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The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization's (WHO) global targets for the care and management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action; however, tracking countries’ progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country's progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to ≤5 per 100 000, reduce HBV prevalence among 1-year-olds to ≤0.1%, reduce HBV and HCV mortality to ≤5 per 100 000, and demonstrate HBV and HCV year-to-year decrease in new HCV- and HBV-related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit. © 2020 John Wiley & Sons Ltd

Background 5-Aminosalicylates (5-ASA) are the key drugs in induction and maintenance therapy in ulcerative colitis (UC). Some UC patients are involved in 5-ASA intolerance after induction of oral 5-ASA compounds. There is no evidence of the prognosis including the risk of colectomy in 5-ASA intolerant UC patients. Methods The aim of this study is to establish the prognosis of 5-ASA intolerant UC patients in a multicenter cohort study. A retrospective review of a prospective multicenter database (2014–2018) of 1,574 UC patients was carried out and a total of 1,286 patients treated with oral 5-ASA compounds were enrolled. We compared the risk of colectomy and biologics induction between patients (i) tolerant to first 5-ASA compound (1079), (ii) intolerant to first 5-ASA compound but tolerant to other 5-ASA compound (107) and (iii) intolerant to 5-ASA compound and withdrawal of 5-ASA (100). Results We identified 1,286 patients with UC, of which 40 patients (3.1%) resulted in colectomy and 247 patients (19%) treated with biologics. Colectomy rate in patients (iii) intolerant to 5-ASA and withdrawal of 5-ASA were higher than (i) tolerant to first 5-ASA and (ii) intolerant to first 5-ASA but tolerant to other 5-ASA (9.0%, 2.7%, 1.9%, respectively). (iii) Patients withdrawal of 5-ASA showed higher risk of colectomy compared with (i) tolerant to first 5-ASA (Hazard ratio (HR) 4.71, 95% Confidence interval (CI): 2.04–10.8). The risk of colectomy among (ii) patients intolerant to first 5-ASA but tolerant to other 5-ASA showed no significant difference compared with (i) tolerant to first 5-ASA (HR 0.76, 95% CI: 0.43–1.35). The biologics induction rate in (iii) patients withdrawal of 5-ASA was significantly higher than (i) tolerant to first 5-ASA and (ii) intolerant to first 5-ASA but tolerant to other 5-ASA (37%, 18%, 16%, respectively). Also (iii) patients withdrawal of 5-ASA showed higher risk of induction with biologics compared with (i) tolerant to first 5-ASA (HR 2.35, 95% CI: 1.50–3.68). Those risk among (ii) patients intolerant to first 5-ASA but tolerant to other 5-ASA showed no significant difference compared with (i) tolerant to first 5-ASA (HR 0.76, 95% CI: 0.43–1.35). Conclusion Patients with UC who had 5-ASA intolerance and withdrew from 5-ASA showed poor prognosis. We should consider trying other 5-ASA compounds even if the patients had intolerance to one 5-ASA compound.

Background A previous randomized phase II study demonstrated that the addition of a c-Met inhibitor tivantinib to an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor erlotinib might prolong progression-free survival (PFS) in patients with previously treated, nonsquamous nonsmall-cell lung cancer (NSCLC). On a subset analysis, the survival benefit was greater in patients with wild-type EGFR (WT-EGFR) than in those with activating EGFR mutations. Herein, this phase III study compared overall survival (OS) between Asian nonsquamous NSCLC patients with WT-EGFR who received erlotinib plus tivantinib (tivantinib group) or erlotinib plus placebo (placebo group). Methods A total of 460 NSCLC patients were planned to be randomized to the tivantinib or placebo group. Primary end point was OS. Secondary end points were PFS, tumor response, and safety. Tissue was collected for biomarker analysis, including c-Met and HGF expression. Results Enrollment was stopped when 307 patients were randomized, following the Safety Review Committee's recommendation based on an imbalance in the interstitial lung disease (ILD) incidence between the groups. ILD developed in 14 patients (3 deaths) and 6 patients (0 deaths) in the tivantinib and the placebo groups, respectively. In the enrolled patients, median OS was 12.7 and 11.1 months in the tivantinib and the placebo groups, respectively [hazard ratio (HR) = 0.891, P = 0.427]. Median PFS was 2.9 and 2.0 months in the tivantinib and the placebo groups, respectively (HR = 0.719, P = 0.019). The commonly observed grade ≥3 adverse events in the tivantinib group were neutropenia (24.3%), leukopenia (18.4%), febrile neutropenia (13.8%), and anemia (13.2%). Conclusions This study was prematurely terminated due to the increased ILD incidence in the tivantinib group. Although this study lacked statistical power because of the premature termination and did not demonstrate an improvement in OS, our results suggest that tivantinib plus erlotinib might improve PFS than erlotinib alone in nonsquamous NSCLC patients with WT-EGFR. Trial registration number NCT01377376.

Significant associations of HLA-DP alleles with chronic hepatitis B (CHB) infection are evident in Asian and Arabian populations, including Japanese, Han Chinese, Korean, and Saudi Arabian populations. Here, significant associations between CHB infection and five DPB1 alleles (two susceptibility alleles, DPB1(*) 05:01 and (*) 09:01, and three protective alleles, DPB1(*) 02:01, (*) 04:01, and (*) 04:02) were confirmed in a population comprising of 2582 Japanese individuals. Furthermore, odds ratios for CHB were higher for those with both DPB1 susceptibility alleles than for those with only one susceptibility allele; therefore, effects of susceptibility alleles were additive for risk of CHB infection. Similarly, protective alleles showed an additive effect on protection from CHB infection. Moreover, heterozygotes of any protective allele showed stronger association with CHB than did homozygotes, suggesting that heterozygotes may bind a greater variety of hepatitis B-derived peptides, and thus present these peptides more efficiently to T-cell receptors than homozygotes. Notably, compound heterozygote of the protective allele (any one of DPB1*02:01, *04:01, and *04:02) and the susceptible allele DPB1*05:01 was significantly associated with protection against CHB infection, which indicates that one protective HLA-DPB1 molecule can provide dominant protection. Identification of the HLA-DPB1 genotypes associated with susceptibility to and protection from CHB infection is essential for future analysis of the mechanisms responsible for immune recognition of hepatitis B virus antigens by HLA-DPB1 molecules.

Several investigations and developments have been made for automotive fuel tanks considering the demanding environmental situation. At Nippon Steel, hot dip tin-zinc coated steel sheet has been developed as alternative material for terne sheet for automotive fuel tanks. Tin-8wt%zinc was selected in view of its corrosion resistance, which is strongly influenced by the morphology of the zinc phase. Tin-zinc coated steel sheet has been widely used by Japanese automotive manufacturers because of its well-balanced characteristics.

Four crystalline phases were found for 4′-octyloxy-4-cyanobiphenyl, C21H25NO. These were square-plate, needle and long parallelepiped crystals, which are all metastable, and a phase found in a commercially available powder specimen, which was the most stable. The structures of the needle and long parallelepiped crystals have been determined at room temperature and 243 K, respectively.

The FIB-4 index is a simple formula to predict liver fibrosis based on the standard biochemical values (AST, ALT and platelet count) and age. We here investigated the utility of the index for noninvasive prediction of progression in liver fibrosis. The time-course alteration in the liver fibrosis stage between paired liver biopsies and the FIB-4 index was examined in 314 patients with chronic hepatitis C. The average interval between liver biopsies was 4.9 years. The cases that showed a time-course improvement in the fibrosis stage exhibited a decrease in the FIB-4 index, and those that showed deterioration in the fibrosis stage exhibited an increase in the FIB-4 index with a significant correlation (P0.001). Increase in the ΔFIB-4 index per year was an independent predictive factor for the progression in liver fibrosis with an odds ratio of 3.90 (P = 0.03). The area under the receiver operating characteristic curve of the ΔFIB-4 index/year for the prediction of advancement to cirrhosis was 0.910. Using a cut-off value of the ΔFIB-4 index/year0.4 or ≥ 0.4, the cumulative incidence of fibrosis progression to cirrhosis at 5 and 10 years was 34% and 59%, respectively in patients with the ΔFIB-4 index/year ≥0.4, whereas it was 0% and 3% in those with the ΔFIB-4 index/year0.4 (P0.001). In conclusion, measurement of the time-course changes in the FIB-4 index is useful for the noninvasive and real-time estimation of the progression in liver fibrosis.

Algicidal bacteria offer a promising tool for the preventionof red tides, because they are able to play a key role in terminating blooms in coastal areas. This study details the detection of vast numbers of algicidal bacteria attached to the surface of seaweeds such as Ulvasp. and Gelidium sp. (of the order of 106 cells g–1 wet weight in some cases). Algicidal bacteria were isolated from Ulva sp. and Gelidium sp. from the coast of Osaka Bay from April to September 1999, and their algicidal properties were assessed using the prey microalgae Karenia mikimotoi, Heterosigma akashiwo, Fibrocapsa japonica and Chattonella antiqua. K. mikimotoi was the red tide species most susceptible to the algicidal bacteria isolated from seaweeds. Sequence analyses ofthe 16S rDNA gene revealed that these algicidal bacteria belonged to the genera Alteromonas, Pseudoalteromonas, Vibrio, Cytophaga, Cellulophaga and Octadecabacter, and the family Rhodobacteraceae. Algicidal properties of five of 10 strains of bacteria isolated from seaweeds, belonging to the genera Alteromonas, Pseudoalteromonas and Cytophaga, have beenpreviously reported in coastal red tide areas. It is therefore possible that seaweed beds play a significant role as providers of algicidal bacteria in preventing red tides to coastal waters.

The quasar 3C279 was the target of an extensive multiwavelength monitoring campaign from January through April 2006, including an optical-IR-radio monitoring campaign by the Whole Earth Blazar Telescope (WEBT) collaboration. In this paper we focus on the results of the WEBT campaign. The source exhibited substantial variability of optical flux and spectral shape, with a characteristic time scale of a few days. The variability patterns throughout the optical BVRI bands were very closely correlated with each other. In intriguing contrast to other (in particular, BL Lac type) blazars, we find a lag of shorter- behind longer-wavelength variability throughout the RVB ranges, with a time delay increasing with increasing frequency. Spectral hardening during flares appears delayed with respect to a rising optical flux. This, in combination with the very steep IR-optical continuum spectral index of ~ 1.5 - 2.0, may indicate a highly oblique magnetic field configuration near the base of the jet. An alternative explanation through a slow (time scale of several days) acceleration mechanism would require an unusually low magnetic field of < 0.2 G, about an order of magnitude lower than inferred from previous analyses of simultaneous SEDs of 3C279 and other FSRQs with similar properties., Accepted for publication in ApJ

In spring 2005 the blazar 3C 454.3 was observed in an unprecedented bright state from the near-IR to the hard X-ray frequencies. A mm outburst peaked in June-July 2005, and it was followed by a flux increase at high radio frequencies. In this paper we report on multifrequency monitoring by the WEBT aimed at following the further evolution of the outburst in detail. In particular, we investigate the expected correlation and time delays between the optical and radio emissions in order to derive information on the variability mechanisms and jet structure. A comparison among the light curves at different frequencies is performed by means of visual inspection and discrete correlation function, and the results are interpreted with a simple model taking into account Doppler factor variations of geometric origin. The high-frequency radio light curves show a huge outburst starting during the dimming phase of the optical one and lasting more than 1 year. The first phase is characterized by a slow flux increase, while in early 2006 a major flare is observed. The lower-frequency radio light curves show a progressively delayed and fainter event, which disappears below 8 GHz. We suggest that the radio major peak is not physically connected with the spring 2005 optical one, but it is actually correlated with a minor optical flare observed in October-November 2005. This interpretation involves both an intrinsic and a geometric mechanism. The former is represented by disturbances travelling down the emitting jet, the latter being due to the curved-jet motion, with the consequent differential changes of viewing angles of the different emitting regions., Comment: 5 pages, 3 figures, to be published in A&A (Letters)

The radio quasar 3C 454.3 underwent an exceptional optical outburst lasting more than 1 year and culminating in spring 2005. The maximum brightness detected was R = 12.0, which represents the most luminous quasar state thus far observed (M_B ~ -31.4). In order to follow the emission behaviour of the source in detail, a large multiwavelength campaign was organized by the Whole Earth Blazar Telescope (WEBT). Continuous optical, near-IR and radio monitoring was performed in several bands. ToO pointings by the Chandra and INTEGRAL satellites provided additional information at high energies in May 2005. The historical radio and optical light curves show different behaviours. Until about 2001.0 only moderate variability was present in the optical regime, while prominent and long-lasting radio outbursts were visible at the various radio frequencies, with higher-frequency variations preceding the lower-frequency ones. After that date, the optical activity increased and the radio flux is less variable. This suggests that the optical and radio emissions come from two separate and misaligned jet regions, with the inner optical one acquiring a smaller viewing angle during the 2004-2005 outburst. Moreover, the colour-index behaviour (generally redder-when-brighter) during the outburst suggests the presence of a luminous accretion disc. A huge mm outburst followed the optical one, peaking in June-July 2005. The high-frequency (37-43 GHz) radio flux started to increase in early 2005 and reached a maximum at the end of our observing period (end of September 2005). VLBA observations at 43 GHz during the summer confirm the, 7 pages, 4 figures, to be published in A&A

This paper deals with a packet loss recovery technique that enables backward compatibility with a standard decoder for transmission of JPEG2000 images over the Internet using RTP. The proposed scheme utilizes packet-level FEC, the JPEG2000 layered structure, and a data embedding technique. Prior to transmission, packets containing some portions of compressed data that related to a predetermined compression rate (bits/pixels) or acceptable image quality, are strongly protected using FEC across packets. At the receiver, the redundant packets are utilized to reconstruct any lost packets of the protected data. With a slight modification in the SOT marker segment of the codestream and careful placement of the redundant packets, the generated codestream is complaint with the standard decoder. Simulations using RTP in an IP network transmission confirmed the proposal's effectiveness.

In this paper, a robust error protection scheme for JPEG2000 codestream is proposed. The error protection is achieved by combining the advantage of the codestream layer structure, a data hiding technique and an FEC code. At encoding stage, multiple quality layers of the codestream are protected by an FEC code with various strengths. The parity data is then hidden in the least significant layer. Prior to image decoding, error recovery is done by means of extracting the hidden data and performing the FEC decoding to the corresponding layers. The proposed method offers several benefits: it preserves the same codestream structure as the one in the JPEG2000 standard part 1, does not require additional bandwidth and can be integrated with the existing JPEG2000 error resilience tools. Hence, it accommodates one of the requirements for the upcoming wireless JPEG2000 (JPWL or JPEG2000 part 11). Simulations in a CDMA environment confirmed the proposal's effectiveness.

A method of error concealment for JPEG2000 images is proposed in this paper. The proposed method uses the layer structure that is a feature of JPEG2000. The most significant layer is hidden in the lowest layer of the JPEG2000 bit stream, and this embedded layer is used for error concealment. The most significant layer is duplicated because JPEG2000 uses bit-plane coding. In this coding, when the upper layers are affected by errors, the coefficients of the lower layers become meaningless. A bit stream encoded using the proposed method has the same data structure as a standard JPEG2000. Therefore, it can be decoded by a standard decoder. Our simulation results demonstrated the effectiveness of the proposed method.

A high performance parallel network simulation environment was developed in the SR2201 project, The SR2201 is one of the highest performance massively parallel supercomputers in the world. The enhanced simulation algorithm achieved a 2.4 times increase in simulation speed compared with conventional simulation methodology. A 98% detection rate for all design errors before physical design contributed to the shortening of development time.

Here we report that a practical prediction system of impending compressor stall was established, which can be incorporated into a real time control system. The system uses a static pressure sensor located on the compressor casing to detect stall precursor. The leading edge of the rotor blades was selected as the axial location of the sensor after analyzing the test data of the blade passage flow implying the tip vortex interaction on the leading edge at stall point. The impending stall detection algorithm has been developed, which computes the auto-correlation coefficients of the past and present static pressure profiles and declares an impending stall if the auto-correlation coefficient decreases below a pre-set threshold. Post experiment analysis proved the effectiveness of the algorithm. The auto-correlation coefficients remained nearly 1.0 at stable operation conditions but showed an abrupt decreasing only when the flow coefficient became next to stall. The algorithm consistently detect the stall inception about 100 rotor revolutions prior to the fully developed stall, which is promising and encouraging for practical active stall control. The effectiveness of the developed auto-correlation algorithm was proved by the successful closed loop demonstration with the dynamically inserted plate in front of the compressor.

A 55-year-old female presented with a unique case of gliosarcoma with a huge cystic component manifesting as loss of consciousness, left-sided hemiparesis, and anisocoria. Computed tomography demonstrated a large cyst in the right frontal lobe, and enhancement of the mural nodule after administration of contrast medium. Emergent operation was performed. Xanthochromic fluid was aspirated, and the tumor was resected. The histological diagnosis was gliosarcoma based on the presence of gliomatous and sarcomatous components. She underwent a second operation because of tumor regrowth 3 weeks after the first operation. The postoperative course was satisfactory during radiation therapy with 60 Gy and chemotherapy. The diagnosis of gliosarcoma was difficult to make preoperatively because of the neuroradiological findings similar to low-grade gliomas. Gliosarcoma should be included in the differential diagnosis of huge cystic tumors.

In order to elucidate the immunogenetic predisposition of tiopronin (mercaptopropionylglycine)-induced intrahepatic cholestasis, human leukocyte antigen (HLA) was analyzed in patients with tiopronin-induced liver injury. HLA-A, -B, -C, and -DR loci of 14 patients (10 males and 4 females) with tiopronin-induced liver injury were compared with those of control subjects. The mean duration of tiopronin administration was 26 days and that of jaundice was 4.5 months. The elevation of biliary enzymes lasted from 2 months to up to 10 years. Most of the cases manifested intrahepatic cholestasis on liver biopsy. Lymphocyte transformation test with tiopronin was positive in 6 of 8 (75%) tested cases. Thirteen patients (92.9%) had HLA-A33, 10 (71.4%) had B44, and 9 (64.3%) patients had DR6. These are statistically higher in the patients with tiopronin-induced cholestasis than in the general population. Ten of those with tiopronin-induced liver dysfunction (71.4%) had A33/B44 and 8 (57.1%) had A33/B44/DR6 in their haplotype. In conclusion, long-lasting tiopronin-induced intrahepatic-cholestasis is highly linked to specific HLA-A33, -B44 and -DR6.

Amino acid mutations in the interferon sensitivity determining region (ISDR) are closely associated with the response to interferon in patients with hepatitis C virus genotype 1b (HCV-1b) infection. In this study, 36 patients chronically infected with HCV-1b, with no history of interferon therapy with respect to ISDR changes in HCV were studied. Two serum samples were obtained from each patient, with an average interval of 3.5 years, and predominant nucleotide and amino acid sequences of the ISDR at initial and subsequent time points were compared for each patient. Three of 12 patients with the wild type ISDR (no amino acid mutation in the ISDR compared to the consensus sequence) changed to the intermediate type (1 to 3 mutations) at later time points, whereas the other 9 still had the wild type. Similarly, 2 of 18 patients with the intermediate type changed to the wild type, whereas the other 16 patients continued to have the intermediate type. One of 6 patients with the mutant type (4 or more mutations) changed to the intermediate type, and the other 5 continued to have the mutant type. Although ISDR nucleotide changes/site/year were not significantly different among the 3 groups of patients, percentages of non-synonymous nucleotide changes were greater in the mutant type (63%) than the wild (9%) or the intermediate type (20%) (P0.05). These results show that mutations in the ISDR do not occur frequently, suggesting that interferon sensitivity does not change greatly during the natural course of the disease in each patient.

Here we propose a new concept of stall suppression to expand the stable flow range of a compressor, i.e. the stall area is controlled when the flow rate is lower than the natural stall point. An artificial standing stall around the hub is formed using movable hub flaps equipped in front of the rotor for the purpose of gathering stall cells. The standing stall causes a displacement effect which is expected to increase the velocity near the tip of the rotor. In order to examine the feasibility of the new concept, a stability analysis was performed using a two dimensional actuator disk model. The compressor in hub stall condition was analyzed to be stable; the first instability at low flow rate appeared at the tip of the rotor, not the hub. Through the test using the research compressor equipped with experimental hub flaps instruments, some interesting results were obtained on the steady state performance of a hub stalled compressor. Dynamic control of the hub stalled compressor was demonstrated successfully to allow compressor operation beyond the natural stall point using proportional logic of the inlet air velocity near the tip of the rotor.

To study the role of antigen-specific T lymphocytes in the pathogenesis of autoimmune hepatitis, messenger RNA of T-cell receptors (TCR) was analyzed in liver biopsy specimens from four patients with autoimmune hepatitis. Using the TCR beta-chain variable region family specific oligonucleotides, a remarkable bias for the usage of beta-chain variable region 3 was detected in all four patients. Therefore, nucleotide and amino acid sequences of the complementarity-determining region 3 rearranged to the beta-chain variable region 3, which is a putative contact site for peptide fragments from antigens bound in the groove of the human leukocyte antigen molecule, was further analyzed in randomly selected 10 clones from each patient. An Asp-Arg-Pro motif in the complementarity-determining region 3 was identified in three of four patients with human leukocyte antigen DR4, and this motif was always rearranged to the beta-chain junctional region 1.2. From these results, beta-chain variable region 3+, Asp-Arg-Pro+, beta-chain junctional region 1.2+ T-cell clones may be among the responsible lymphocytes involved in the liver damage in autoimmune hepatitis, especially in patients with human leukocyte antigen DR4. Thus, an analysis of the complementarity-determining region 3 may give us an important clue to clarify characteristics of target antigens included in autoimmune hepatitis.

This study was undertaken to assess whether the converting enzyme inhibitor lisinopril, and the long-acting nitrate, isosorbide-5-mononitrate, affect left ventricle dysfunction and anatomical remodelling in rats with myocardial infarction. Lisinopril, isosorbide-5-mononitrate or vehicle were given to rats (n = 10-14 per group) immediately after coronary artery occlusion (by an intravenous bolus) and then for nine weeks (in drinking water). At the end of the study, left ventricular pressures were measured, the heart arrested in diastole, and infarct size, left ventricular chamber volume and wall thicknesses measured. Lisinopril significantly lowered systemic blood pressure and left ventricular systolic pressure in rats with small (15% scarred tissue of the left ventricle) and large (15%) infarcts; the weight of the left ventricle (including the septum) was reduced by 24% and 28% in animals with small and large infarcts, respectively. Lisinopril lowered left ventricular end-diastolic pressure (by 33% and 39%) and chamber volume (by 4% and 34%) in rats with small and large infarcts, respectively, compared with controls (NS). The combined anatomical and hemodynamic changes led to a reduction of the circumferential wall stress by 20% and 44% in lisinopril-treated rats with small and large infarcts, respectively (NS). No significant changes were seen in the nitrate-treated hearts compared with controls. Lisinopril, given early after myocardial infarction and continued for nine weeks, significantly affected cardiac hemodynamics and ventricular weights in rats with infarcts of different sizes.(ABSTRACT TRUNCATED AT 250 WORDS)

Normal chroid plexus tissue and five choroid plexus papillomas were examined with antibody specific for the glucose transporter GLUT1, one isoform of facilitated-diffusion glucose transporters, using the avidin-biotin-peroxidase complex (ABC) technique. GLUT1 in normal choroid plexus was localized at the basolateral plasma membrane of almost all epithelial cells. In three of five tumors, GLUT1 immunoreactivity was observed. A positive reaction was demonstrated at the plasma membrane of tumor cells. The number of GLUT1-positive cells was, however, much smaller than that of the normal choroid plexus. Our results suggest that GLUT1 expression in the choroid plexus is restrained during the course of transformation and that choroid plexus papilloma is composed of various differentiation tumor cells.

We investigated the fluctuation of hepatitis C virus (HCV) quasispecies during interferon therapy by single strand conformation polymorphism (SSCP) analysis. In 13 of 16 interferon ineffective patients, the predominant HCV population was replaced with other quasispecies during the treatment. Especially, in 9 patients, a part of the HCV quasispecies, pre-existing before interferon therapy, became predominant after the therapy. These results indicate that sensitivity to interferon differs among HCV quasispecies and that interferon selects resistant HCV strains. Existence of such HCV quasispecies seems to be associated with interferon treatment failure.

The authors have treated a total of 60 consecutive patients with ruptured aneurysms of the posterior circulation during the last ten years. Among them 54 patients were operated on by one of us (TM) within three days following the hemorrhage. These included 17 upper basilar aneurysms, 2 basilar trunk aneurysms, 31 VA-PICA complex aneurysms and 4 PCA aneurysms. Preoperatively 20 patients were in grade I—II (Hunt and Hess), 16 in grade III, and 18 in grade IV. The final outcome has been favorable in 38 patients (70%). Compared to our 200 consecutive cases with ruptured aneurysms of the anterior circulation operated on early, our experience suggests the following: 1) Early surgery for posterior circulation aneurysms may be more effective in improving the overall management outcome. This may be because posterior circulation aneurysms have a tendency to rebleed more frequently and the incidence of vasospasm is lower, especially in VA-PICA complex aneurysm. 2) Early operation can be carried out safely at any time after subarachnoid hemorrhage with the recent advances in neurosurgical techniques.

A 20-year-old female with von Recklinghausen's disease became aware of hoarseness and dysphagia with a right neck mass, and received subtotal resection of a jugular foramen neurofibroma. One year later the jugular foramen tumor recurred and pathologic examination at excision showed a malignant transformation. Despite postoperative chemotherapy and radiotherapy, it recurred soon and followed the metastatic cerebral tumor by meningeal dissemination. Malignant nerve sheath tumors of the jugular foramen are very rare and the clinical course and pathological pictures of this tumor are reviewed.

To determine the prevalence of hepatitis C viral infection in patients with sporadic non-A, non-B (NANB) acute hepatitis, hepatitis C viral RNA was studied in the plasma of 15 patients by reverse transcription-polymerase chain reaction assay. Plasma samples were sequentially obtained from 15 patients, and polymerase chain reaction was performed with two nested pairs of primers deduced from the 5'-non-coding region of hepatitis C viral sequences. Anti-C100 and anti-GOR antibodies were also measured with an enzyme-linked immunosorbent assay system. Plasma hepatitis C viral RNA was detected transiently in 7 of 15 patients (47%) at an early phase of the clinical course, while anti-C100 antibodies were detectable in only 2 (29%) of hepatitis C viral RNA-positive patients, and in 1 (13%) of the negative patients. Of 7 patients that were positive for plasma hepatitis C viral RNA, 4 (57%) had relapsing or protracted courses. In contrast, in all patients with undetectable hepatitis C viral RNA, hepatitis C viral RNA recovered and remained normal for at least 1 year. Thus, hepatitis C viral infection represents almost half the patients with acute sporadic NANB hepatitis, and detection of hepatitis C viral RNA in an early clinical phase is superior to anti-C100 measurement for diagnosing acute sporadic hepatitis C viral infection.

A case of interhemispheric choroidal epithelial cyst is reported. The patient is a 9-month-old female who was transadmitted to our hospital for further examination because of the enlargement of her head. She had no neurological deficits nor symptoms of increased intracranial pressure. CT scanning performed on admission showed multiple cystic lesions in the right frontoparietal interhemispheric space, whose circumference was partially enhanced with contrast medium. Metrizamide CT cisternography demonstrated no communication between the lesions and the ventricular system. The signal intensity of the cysts was higher than that of cerebrospinal fluid on both T1-weighted and T2-weighted MR images. Sagittal T1-weighted images showed partial agenesis of the corpus callosum. The surgical exploration was performed via interhemispheric approach. The cyst wall was found to be white, relatively rich in vascular components, and was removed as much as possible. The examination of the cyst fluid showed total protein levels of 1250 to 3440 mg/dl, and sugar contents of 43 to 99mg/dl. Callosal agenesis was confirmed at operation. The light microscopic examination revealed that the cyst wall was composed of a single layer of columnar or cuboidal epithelium with occasional papillary configuration and thick collagenous connective tissue. The epithelial cells contained PAS-positive granules in the cytoplasm. Electron microscopy showed numerous club-shaped microvilli with no coating materials, continuous basement membrane, tight junction, interdigitation, and multiple fenestrations of endothelium of stromal vessels. On the basis of these findings, the lesion was diagnosed as choroidal epithelial cyst. In the literature, interhemispheric choroidal epithelial cyst associated with partial callosal agenesis, confirmed ultrastructurally, has not, to out knowledge, been reported.

An optical nonlinearity due to virtual charge polarization in a quantum-well structure biased by a DC electric field is proposed and discussed. The switching time of the nonlinearity is expected to be extremely short, on the order of 100 fs. An effective degenerative four-wave chi /sup 3/ parameter is estimated to be 1.0*10/sup -9/ (esu) for a graded gap AlGaAs quantum well and a detuning energy of pump light, 35 meV. The nonlinearity is observable and quite useful for designing an all-optical and ultrafast optical gate. >

Etude sur l'alliage Al-11,7% at. Si prepare par solidification dirigee dans des conditions d'ecoulement de convection force du liquide en tete de l'interface solide-liquide

Intrarenal blood flow was measured by the 133Xe washout method in 22 patients with essential hypertension. Mean RBF, the percentage of flow in component I, and fraction of renal mass supplied by component I were significantly reduced in patients with proteinuria, severe nephrosclerosis, cardiomegaly, and retinal changes of Keith-Wagener III and IV. Flow rate in component I was also reduced in the patients with severe nephrosclerosis, retinal changes of Keith-Wagener III and IV, and proteinuria. We conclude that redistribution of intrarenal blood flow occurs in essential hypertension with renal, cardiac, and retinal complications.

The primary goal of the current gravity gradiometer research at Stanford has been to establish the feasibility of using a gravity gradiometer with 1 E accuracy, as the primary sensor in various applications. The two applications considered here in detail are geodesy missions and inertial navigation systems. Preliminary sections on gravity models and gravity gradiometer bias estimation are also included.