1.0 tool. Independently, member dermatopathologists participating in an IMPSG workshop dedicated to the MPATH-Dx schema provided additional input for refining the MPATH-Dx tool. A reference panel of 3 dermatopathologists, the original authors of the MPATH-Dx version 1.0 tool, integrated all feedback into an updated and refined MPATH-Dx version 2.0.FindingsThe new MPATH-Dx version 2.0 schema simplifies the original 5-class hierarchy into 4 classes to improve diagnostic concordance and to provide more explicit guidance in the treatment of patients. This new version also has clearly defined histopathological criteria for classification of classes I and II lesions; has specific provisions for the most frequently encountered low–cumulative sun damage pathway of melanoma progression, as well as other, less common World Health Organization pathways to melanoma; provides guidance for classifying intermediate class II tumors vs melanoma; and recognizes a subset of pT1a melanomas with very low risk and possible eventual reclassification as neoplasms lacking criteria for melanoma.Conclusions and RelevanceThe implementation of the newly revised MPATH-Dx version 2.0 schema into clinical practice is anticipated to provide a robust tool and adjunct for standardized diagnostic reporting of melanocytic lesions and management of patients to the benefit of both health care practitioners and patients.

Background Histopathologically ambiguous melanocytic lesions lead some pathologists to list multiple diagnostic considerations in the pathology report. The frequency and circumstance of multiple diagnostic considerations remain poorly characterized. Methods Two hundred and forty skin biopsy samples were interpreted by 187 pathologists (8976 independent diagnoses) and classified according to a diagnostic/treatment stratification (MPATH-Dx). Results Multiple diagnoses in different MPATH-Dx classes were used in n = 1320 (14.7%) interpretations, with 97% of pathologists and 91% of cases having at least one such interpretation. Multiple diagnoses were more common for intermediate risk lesions and are associated with greater subjective difficulty and lower confidence. We estimate that 6% of pathology reports for melanocytic lesions in the United States contain two diagnoses of different MPATH-Dx prognostic classes, and 2% of cases are given two diagnoses with significant treatment implications. Conclusions Difficult melanocytic diagnoses in skin may necessitate multiple diagnostic considerations; however, as patients increasingly access their health records and retrieve pathology reports (as mandated by US law), uncertainty should be expressed unambiguously.

Background Synoptic reporting is recommended by many guideline committees to encourage the thorough histologic documentation necessary for optimal management of patients with melanoma. Methods One hundred fifty-one pathologists from 40 US states interpreted 41 invasive melanoma cases. For each synoptic reporting factor, the authors identified cases with "complete agreement" (all participants recorded the same value) versus any disagreement. Pairwise agreement was calculated for each case as the proportion of pairs of responses that agreed, where paired responses were generated by the comparison of each reviewer's response with all others. Results There was complete agreement among all reviewers for 22 of the 41 cases (54%) on Breslow thickness dichotomized at 0.8 mm, with pairwise agreement ranging from 49% to 100% across the 41 cases. There was complete agreement for "no ulceration" in 24 of the 41 cases (59%), with pairwise agreement ranging from 42% to 100%. Tumor transected at base had complete agreement for 26 of the 41 cases (63%), with pairwise agreement ranging from 31% to 100%. Mitotic rate, categorized as 0/mm2 , 1/mm2 , or 2/mm2 , had complete agreement for 17 of the 41 cases (41%), with pairwise agreement ranging from 36% to 100%. Regression saw complete agreement for 14 of 41 cases (34%), with pairwise agreement ranging from 40% to 100%. Lymphovascular invasion, perineural invasion, and microscopic satellites were rarely reported as present. Respectively, these prognostic factors had complete agreement for 32 (78%), 37 (90%), and 18 (44%) of the 41 cases, and the ranges of pairwise agreement were 47% to 100%, 70% to 100%, and 53% to 100%, respectively. Conclusions These findings alert pathologists and clinicians to the problem of interobserver variability in recording critical prognostic factors. Lay summary This study addresses variability in the assessment and reporting of critical characteristics of invasive melanomas that are used by clinicians to guide patient care. The authors characterize the diagnostic variability among pathologists and their reporting methods in light of recently updated national guidelines. Results demonstrate considerable variability in the diagnostic reporting of melanoma with regard to the following: Breslow thickness, mitotic rate, ulceration, regression, and microscopic satellites. This work serves to alert pathologists and clinicians to the existence of variability in reporting these prognostic factors.

Expert radiologists can quickly extract a basic "gist" understanding of a medical image following less than a second exposure, leading to above-chance diagnostic classification of images. Most of this work has focused on radiology tasks (such as screening mammography), and it is currently unclear whether this pattern of results and the nature of visual expertise underlying this ability are applicable to pathology, another medical imaging domain demanding visual diagnostic interpretation. To further characterize the detection, localization, and diagnosis of medical images, this study examined eye movements and diagnostic decision-making when pathologists were briefly exposed to digital whole slide images of melanocytic skin biopsies. Twelve resident (N = 5), fellow (N = 5), and attending pathologists (N = 2) with experience interpreting dermatopathology briefly viewed 48 cases presented for 500 ms each, and we tracked their eye movements towards histological abnormalities, their ability to classify images as containing or not containing invasive melanoma, and their ability to localize critical image regions. Results demonstrated rapid shifts of the eyes towards critical abnormalities during image viewing, high diagnostic sensitivity and specificity, and a surprisingly accurate ability to localize critical diagnostic image regions. Furthermore, when pathologists fixated critical regions with their eyes, they were subsequently much more likely to successfully localize that region on an outline of the image. Results are discussed relative to models of medical image interpretation and innovative methods for monitoring and assessing expertise development during medical education and training.

International audience; We measured an Al K-edge x-ray absorption near edge structure (XANES) spectrum of Al doped NiO for anode materials of lithium ion batteries. We found that the spectrum of the Al doped NiO is similar to that of γ-Al2O3. Calculated site-specific XANES spectra strongly correspond to the coordination nature around the absorbing Al ion, indicating aggregation of cation vacancies surrounded by Al ions in the Al doped NiO. These finding could be useful to understand how Li ions migrate in the anode.

The thermoelectric properties of ternary full-Heusler alloys, Co2 YZ, which are in a ferromagnetic state up to high temperature above 300 K, were measured and are discussed in terms of the crystal structure and electronic states. Among the full-Heusler alloys studied, the Co2MnSi sample exhibited the highest absolute value of Seebeck coefficient and also the highest electrical conductivity in the temperature range from 300 K to 1023 K. The highest power factor of 2.9 × 10−3 W/m-K2 was obtained for the Co2MnSi sample at 550 K, demonstrating the potential of half-metallic full-Heusler alloys as thermoelectric materials.

To evaluate in detail the dose distribution during computed tomography (CT), a sheet roll CT dosimetry phantom (SRCT-P) with a radiochromic film (RF) was experimentally developed. The SRCT-P was made by rolling up a vinyl chloride sheet in a cylindrical shape to arbitrarily select the SRCT-P diameter, dose measurement position, and depth. The SRCT-P centre core consisted of a plastic hose in which a 10 mm acrylic bar with a RF was inserted. To determine the availability of the SRCT-P, the surface and centre doses (at a 5 mm radius) at each SRCT-P diameter (6-16 cm; every 2 cm) were measured. The ratios of the centre-to-surface doses (D(centre)/D(surface)) systematically increased, from 80 to 111%, for decreasing SRCT-P diameters, between 16 and 6 cm, respectively. The centre dose approached the surface dose as the SRCT-P diameter decreased. To use a RF for a CT dose measurement, further detailed research and analysis is necessary. However, this study has shown that a SRCT-P is useful and beneficial for the measurement of the dose distribution during a CT examination.

Pulsed field gel electrophoresis (PFGE) and random amplified polymorphic DNA (RAPD) methods were applied for molecular typing of 130 Mannheimia (Pasteurella) haemolytica serotype A1 isolates obtained from 13 prefectures in Japan. These isolates were divided into 15 ApaI PFGE profiles that formed six distinct clusters (clusters A–F). Fifty-three (40·7%) isolates were classified in cluster B, and 20·0, 13·8, 12·3, 6·9 and 6·1% of isolates were in clusters E, A, F, D and C, respectively. The isolates of cluster B were differentiated into seven subtypes (B1–B7) and subtype B5 contained 63% (34/53) of isolates. RAPD revealed four banding patterns (types I–IV), and among 130 isolates 60·7% (79/130) of isolates were RAPD type I. All of the RAPD type I isolates were grouped into clusters A–C by PFGE. There was no relationship between molecular typing and geographic origin of these isolates. These results indicate that isolates of M. haemolytica A1 strain with various molecular profiles have already spread in Japan and may have caused sporadic infections.

We apply the algebraic–geometric techniques developed for the study of mappings which have the singularity confinement property to mappings which are integrable through linearization. The main difference with respect to the previous studies is that the linearizable mappings have generically unconfined singularities. Despite this fact we are able to provide a complete description of the dynamics of these mappings and derive rigorously their growth properties.

SUMMARYA total of 105 033 eggs were collected across Japan from June 2010 to January 2011 and tested for Salmonella Enteritidis to provide data for the risk profiling of S. Enteritidis in eggs by the Food Safety Commission of Japan. S. Enteritidis isolates were recovered from three samples (20 eggs/sample) and these samples were different in regard to sampling period, grading and packaging centre and farm. The prevalence of S. Enteritidis in commercial eggs in Japan is estimated at ∼0·003% which was a tenfold decrease in prevalence compared to similar surveillance in the mid 1990s. The decrease in the contamination in commercial eggs is considered a contributory factor in the decrease of foodborne diseases associated with S. Enteritidis in this period.

The X-linked lymphoproliferative disease (XLP) is an inherited immunodeficiency characterized by an abnormal responses to infection with Epstein-Barr virus (EBV), resulting in fatal infectious mononucleosis, hypogammaglobulinemia, virus-associated hemophagocytic syndrome, and malignant lymphoma. Mutations in the gene coding for a T cell-specific SLAM-associated protein (SAP) have been recently identified in XLP patients. We report on a 1-year-old boy representing fulminant hemophagocytic syndrome. He developed high fever, lymphadenopathy, hepatosplenomegaly with liver dysfunction, and pancytopenia with marrow hemophagocytosis. EBV DNA was abnormally increased in the blood. Polymerase chain reaction failed to amplify SAP mRNA and genomic DNA products from the patient' As peripheral blood. A large deletion of the SAP gene was confirmed by fluorescence in situ hybridization (FISH). FISH analysis also disclosed that the patient's mother was a carrier. We conclude that FISH can be useful in the diagnosis of XLP with large deletions of the SAP gene and its carrier state.

This report describes a patient with multiple colonic ulcers and mixed connective tissue disease. The histological findings of the colonic lesions showed vasculitis with T-cell infiltration, and the peripheral T cells were frequently in the activated phase of the cell cycle. In this patient, low-dose cyclosporin treatment (2.5 mg/kg/day) inhibited the T-cell activation in the peripheral lymphocytes and was very effective in the gastrointestinal disorder, which might be related to T-cell activation. This case suggests the possibility that even low-dose cyclosporin can exert a great influence on peripheral T cells and directly inhibit T-cell activation, thereby improving symptoms related to T-cell activation.

S-PED means a superconducting power electronics device. We made some thermally controlled S-PED which is a normally-on device. They work up to 100 Hz as a full wave rectifier. For the power supply of superconducting magnets, the flux pump can be used as SPEED (superconducting power electronics excitation device). In this paper, we describe the turn off characteristics of one of the S-PED (type d). The relations between generated resistance, gate-trigger energy and channel current were obtained.

Round-robin tests were conducted in order to investigate a simple and easy method for preparing a standard gas mixture of volatile organic hazardous air pollutants from their mixed solution by 16 members of the Association for Environmental Analysis in Osaka. Seven compounds (acrylonitrile, dichloromethane, chloroform, 1, 2-dichloroethane, benzene, trichloroethylene, and tetrachloroethylene) were accurately weighed into a vial one by one. An aliquot of this liquid mixture was transferred into a glass vessel (1 or 21) using a microsyringe, and then vaporized. The resulting gas mixtures (about 300 ppm each) were evaluated as a first standard gas by gas chromatography. The obtained results prove this method to be accurate and precise for the preparation of a standard gas mixture.

Miscibility and dehydration of poly(2-hydroxyethyl methacrylate) and poly(methacrylic acid) (PHEMA/PMAA) blends were investigated by temperature modulated DSC (TMDSC), TG and solid-state 13C NMR methods. TMDSC spectra and 1H spin-relaxation times showed that the blends are homogeneous on a scale of 5-10 nm for all compositions. From TG and 13C NMR, we elucidated that the mass loss of the blends at 300°C is ascribed to the dehydration between the hydroxyl group of PHEMA and the carboxyl group of PMAA.

Polarization of the radiation from Zn and Cd atoms (n = 4 for Zn and 5 for Cd, respectively) was observed after electron impact with energy slightly above the threshold excitation energy. The observing direction was perpendicular to both the incident electron beam and the atomic beam. All of the triplet radiation (J = 0, 1 and 2) was slightly polarized. The observed fractional polarization degrees were and corresponding to J = 0, 1 and 2 spectra in the final states of the Zn atom and , 4.3 and for the Cd atom. These values could be explained by assuming populations in the sublevels and of the states deviating from an equal mean value of for each sublevel. It is interesting and reasonable that the deviations determined independently for different states coincided with each other quite well. The deviated values of fractional population for the sublevel were 0.36 for Zn and 0.37 for Cd, respectively.

p16 and p15 genes are putative tumor suppressor genes located on chromosome 9p21. In acute leukemias, alterations of p16 and p15 genes have been reported to occur exclusively in lymphoid lineage. We analyzed alterations of p16 and p15 genes in 46 acute leukemias with MLL gene rearrangements by Southern blot analysis, and investigated the association with clinical characteristics. We identified homozygous deletion of p16 and p15 genes in five (19%) of 27 acute lymphoblastic leukemias (ALLs) and in two (11%) of 19 acute myeloid leukemias (AMLs). Patients with homozygous deletion of p16 and p15 genes showed higher average leukocyte counts (343 x 10(9)/l vs 271 x 10(9)/l) and lower estimated 2-year survival rates than those with normal p16 and p15 genes (14.3 vs 30.7%), although the differences were not statistically significant. In addition, we investigated mutation of p16 gene by polymerase chain reaction single strand conformation polymorphism (PCR-SSCP) in 31 patients, but no mutation was found in the patients tested. Our results suggest that alterations of p16 and p15 genes are involved in a subset of acute leukemias with MLL gene rearrangement not only of lymphoid but also of myeloid phenotype. Homozygous deletion of p16 and p15 genes may be a possible adverse prognostic factor, although further analysis would be needed to confirm it.

Ultrathin sections of bone marrow cells from two patients with homozygous beta-thalassaemia, two patients with haemoglobin H (HbH) disease, a patient with congenital dyserythropoietic anaemia (CDA) type III and two patients with severe congenital dyserythropoietic anaemia of an unusual type were reacted with mouse monoclonal antibodies against various globin chains and the reaction visualized using a gold-labelled goat antibody against mouse IgG. The multiple rounded intra-erythroblastic inclusions found in homozygous beta-thalassaemia reacted with the monoclonal antibody against alpha-globin chains but not beta-globin chains, thus confirming that they consisted of precipitated alpha-globin chains. The branching intra-erythroblastic inclusions found in HbH disease and CDA type III reacted with the monoclonal antibody against beta-globin chains but not alpha-globin chains, indicating that they consisted of precipitated beta-globin chains. The two patients with severe CDA had been transfusion-dependent since infancy, had a normal alpha:beta globin chain synthesis ratio or parents with normal red cell indices, displayed prominent dysplastic changes in their erythroblasts, and had intra-erythroblastic inclusions resembling those seen in homozygous beta-thalassaemia. However, unlike those in beta-thalassaemia, the inclusions in these two patients did not react with the monoclonal antibody against either alpha- or beta-globin chains. The inclusions reacted with antibody against zeta-globin chains, but detailed studies in one of the patients indicated that the antigen involved was not zeta-globin. These patients have features not reported in the condition known as dominantly inherited inclusion body beta-thalassaemia and appear to suffer from a novel type of CDA in which the intra-erythroblastic inclusions may consist of some non-globin protein or structurally-abnormal alpha-globin chains.

The vector finite element method is used for investigating the behavior of a set of the first higher-order, four-fold degenerate modes (TE/sub 01/, TM/sub 01/, and two-fold degenerate HE/sub 21/ modes) of a circular core optical fiber whose core cross-section changes into an ellipse. It is found that the TE/sub 01/ mode becomes the first higher-order mode polarized along the minor axis, E/sub 21//sup y/ mode, in a dual-mode region. The remaining three modes become, respectively, the first higher-order mode polarized along the major axis, E/sub 21//sup x/ mode, and the second higher-order modes polarized along the major and minor axes, E/sub 12//sup x/ and E/sub 12//sup y/ modes, in the order of magnitude of the effective index. It is also found that the effective index of the E/sub 21//sup x/ mode is smaller than that of the E/sub 21//sup y/ mode in a small ellipticity region. >

We developed a simple genotyping method for Flavobacterium psychrophilum for analysing two single nucleotide polymorphisms (SNPs) in the gyrA gene and to distinguish between isolates that are virulent and avirulent to ayu, Plecoglossus altivelis altivelis (TemminckSchlegel). The genotyping method is an on/off switch assay and is based on the polymerase chain reaction technique with phosphorothioated primers. We classified 232 isolates from four families of fish (i.e. Plecoglossidae, Osmeridae, Cyprinidae and Salmonidae) into four genotypes (G-C, A-T, A-C and G-T). The G-C type isolates exhibited strong pathogenicity to ayu, whereas the A-T and G-T types did not show any pathogenicity to this species. The A-C type exhibited no or weak pathogenicity to ayu. These results indicate that genotyping F. psychrophilum isolates with two SNPs from gyrA can clearly distinguish between isolates potentially harmful to ayu (G-C type) and those that are potentially not harmful or less harmful (A-C, A-T and G-T type). The on/off switch assay provides a quick, simple, and very powerful DNA genotyping technique for F. psychrophilum isolates.

The ETV6/TEL gene has been reported to fuse to PDGFRbetab MDS1/EVI1, BTL, ACS2, STL, JAK2, ABL, CDX2, TRKC, AML1, and MN1. Among them, PDGFRbeta, ABL, JAK2, and TRKC are tyrosine kinases (TK). We identified a novel ETV6 partner gene, ARG (ABL-related gene or ABL2), another TK gene in a cell line established from a patient with acute myelogenous leukemia (AML-M3) with a t(15;17)(q22;q11.2) and a t(1;12)(q25;p13), which has the remarkable feature to differentiate to mature eosinophils in culture with all-trans retinoic acid and cytokines. The ETV6/ARG transcripts consisted of exon 1 to 5 of ETV6 and the 3' portion of ARG starting from exon 1B or exon 2, resulting in an open reading frame for a fusion protein consisting of the entire PNT oligomerization domain of ETV6 and all of the functional domains of ARG including the TK domain. This is the same protein structure as identified in the other ETV6 TK fusion proteins. The reciprocal ARG/ETV6 transcript was not expressed, and the normal ETV6 allele was not deleted or rearranged. Although the ABL is known to be involved in various human malignancies, ARG has not been involved in human malignancies despite its high homology to ABL. Thus, this is the first report showing involvement of ARG in human leukemia. The ETV6/ARG protein may be involved in the unique differentiation capacity of this cell line. (Blood. 2000;95:2126-2131)

The effects of a protein-restricted diet on renal recovery following renal ischemia were studied. The renal function was assessed by measuring the inulin clearance (CIN), the p-aminohippurate clearance (CPAH), and the percent fractional sodium excretion (%FENa) 24 h after 45 min renal ischemia. In rats fed with a regular diet (containing 19.6% protein), CIN was 10.0 +/- 2.2 microL/min/100 g body weight (BW), CPAH 0.08 +/- 0.02 mL/min/100 g BW, and %FENa 14.8 +/- 2.0, 24 h after renal ischemia. In contrast, feeding rats with a no-protein diet (0% protein) for 1 week prior to the ischemic insult significantly improved renal recovery (CIN 48.0 +/- 9.3 microL/min/100 g BW, CPAH 0.16 +/- 0.04 mL/min/100 g BW, and %FENa 2.43 +/- 0.58). Feeding rats with a no-protein diet for 3 weeks prior to ischemic insult further improved the renal recovery (CIN 113 +/- 30 microL/min/100 g BW, CPAH 0.47 +/- 0.17 mL/min/100 g BW, and %FENa 1.55 +/- 0.29). When rats fed with a regular diet were exposed to 45 min of ischemia, the survival rate on day 7 was 16.7%. In rats fed with the no-protein diet for 1 week and for 3 weeks, the 7-day survival rate was 100% in each case. The survival rate of rats fed for 3 days instead of 7 days with the no-protein diet was 87.5%. When a no-protein feeding was shortened to 1 day, no beneficial effects were observed and survival rate was 14.3%. (ABSTRACT TRUNCATED AT 250 WORDS)

A 42-year-old woman had been given a diagnosis of malignant lymphoma, follicular, small cleaved cell. She had undergone chemotherapy including etoposide (1,500 mg/total) and was in her second complete remission. Four years and 4 months later, refractory anemia with excess of blasts (RAEB) with dup(11) (q21q23) x 2 developed in the patient and progressed to acute myeloid leukemia (AML-M5b). Despite regression of the AML to RAEB, a clone with the additional abnormality of del(20) (q11q13.1) appeared and transformed the RAEB into AML-M6. Rearrangement of the MLL gene was observed, and FISH analysis demonstrated that the signal sequences from the gene's 5' and 3'-terminal regions had detached. RT-PCR techniques detected a tandem duplication of MLL gene exons 2 through 8. This was considered to be one of the mechanisms behind the formation of the 11q23 abnormality observed in this patient.

The authors describe the method of reducing the fan noise, especially the impeller noise, of a household refrigerator. The fan in the refrigerator tested is a propeller fan, and the fan unit consists of an impeller, which has four blades, a rear board, which covers the evaporator, and a front board, which has a number of openings. The flow through the openings freezes food in the freezer. By measuring the internal flow with a laser Doppler velocimeter, it was made clear that the flow through the impeller was not symmetrical to the axis. The unsymmetrical flow seems to be caused by the restrictions of flow passages, and it might produce the impeller noise. The search for the sound source by the sound intensity method indicated that the noise was radiated through the openings of the front board. Guiders were installed on the rear board in the fan unit to guide the flow away from the openings. As a result, the impeller noise was reduced, whereas the flow was kept almost the same. >

Dynamic liver MRI images have been obtained under expiration breath holding (BH). However, problems with obtaining reproducible liver positions often observed. This study investigated ways to improve the reproducibility of liver position on dynamic liver MRI.After giving informed consent, 60 patients (32 males and 28 females, ages 33-85, median age 69) were examined by liver dynamic MRI under two types of BH. The BH phases were voluntary expiration (VE) phase without any explanations and functional residual capacity (FRC) phase after careful explanation was provided. Plain images, arterial phase images, portal phase images and parenchymal phase images were obtained. For statistical evaluation of reproducibility, the area of the 2nd or 3rd images from top of the liver was measured in each phase using a threshold value of half maximum. Misregistration areas were calculated by finding the remainder of the liver area in the plain-arterial (Pl-A) phase, arterial-portal (A-Po) phase, plain-parenchymal (Pl-Pa) phase. Contingency table analysis was done due to the misregistration was occurred or not.Misregistration of liver image on the VE and the FRC of three phase types were statistical significant on the Pl-A (p0.01), on the A-Po (p0.01) and on the Pl-Pa (p0.05), respectively.The FRC phase following careful explanation of the BH provided significantly improved reproducibility of liver position on dynamic liver MRI. Therefore, precise subtraction images could be obtained for routine clinical examinations without slice matching.

The aim of this study was to clarify the epidemiological association and bacteriological characteristics of human and animal Staphylococcus aureus isolates. Pulsed-field gel electrophoresis showed that pulsotypes (PT) of isolates from bulk milk differed from PT from human isolates, suggesting that there is no epidemiological association between isolates from these 2 sources. The absence of a common PT could result from the lack of contact between the sources. Methicillin-resistant S. aureus from human secretions and S. aureus from bulk milk in Japan consisted of 1 and 2 dominant clusters, respectively, whereas methicillin-susceptible S. aureus from humans consisted of assorted clusters. Isolates belonging to the dominant clusters showed the coagulase serotype, the capsule serotype, detection of exotoxin genes, and antimicrobial susceptibility. Isolates from bulk milk did not show the penicillin-binding protein 2a gene, and 252 of 275 isolates belonging to the 2 dominant clusters of bulk milk were susceptible to ampicillin, cefazolin, erythromycin, chloramphenicol, oxacillin, and vancomycin. Moreover, the LukM/LukF'-PV leukotoxin gene was detected in 233 of 275 isolates belonging to the dominant clusters in bulk milk isolates. These results support the hypothesis that a number of factors play a role in the adaptation of S. aureus isolates to specific hosts.

To precisely measurement the high-resolution dose delivered during Computed Tomography (CT) examination, a histogram evaluation technique was performed using GAFCHROMIC-EBT (GAF-EBT). GAF-EBT strips were posted at the 12 o’clock position on a cylindrical phantom measuring 20 cm in diameter. Exposure parameters were 120 kV, 250 mA, 1.0 sec/rot, 320 mm Field of View. Slice Thickness (ST) was set to 5 mm. Helical Pitches (HPs) ranged between 0.6 – 1.4 in increments of 0.2. Calibration curves and dose profiles were generated according to the relationship between Net Pixel Value (NPV) and absorbed dose. Dose histograms were obtained based on each dose profile and analyzed using the dose evaluation methods for Single Detector (SD) CT. The calibration curve corresponded to NPV = 0.6346 x absorbed dose [cGy] and the coefficient of determination = 0.992. Maximal doses on the phantom surface were 4.39 cGy (HP = 0.6), 3.52 cGy (HP = 0.8), 3.11 cGy (HP = 1.0), 2.97 cGy (HP = 1.2), and 2.89 cGy (HP = 1.4). The modes of absorbed dose on the dose histogram were 3.7 cGy (HP = 0.6), 2.8 cGy (HP = 0.8), 2.5 cGy (HP = 1.0), 2.4 cGy (HP = 1.2), and 2.2 cGy (HP = 1.4). When HP was 0.6, 36.6 % of the dose intensity ratios were greater than 4 cGy. At other HPs, 2 – 2.9 cGy areas were frequently observed. Dose profiles using GAF-EBT was able to easily measure the dose distributions and maximal dose. Furthermore, it was able to clarify the characteristic of the dose intensity ratio of SDCT. It was also shown that the dose histogram analysis method is available for measuring the absorbed dose from Multi Detector CT as well as Single Detector CT.

In dynamic liver MRI, reproducibility of the liver position is quite poor when making subtraction images. To improve this, moving directions and positions were analyzed to determine any recognizable pattern of liver motion.

Currently, it is imperative to establishing a useful method of dose measurement for computed tomography (CT) and interventional radiology (IVR). This study investigated the usefulness of high-resolution GAFCHROMIC XR Type R Film (GAF-R film) for measurement of exposure dose for CT and IVR based on directional dependence.

Currently, acquisitions of dynamic liver MR image information have been obtained under voluntary expiration phase (VE) breath holding (BH). However, during subtraction processing of axial images, there is a problem with reproducibility of the liver position. Therefore, it is important for this study to improve the reproducibility of organ position.

Observing the OT-for-OH exchange reaction between iron(II or III) hydroxide and tritiated water (HTO) leads to the following results: (1) isotope exchange as “atomic group” occurred between the OH group in each iron hydroxide (i.e., Fe(OH)2 or Fe(OH)3) and OT− resulted from the dissociation of HTO; (2) the ratio of the reactivity of the hydroxides is roughly [iron(III) hydroxide]: [iron(II) hydroxide]=1.2∶1.0 and the result is related to a difference in electronegativity between Fe2+ and Fe3+. (In other words, if the reactivity depends on the number of the charge, the ratio should be 1.5∶1.0).

This paper proposes the configuration of the Intelligent Digital Mobile Communications Network which is based on the hierarchical function arrangement. The network is layered to the intelligent layer and the transport layer And each layer is also layered to several sub-layers. The network has a capability which guarantees the mobility between plural mobile communications networks. The MSSP (multi-switch simultaneous paging) technique is applied in metropolitan areas to simultaneously page the mobile station through plural switch units in a location area. Moreover, this paper describes the digital mobile subscriber line signalling configuration applied to the digital mobile subscriber line and the mobility guarantee capability of the personal telecommunications numbers in the mobile communications network considering the evolution to the PTN service.