Search

Orexin 2 receptor (OX2R) is thought to play an important role in the arousal-promoting function, but its distribution and function in the pathophysiology of orexin-mediated disorders remains to be fully elucidated. In the present study, we synthesized and characterized a novel 18F-labeled 2,5-diarylnicotinamide (DAN) derivative as a potential positron emission tomography (PET) probe for in vivo imaging of OX2R. In in vitro binding experiments, [18F]DAN-1 selectively bound to OX2R. In a biodistribution study using normal mice, [18F]DAN-1 displayed moderate brain uptake (2.10% ID per g at 10 min post-injection). In addition, the radioactivity in the mouse brain at 30 min post-injection was significantly decreased by co-injection with nonradioactive DAN-1, but high nonspecific binding was observed. These results suggested that further structural modifications of [18F]DAN-1 are needed to use it for imaging OX2R in the brain.

Orexin 2 receptor (OX(2)R) is thought to play an important role in the arousal-promoting function, but its distribution and function in the pathophysiology of orexin-mediated disorders remains to be fully elucidated. In the present study, we synthesized and characterized a novel (18)F-labeled 2,5-diarylnicotinamide (DAN) derivative as a potential positron emission tomography (PET) probe for in vivo imaging of OX(2)R. In in vitro binding experiments, [(18)F]DAN-1 selectively bound to OX(2)R. In a biodistribution study using normal mice, [(18)F]DAN-1 displayed moderate brain uptake (2.10% ID per g at 10 min post-injection). In addition, the radioactivity in the mouse brain at 30 min post-injection was significantly decreased by co-injection with nonradioactive DAN-1, but high nonspecific binding was observed. These results suggested that further structural modifications of [(18)F]DAN-1 are needed to use it for imaging OX(2)R in the brain.

This paper discussed about suppressions of cavitation surge in a double suction centrifugal pump. In order to suppress the cavitation surge, CFD simulation was carried out. Cavitation surge was observed near the best efficiency point, and it was difficulty to operate the pump stably. The specific speed of the tested pump was about 81 [m3/min, min−1, m] or 533 [ft., USGPM, min.−1]. In general, the main cause of the cavitation surge is inlet reverse flows at the impeller inlet. In order to prevent the inlet reverse flow, two kinds of modification at the impeller inlet were applied. One was the reduction of impeller inlet area by using a suction ring, and the other was the reduction of impeller inlet diameter. To reduce the computational time, in CFD model, a half of the double suction centrifugal pump was modeled. CFD simulations were carried out using ANSYS CFX with the Rayleigh Preset cavitation model. It was confirmed that the head fluctuation caused by the cavitation phenomena was predicted qualitatively by use of unsteady CFD simulation in the original pump impeller. The head fluctuation was about the 16% of the time averaged head and the very low frequency was confirmed by the FFT analysis. In addition, the relationship between head characteristics and cavitation behavior was observed clearly. The objective of the suction ring was to eliminate the head fluctuations caused by the cavitation. It was concluded that the suction ring was very effective to prevent the cavitation surge. On the other hand, the decrease of impeller inlet diameter was effective to reduce the head fluctuations, which became half of that for the original pump impeller. As a result, it was suggested that the complete suppression of the cavitation surge by the reduction of impeller inlet diameter was difficult in this case. It was concluded that unsteady CFD simulations with cavitation model is very effective for clarification of the impeller inlet modification on the cavitation surge.

Objective To evaluate the treatment results of late course accelerated hyperfractionation (LCAHF) compared with conventional fractionation (CF) for stage II laryngeal cancer. Methods Fifty-nine consecutive patients treated for stage II laryngeal cancer were retrospectively reviewed. Thirty-two patients underwent LCAHF, twice-daily fractions during the latter half with a total dose of 69 Gy. Twenty-seven patients received CF of 70 Gy. Results The local control rates (LCRs), overall survival (OS), and disease-specific survival (DSS) at 5 years were 80.6%, 74.0%, and 90.4%, respectively, after LCAHF and 64.7%, 68.2%, and 90.5%, respectively, after CF. There were no significant differences in LCR, OS, and DSS (p = .11, 0.68, and 0.69, respectively). In a small number of patients with supraglottic cancer, LCAHF was associated with a significantly higher LCR at 5 years compared with CF (100% vs. 41.7%; p = .02). Conclusions This is the first report that compared the results of LCAHF and CF for stage II laryngeal cancer. We could not find significant differences in LCR, DSS, and OS rates between LCAHF and CF groups. Although in a small number of patients with supraglottic cancer, LCAHF may improve the LCR compared with CF.

Conclusion Three-dimensional cone beam computed tomography (3DCT) images revealed characteristic malformations of the membranous labyrinth of the inner ear in Meniere’s disease (MD). The morphology of the membranous region between the vestibular cecum of the cochlea and the saccule of ears with MD was compared to that of healthy ears. The present study supports the hypothesis proposed earlier that reuniting duct blockade is a result of the dislodgement of saccular otoconia. Objective To visualize the membranous labyrinth using 3DCT and to investigate the pathology of MD. Methods A preparatory study was conducted to determine the optimal 3DCT window settings for the detection of water, muscle, calcium carbonate (CaCO3), and bone. Based on this preparatory study, the ears of 13 healthy volunteers and 25 MD patients definitely diagnosed according to the criteria issued by the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology, Head and Neck Surgery (AAO-HNS), were visualized. Results The differences in the membranous labyrinth between MD ears and healthy ears could be visualized using 3DCT. The images were classified into three types based on their morphological pattern. The ears of patients with MD were different from normal ears in terms of this classification.

The necessity of considering cervical tuberculous lymphadenitis (CTL) should be emphasized even today for the differential diagnosis of cervical lymphadenopathy, particularly when it is located in the posterior triangle and supraclavicular regions even in patients without active pulmonary tuberculosis (PTB).This study was conducted to highlight the characteristics of patients with CTL without active PTB who were treated in our department.Between 2004 and 2011, 21 cases of CTL without active PTB were included in this retrospective study. Histological examination after excisional biopsy of the affected lymph node was performed in 18 patients using hematoxylin and eosin staining and Ziehl-Neelsen (Z-N) staining for acid-fast bacilli (AFB) identification. Growth of Mycobacterium tuberculosis was detected by culturing and/or nucleic acid amplification tests including polymerase chain reaction (PCR) and transcription-mediated amplification (Mycobacterium Tuberculosis Direct: MTD).The male to female ratio was 1:1.3. Patient ages ranged from 22 to 89 years. Eighteen patients (85.7%) complained of indolent unilateral cervical lymphadenopathy in the posterior triangle (26.5%), internal jugular (24.5%), or supraclavicular nodes (18.4%). Positive rates of AFB according to Z-N staining and culturing of M. tuberculosis and/or PCR or MTD were 33.3% (6/18) and 72.2% (13/18), respectively.

Accessory parotid gland tumors are relatively rare; hence, adequately detailed clinical analyses of these tumors are difficult to perform at a single institution. In this report, we describe the findings for 65 patients [29 men, 36 women; median age, 51 (9-81) years] with accessory parotid gland tumors, consisting of 4 cases documented by us and 61 cases previously reported by other Japanese authors. Approximately 50% of the patients were treated in an otolaryngology department, while the remaining patients were treated in plastic surgery, oral surgery, or dermatology departments. In 4 patients, the results of preoperative fine-needle aspiration cytology indicated that the tumor was benign; however, the postoperative histopathology results revealed malignant tumors. The frequencies of malignant and benign tumors were 44.6% (n = 29) and 55.4% (n = 36), respectively. Mucoepidermoid carcinoma and pleomorphic adenoma were the most frequent types of malignant and benign accessory parotid gland tumors, respectively. Among the various surgical methods that were used, such as direct cheek and intraoral incisions, a standard parotidectomy incision was the most preferred treatment approach for these tumors. Recently, an endoscopic approach has also been found to yield satisfactory results. An optimal approach should be selected after evaluating the advantages and disadvantages of these methods. No definite guidelines are available regarding the choice of elective neck dissection and postoperative radiation therapy for malignant accessory parotid gland tumors. Although tumor resection (plus elective neck dissection) and postoperative radiation therapy have been frequently performed for various kinds of malignant accessory parotid gland tumors to date, additional studies are needed regarding the criteria for selecting elective neck dissection and postoperative radiation therapy. Since the malignancy rate for accessory parotid gland tumors is higher than that for parotid gland tumors, the possibility of malignancy (especially mucoepidermoid carcinoma and carcinoma ex pleomorphic adenoma) should be considered when resecting accessory parotid gland tumors, even if the results of preoperative fine-needle aspiration cytology indicate that the tumor is benign.

Most hematolymphoid malignancies in the head and neck were malignant lymphomas that most often occurred in sexagenarian men. Approximately 80% of them were B-cell lymphomas with a predominance of diffuse large B-cell lymphoma (DLBCL) in both nodal and extranodal sites. Our results were compatible with those in a previous study that was conducted in the central part of Japan.This analysis was performed to describe the anatomic distribution of hematolymphoid malignancies that were diagnosed by biopsy in our department.Clinical medical records of 122 patients with hematolymphoid malignancies in the head and neck from January 2004 to December 2010 were retrospectively reviewed. The anatomic site of origin according to the histopathology of each malignancy was analyzed.The incidence ratio of hematolymphoid malignancies was 15.1%. The male:female ratio was 2.3:1. Ages ranged from 17 to 89 years (median, 66). Of the 122 cases, 121 were lymphoid neoplasms (4 cases of Hodgkin lymphoma and 117 cases of non-Hodgkin lymphoma) and the remaining 1 was myeloid. The most common histopathology was DLBCL (54.9%), followed by follicular lymphoma (8.2%), and peripheral T-cell lymphoma (8.2%). Most commonly, the oropharynx (36.1%) and the cervical lymph node (34.4%) were affected.

The incidence of bone metastasis in patients with hepatocellular carcinoma (HCC) has reportedly been increasing. The hyoid bone is rarely a target of metastatic HCC. We present a unique case of HCC which showed a single distant metastasis to the hyoid bone. An 81-year-old Japanese man was referred to us from the Department of Gastroenterology complaining of a 1-month history of a painful left neck mass when swallowing. He had a serial history of non-surgical treatments for HCC in the previous six years. Ultrasonography-guided fine needle aspiration cytology yielded a diagnosis of poorly differentiated carcinoma. PET-CT demonstrated a mass (SUV 3.8) which had destroyed the left side of the hyoid body. Based on these cytological and radiological findings of the mass in addition to his medical history of having recurrent HCC, we strongly suspected that the mass was a solitary metastatic HCC of the hyoid bone. The mass was completely resected combined with the hyoid bone under general anesthesia. Postoperative pathologic findings were consistent with metastatic HCC. The patient was relieved from pain in swallowing just after surgery. Minimally invasive surgery can be an effective treatment modality for pain relief even in patients with bone metastasis from HCC.

The accuracy and sensitivity of fine-needle aspiration cytology (FNAC) in this analysis were not satisfactory, and the false-negative rate seemed to be higher than for parotid tumours. The possibility of low-grade malignancy should be considered in the surgical treatment of accessory parotid gland (APG) tumours, even if the preoperative results of FNAC suggest that the tumour is benign.Little is known about the usefulness of FNAC in the preoperative evaluation of APG tumours, probably due to the paucity of APG tumour cases. We examined the usefulness of FNAC in the detection of malignant APG tumours.We conducted a retrospective analysis of 3 cases from our hospital, along with 18 previously reported Japanese cases. We compared the preoperative FNAC results with postoperative histopathological diagnoses of APG tumours and evaluated the accuracy, sensitivity, specificity and false-negative rates of FNAC in detecting malignant APG tumours.There were four false-negative cases (19.0%), three of mucoepidermoid carcinomas and one of malignant lymphoma. One false-positive result was noted in the case of a myoepithelioma, which was cytologically diagnosed as suspected adenoid cystic carcinoma. The accuracy, sensitivity and specificity of FNAC in detecting malignant tumours were 76.2%, 60.0% and 90.9%, respectively.

We report the case of a 12-year-old girl with an intracranial epidural abscess and sphenoiditis. Although she had no history of sinusitis, she developed acute severe headache, fever, and vomiting. Emergent CT and MRI showed a spherical space-occupying lesion of diameter 3 cm in the right cranial fossa with rim enhancement. The lesion was thought to be an epidural abscess adjacent to the right sphenoiditis. On the basis of the MRI findings, we performed emergent surgery to drain the abscess and sinusitis because of severe and rapidly worsening headaches. The patient showed great improvement the day after the operation. Intravenous antibiotics were administered for 8 days. She has completely recovered, with neither sequelae nor recurrence at 7 months after the operation. We believe that this report will be a useful reference for cases of acute onset headache and may be helpful in diagnosis and treatment decisions for severe sinusitis-related intracranial abscess in childhood.

Congenital epiglottic cyst, although rare, may potentially cause severe airway obstruction. Major symptoms include mild stridor, trouble eating, chest retraction, apnea, and cyanosis. We report a case presenting with hydramnios in which a congenital epiglottic cyst caused severe airway obstruction and asphyxiation at birth. After surgical removal of the cyst, no airway obstruction has recurred in the half year of follow-up. It appears likely that a large congenital epiglottic cyst caused hydramnios with dysphagia. We therefore suggest that hydramnios is considered a possible sign of congenital epiglottic cyst, and that it is necessary to prepare to maintain the airway in cases of airway obstruction at birth.

Plastic bronchitis is characterized by marked obstruction of the large airways by bronchial casts. The condition is rare but can occur at any age. Asthma or allergy is often the cause of cast production, but in some instances there is no etiology identified. Especially in children, it is difficult to differentiate plastic bronchitis from bronchial foreign bodies. Bronchoscopic extraction of casts benefits some patients. Plastic bronchitis causes acute respiratory failure. A 2-year old boy with no history of asthma or allergy presented with severe respiratory distress following a 3-day history of upper-respiratory-tract infection. Chest X-ray showed complete collapse of the left lung with mediastinal shift. Bronchoscopy demonstrated obstruction of casts. The patient improved after bronchoscopic extraction of casts. But in the emergency care unit, this patient became very difficult to oxygenate despite aggressive ventilation and suddenly developed cardiopulmonary arrest. This patient was recovered by CPR, and a complete cast of the bronchial tree from carina to the small airways was removed by repeated bronchosopies.

Tracheal cartilaginous sleeve (TCS) is a congenital malformation involving fusion of the tracheal arches that may be isolated to a few tracheal arches, include the entire trachea, or extend beyond the carina into the bronchi. Tracheotomy was required in 9 of 23 craniosynostosis cases undergoing gradual distraction at Osaka City General Hospital from March 2002 to April 2006. TCS was diagnosed in 5 of 9 cases-four Pfeiffer patients and one Crouzon patient. Diagnosis was made intraoperatively during tracheotomy or at autopsy. 3D-CT was not useful in diagnosing TCS. Aggressive management of respiratory infection and pulmonary secretion, selection of appropriate tracheostomy tubes, and endoscopic evaluation are very important to care in managing TCS patients.

B-cell non-Hodgkin's lymphoma (B-NHL) in the head and neck most commonly affected the oropharynx and the cervical lymph node in sexagenarian patients, with more than 70% of these cases being diffuse large B-cell lymphoma (DLBCL). Accordingly, B-NHL should be considered one of the most important differential diagnoses of head and neck malignancies.It has previously been reported that the majority of head and neck malignant lymphomas are B-NHLs. This analysis aimed to assess the site-specific profiles of B-NHL of the head and neck.The medical records of patients with B-NHL of the head and neck diagnosed between January 2004 and December 2013 were retrospectively reviewed. The clinical parameters of these patients, including age, sex, site distribution, and histopathologic sub-type, were analyzed.A total of 153 cases (95 males; 58 females) were included in this analysis (male-to-female ratio = 1.64:1). The patient age at the time of diagnosis ranged from 30-92 years (median = 68 years). The oropharynx was the most commonly affected site (40.5%), followed by the cervical lymph nodes (33.3%). The most common histopathologic sub-type was DLBCL (71.9%), followed by follicular lymphoma (11.1%), and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (9.2%).

Radiographic visualization of the vestibular aqueduct (VA) from a lateral inside view was effective in assessing patients with Meniere's disease (MD). There were no VA shapes specific to MD on radiography, except for an obliterated VA. This technique could yield more accurate images and functional assessment of the VA for MD evaluation in a clinically useful and convenient manner, without requiring morphologic measurement.To visualize the detailed images of the VA using three-dimensional (3D) computed tomography (CT) and discuss its clinical utility in assessing MD.The VAs in 13 healthy subjects and 25 MD patients, who were definitely diagnosed according to criteria described by the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology, Head and Neck Surgery (AAO-HNS), were imaged from the medial and lateral sides using 3DCT and compared to conventional CT images.Examination of the VA from both the lateral outside and inside views on 3DCT yielded more precise images than generated by conventional CT and could be useful to estimate the VA function. The estimated VA function in the MD ears was significantly abnormal compared to the function in healthy ears. An obliterated VA was characteristic of affected MD ears.

A design concept of two-phase flow centrifugal impeller is described with experimental results. The short bladed forward impeller with high outlet blade angle is recommended to keep theoretical head higher even in two-phase flow condition and to disperse the air accumulating region on the suction blade surface by the water jet flow coming along the pressure blade surface. Furthermore, tandem arrangement of outer and inner rotating cascades with the same blade numbers was adopted to suppress the rotating stall phenomena appearing in the case of a single stage of outer cascade. Then how to evaluate the impossibility of pumping due to two-phase flow is shown from a relation between the two-phase flow head characteristic curve and the resistance curve of piping system.

Malignant tumors of Stensen's duct are often squamous cell carcinomas. Surgery is the treatment of choice, and maintaining an adequate safety margin and performing parotidectomy may help to reduce postoperative recurrence.Since malignant tumors of Stensen's duct are extremely rare, the number of cases is limited in single-facility studies, making it difficult to perform a sufficient number of clinical examinations. Therefore, we reviewed 26 cases with Stensen's duct malignancies to examine their clinical features.We conducted a retrospective study of 26 cases with Stensen's duct malignancies, including 1 patient whom we treated and 25 cases previously reported in the English literature, and analyzed their clinical parameters, including age, sex, affected side, chief complaint, tumor size, histopathology, treatment method, and treatment outcome.Most cases were diagnosed in patients between 40 and 69 years of age. The chief complaint was swelling in the cheek in 24 patients, in 14 of whom the swelling was painful. The most common tumor diameter range was 10-19 mm. Squamous cell carcinoma was the most frequent histopathology. The recurrence rate in surgical patients who did not undergo parotidectomy was 60%, whereas in patients who underwent parotidectomy, the recurrence rate was only 7%.

A vast amount of metagenomic data has been obtained by extracting multiple genomes simultaneously from microbial communities, including genomes from uncultivable microbes. By analyzing these metagenomic data, novel microbes are discovered and new microbial functions are elucidated. The first step in analyzing these data is sequenced-read classification into reference genomes from which each read can be derived. The Naive Bayes Classifier is a method for this classification. To identify the derivation of the reads, this method calculates a score based on the occurrence of a DNA sequence motif in each reference genome. However, large differences in the sizes of the reference genomes can bias the scoring of the reads. This bias might cause erroneous classification and decrease the classification accuracy. To address this issue, we have updated the Naive Bayes Classifier method using multiple sets of occurrence profiles for each reference genome by normalizing the genome sizes, dividing each genome sequence into a set of subsequences of similar length and generating profiles for each subsequence. This multiple profile strategy improves the accuracy of the results generated by the Naive Bayes Classifier method for simulated and Sargasso Sea datasets.

A 55-year-old male with progressively worsening hoarseness was found to have a vocal cord polyp of >10 mm in diameter on the right true cord. It was necessary to remove the polyp in order to prevent airway obstruction by prolapse. However, the patient was a poor candidate for resection by standard otolaryngologic procedures because of the large size of the polyp and because he had a symptomatic cervical disc herniation. Therefore, endoscopic resection under general anesthesia using a bipolar electrocautery snare was selected. This case was our first attempt to treat a vocal cord polyp using this technique, and we found that polypectomy with the bipolar snare was an efficient and safe method for the treatment of this lesion.

A 41-year-old man was referred to our university clinic by a local physician for further examination of a left mid-cheek mass, suspected to be a benign subcutaneous tumor. The patient had noticed the indolent mass three years previously, which had slowly increased in size. Clinically, the mass in the left mid-cheek area showed good mobility, was elastic and hard, had a smooth surface, and was 10 mm in the greatest dimension. Cervical lymph nodes were not palpable. Facial paralysis was not recognized. The results of laboratory examinations, including serum and urine amylase levels, were within normal ranges. Imaging studies, including ultrasonography, computed tomography (CT), and magnetic resonance imaging, revealed a well-circumscribed and homogeneously well-enhanced solitary mass, 6 × 12 mm in size, anterior to the front edge of the left parotid gland and on the outer layer of the masseter muscle (Figure 1 and 2). These findings suggested a benign tumor derived from the APG, facial nerve, or blood vessel. Ultrasound-guided fine needle aspiration Abstract

Air-water two-phase flow performance of conventional centrifugal pumps causes the impermissible head deterioration even at an inlet void fraction less than about 10%. A tandem arrangement of double rotating cascades and higher blade outlet angle more than 90° only in outer rotating cascade has been proposed as a centrifugal pump impeller with high performance in air-water two-phase flow condition. To obtain further improvement of pump performances, a diffuser cascade is installed downstream of impeller outlet. In design of air-water two-phase flow centrifugal pump in various size and operating conditions as well as in single-phase flow, similarity law of pump performances is very useful. The similarity law of impeller diameter, blade height and rotational speed is investigated for the proposed impeller in the present paper. As the results, the similarity law of impeller diameter and rotational speed is certified experimentally even in two-phase flow condition. In addition, influences of blade height on air-water two-phase flow performances indicate a little difference from the similarity law. This difference is, then, discussed by using the results of static head on the shroud wall and air behaviors in the impellers.Copyright © 2007 by ASME

A tandem arrangement of double rotating cascades and single diffuser cascade, proposed as a centrifugal pump with high performance in air-water two-phase flow condition, yields lower head due to the smallness of the impeller outlet in comparison with a impeller with large outlet diameter and no diffuser. Influences of impeller diameter change and installation of diffuser blades on two-phase flow performance were experimentally investigated under the case of the same volute casing. As the result, the similarity law of the diameter of impeller having the similar blade geometry and the rotational speed is satisfied even in two-phase flow condition. Comparing pump performances between a large impeller without diffuser blades and a small one with diffuser blades, higher two-phase flow performance is obtained by controlling the rotational speed of a small impeller with diffuser blades in the range of small water flow rates, while a large impeller with no diffuser gives high performance in the range of high water flow rate and small air flow rate.Copyright © 2005 by ASME

Superlattice films with full-Heusler Co2MnSi (CMS) alloy and Pd layers prepared on Pd-buffered MgO(001), (110), and (111) substrates were investigated. Crystal orientation and epitaxial relationship of Pd and CMS layers were analyzed from x-ray diffraction, pole figure measurements, and transmission electron microscope observation. Formation of the L21-ordered structure in the CMS layers was confirmed by observation of CMS(111) diffraction. Perpendicular magnetic anisotropy (PMA) was obtained in the [CMS (0.6 nm)/Pd (2 nm)]6 superlattice film formed using MgO(111) substrates although other superlattice films prepared using MgO(001) and (110) substrates showed in-plane and isotropic magnetic anisotropy, respectively. The perpendicular magnetic anisotropy energy constant K for the superlattice films prepared using MgO(111) substrate was estimated to be 2.3 Mergs/cm3, and an interfacial anisotropy constant K i per one CMS-Pd interface in the superlattice films was estimated to be 0.16 ergs/cm2. K i in superlattice films with various crystal orientations showed positive values, indicating that Pd/CMS interfaces had an ability to induce PMA regardless of their crystal orientation.