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Most sediment disasters are caused by surface failures, mostly induced by rainfall, and many of them cause extensive damages. Assessment of the risk of such disasters is crucial for the safety and security of society. This is becoming increasingly important in the era of global warming when torrential rains and localized heavy rains are on the increase. Instead of the index such as accumulated rainfall amount, we attempted to make a risk assessment using the soil moisture deficit, i.e., the remained capacity of the soil column to accept rainwater. First, a numerical model was developed to calculate soil moisture deficit in any or all tertiary meshes with existing routine data. The model was then applied to 446 tertiary meshes in Niigata Prefecture within which failures occurred during a period from 2010 to 2011. The model showed that the soil moisture deficit near the failure occurrence became smaller, i.e., the soil column was closer to complete saturation. This suggests that soil moisture deficit could be a good indicator of the risk. Furthermore, a probability distribution model was constructed from the minimum soil moisture deficit data near the failure occurrence. With this probability model, the threshold of soil moisture deficit to put an area on alert, corresponding to the disaster coverage ratio, can be easily calculated. The possibility of early warning is also demonstrated by combining the soil moisture deficit at a certain time with a short-time rainfall forecast for several hours in the future.

Purpose: To evaluate the clinical utility of the Gore Excluder iliac branch endoprosthesis (IBE) for Japanese patients with aortoiliac aneurysms., Materials and Methods: This was a multicenter retrospective cohort study (J-Preserve Registry). Patients undergoing endovascular aortic repair using the Gore Excluder IBE for aortoiliac aneurysms between August 2017 and June 2020 were enrolled. Data pertaining to the baseline and anatomical characteristics, technical details, and clinical outcomes were collected from each institution. The primary endpoints were technical success, IBE-related complications, and reinterventions. Secondary endpoints were mortality, aneurysm size change, and reintervention during follow-up. Technical success was defined as accurate deployment of the IBE without type Ib, Ic, or III endoleaks on the IBE sides on completion angiography. A change in aneurysm size of 5 mm or more was taken to be a significant change., Results: We included 141 patients with 151 IBE implantations. Sixty-five IBE implantations (43.0%) had at least one instruction for use violation. Twenty-two patients (15.6%) required internal iliac artery (IIA) embolization for external iliac artery extension on the contralateral side. Of 151 IBE implantations, 19 exhibited IIA branch landing zones due to IIA aneurysms. Mean maximum and proximal common iliac artery (CIA) diameters were 32.9±9.9 mm and 20.5±6.9 mm, respectively. The mean CIA length was 59.1±17.1 mm. The IIA landing diameter and length were 9.0±2.3 mm and 33.8±14.6 mm. The overall technical success rate was 96.7%. There were no significant differences in IBE-related complications (2.3% vs 5.3%, p =0.86) or IBE-related reinterventions (1.5% vs 5.3%, p =0.33) between the IIA trunk and IIA branch landing groups. The mean follow-up period was 635±341 days. The all-cause mortality rate was 5.0%. There were no aneurysm-related deaths or ruptures during the follow-up. Most patients (95.7%) had sac stability or shrinkage., Conclusion: The Gore Excluder IBE was safe and effective for Japanese patients in the midterm. Extending the IIA device into the distal branches of the IIA was acceptable, which may permit extending indications for endovascular aortic aneurysm repair of aortoiliac aneurysms to more complex lesions., Clinical Impact: This study suggests clinical benefits of the Gore Excluder IBE for Japanese patients, despite 43% of the IBE implantations having at least one IFU violation., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: N.F. receives consulting fees from Cook Medical, Endologix, Medtronic, and W.L. Gore. H.N. activities not related to this article and is employed by Dantex. All other authors declare no conflict of interest.

Purpose: This study retrospectively evaluated the 12-month outcomes of the Zenith Alpha Abdominal Endovascular graft (Zenith Alpha AAA, Cook, Inc, Bloomington, Indiana), which was launched partially in Japan in March 2019, starting with 9 selected sites., Methods: A retrospective analysis was performed of all endovascular aneurysm repairs (EVAR) for abdominal aortic aneurysms using the Zenith Alpha AAA. Late complications were defined as any aneurysm-related events occurring >30 days after EVAR, including an aneurysm sac enlargement of >5 mm and any reinterventions performed. Endoleaks without sac enlargement or reinterventions were excluded from late complications., Results: During the study period, 79 EVARs using the Zenith Alpha AAA were performed. The mean age was 76.6±6.9 years old, 91.1% of patients were male, and the mean aneurysm diameter was 51.1±7.5 mm. Instructions for use violation was observed in 27 patients (34.2%), most frequently being a severely angulated proximal neck (>60°). There were 4 intraoperative complications, including 2 unintentional partial renal artery coverages caused by the premature anchoring of the exposed suprarenal stent barb to the aortic wall, which was a result of the design change of the top cap deletion. Since it was a partial coverage without flow impairment and since renal stenting was unsuccessful, it was left untreated and had no subsequent renal function impairment. During the mean follow-up of 444±123 days, 74 patients completed 12 months of follow-up. Freedom from late complications at 12 months was 90.8%, which included 2 limb occlusions (2.5%). Of 71 patients with a 12-month computed tomography scan, there was only 1 type 1a endoleak (1.3%), 1 sac enlargement of >5 mm (1.3%), and an aneurysm sac shrinkage of >5 mm was observed in 42.2% of patients. There was no type 3 endoleak during the follow-up., Conclusions: This study demonstrated that the new generation of low-profile Zenith Alpha AAA has satisfactory early clinical outcomes, comparable to those obtained with the conventional Zenith endovascular graft. Long-term follow-up is needed to determine whether these favorable outcomes persist.

An aneurysm sac enlargement caused by type II endoleak (T2EL) following endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms may cause serious complications such as rupture. Consequently, methods that preoperatively prevent or postoperatively treat T2EL have been employed. When significant aneurysm enlargement occurs due to persistent T2EL, embolization is first performed through several access points. However, although these endovascular reinterventions have a high technical success rate and are safe, their effectiveness remains questionable. When such endovascular procedures fail to stabilize sac enlargement, open surgical conversion (OSC) becomes the last-resort treatment option. We review several strategies of OSC for the repair of T2EL following EVAR. Among the three main OSC procedures, namely, complete endograft removal, partial endograft removal, and complete endograft preservation, partial endograft removal under infrarenal clamping was considered the most appropriate owing to its less invasiveness and durability., Competing Interests: Conflict of Interest StatementThe authors declare no conflicts of interest in association with the present study., (© 2023 The Editorial Committee of Annals of Vascular Diseases.)

The coronavirus disease 2019 (COVID-19) pandemic has necessitated the development of antiviral agents against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 3C-like protease (3CL pro ) is a promising target for COVID-19 treatment. Here, we report a new class of covalent inhibitors of 3CL pro that possess chlorofluoroacetamide (CFA) as a cysteine-reactive warhead. Based on an aza-peptide scaffold, we synthesized a series of CFA derivatives in enantiopure form and evaluated their biochemical efficiency. The data revealed that 8a ( YH-6 ) with the R configuration at the CFA unit strongly blocks SARS-CoV-2 replication in infected cells, and its potency is comparable to that of nirmatrelvir. X-ray structural analysis showed that YH-6 formed a covalent bond with Cys145 at the catalytic center of 3CL pro . The strong antiviral activity and favorable pharmacokinetic properties of YH-6 suggest its potential as a lead compound for the treatment of COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic has necessitated the development of antiviral agents against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The main protease (M pro ) is a promising target for COVID-19 treatment. Here, we report an irreversible SARS-CoV-2 M pro inhibitor possessing chlorofluoroacetamide (CFA) as a warhead for the covalent modification of M pro . Ugi multicomponent reaction using chlorofluoroacetic acid enabled the rapid synthesis of dipeptidic CFA derivatives that identified 18 as a potent inhibitor of SARS-CoV-2 M pro . Among the four stereoisomers, ( R , R )-18 exhibited a markedly higher inhibitory activity against M pro than the other isomers. Reaction kinetics and computational docking studies suggest that the R configuration of the CFA warhead is crucial for the rapid covalent inhibition of M pro . Our findings highlight the prominent influence of the CFA chirality on the covalent modification of proteinous cysteines and provide the basis for improving the potency and selectivity of CFA-based covalent inhibitors., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

The red alga Chondria armata is known to produce and contain a rich diversity of secondary metabolites, such as domoic acid-related alkaloids and triterpene polyethers. Our investigation on red alga C. armata from Kagoshima coast, Japan, resulted in the isolation of two new triterpene polyethers, bandokorols A ( 1 ) and B ( 2 ). The structures of these compounds were determined based on spectroscopic data such as infrared (FTIR), 1 H-NMR, APT, 1 H- 1 H-COSY, HSQC, HMBC, NOESY and FAB mass spectrometry (HRFABMS). The anticancer potentials of these compounds were tested against adult T-cell leukaemia (ATL), S1T cells and their IC 50 values are reported here.

Many studies have reported that pre-exercise ice slurry ingestion improves exercise performance; however, it may increase the risk of developing heat stroke. Some studies have suggested that pre-exercise ice slurry ingestion accelerates the core temperature increase that occurs during exercise. Therefore, this study aimed to investigate whether the ingestion of ice slurry before and during exercise can inhibit this acceleration. Moreover, we measured the deep-forehead temperature (T deep head ) to determine whether ice slurry ingestion before and during exercise can maintain this reduction in brain temperature. Eleven male participants at room temperature (24 °C, 50% relative humidity [RH]) ingested 7.5 g/kg of ice slurry or a thermoneutral sports drink within 30 min. They then exercised for approximately 60 min at 50% of the maximal oxygen uptake in a hot environment (34 °C, 50% RH) while ingesting 1.25 g/kg of ice slurry or a thermoneutral sports drink every 10 min. Rectal temperature (T re ), T deep head , forehead skin temperature, mean skin temperature, heart rate, nude body mass, and urine specific gravity were measured as physiological indices. The rating of perceived exertion, thermal sensation, and thermal comfort were measured at 5-min intervals throughout the experiment. The T re and T deep head during the second half of the exercise session were significantly reduced after ingestion of the ice slurry before and during exercise (p < 0.05). In addition, the rate of increase in T re and T deep head slowed during the second half of the exercise session after the ingestion of the ice slurry before and during exercise (p < 0.05). These results indicate that the increases in T re and T deep head , reflecting brain temperature in the second half of the exercise session, were significantly inhibited by ice slurry ingestion before and during exercise., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

In Japan, all 3-year-old children undergo a three-step municipal vision screening that includes home-based screening, secondary screening at a health center, and comprehensive ophthalmologic examination, if warranted. We investigated whether screening by a certified orthoptist (CO) could improve the detection of visual dysfunctions, including amblyopia. Three-year-olds in Nobeoka City were invited to undergo primary and secondary screenings from April 2008 to March 2011. COs performed the secondary screening tests; children with a positive secondary screening received a comprehensive ophthalmologic examination. Of the 3,303 eligible children, 98 were positive on detailed examination. Of these, 25% were classified as false-negatives. Eight children with amblyopia in the false-negative group accounted for 24% of all 33 amblyopia cases detected on detailed examination., (Copyright © 2020 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)

Background: Limited data is available on the use of a polyester graft limb with a helical stent configuration deployed in the external iliac artery (EIA) during endovascular aneurysm repair (EVAR), so we prospectively analyzed the efficacy of the Zenith Spiral-Z limb deployed in the EIA., Methods and results: Patients undergoing EVAR using a Zenith stent-graft and Spiral-Z limb deployed in the EIA were prospectively registered in 24 Japanese institutions from June 2017 to November 2017. In total, 65 patients (74 limbs) (mean age: 77.1±8.0 years, 87.7% men, mean abdominal aortic aneurysm (AAA) diameter: 51.9±7.2 mm, mean iliac artery aneurysm (IAA) diameter: 38.3±10.0 mm) were registered and followed up. The most common reason for deployment in the EIA was a common IAA (43 limbs, 58.1%), and 8 limbs (10.8%) had a bare nitinol stent placed at the Spiral-Z limb. A total of 61 patients (70 limbs) completed a 24-month follow-up. There were 2 Spiral-Z limb stenoses and 1 occlusion, leading to a primary patency of 95.5% and a secondary patency of 100%, at 24 months. Buttock claudication occurred in 24.3% of the limbs treated at 1 month but decreased to 4.3% at 24 months., Conclusions: Our multicenter prospective study showed that Spiral-Z limb deployed in the EIA was associated with satisfactory results and seems to be a durable option, even in the era of iliac branch devices.

Sour citrus are prized for their flavor and fragrance. This work identified the components of the peel oil of Hetsuka-daidai (Citrus sp. hetsukadaidai), a special sour citrus that is native to the southern part of the Osumi peninsula, Kagoshima, Japan. These compounds were compared to those identified from the peels of six other major sour citrus: lime (Citrus latifolia), lemon (Citrus limon), Yuzu (Citrus junos), Kabusu (Citrus aurantium), Kabosu (Citrus sphaerocarpa), and Sudachi (Citrus sudachi). Peel oil contents were analyzed for the duration of four months during harvest season to investigate the differences in peel oil/fragrance during ripening. These results could facilitate the development of preferred flavor and scent profiles using local species.

Endurance and intermittent exercise performance are impaired by high ambient temperatures. Various countermeasures are considered to prevent the decline in exercise performance in the heat, convenient, and practical cooling strategies attracts attention. The purpose of this study was to investigate the effect of wearing a new type of cooling vest which cooled torso and neck during half-time (HT) on intermittent exercise performance that imitated intermittent athletic games. All measurements on the experiments were carried out with the bicycle ergometer. Eight male soccer players performed a familiarization session and two experimental trials of a 2 × 30 min intermittent cycling exercise protocol, which consisted of a 5 s maximal power pedaling (body weight ×0.075 kp) every minutes separated by 25 s unloaded pedaling (80 rpm) and rest (30 s) in the heat (33.0°C; 50% relative humidity). The two trials included cooling-vest condition (VEST) and control condition (CON), and the difference is with or without wearing cooling vest imposed for 15 min at HT. Mean and peak power output, rectal (Tre) and skin temperature (neck, upper back, chest, right upper arm, and thigh), heart rate (HR), deep thigh temperature, rating of perceived exertion (RPE), and thermal comfort (TC) and thermal sensation (TS) were measured. Mean power output at 2nd half was significantly greater ( p < 0.05) in VEST (3rd trial: 589 ± 58 W, 4th trial: 584 ± 58 W) than in CON (3rd trial: 561 ± 53 W, 4th trial: 561 ± 53 W). HR were significantly lower in VEST during HT and higher in VEST at the last maximal pedaling ( p < 0.05). At the end of HT, neck skin temperature and mean skin temperature were significantly lower in VEST (32.04 ± 1.47°C, 33.76 ± 1.08°C, respectively) than in CON (36.69 ± 0.78°C, 36.14 ± 0.67°C, respectively) ( p < 0.05). During 2nd half, TS, TC, and RPE were significantly lower in VEST than in CON ( p < 0.05). There was no significant difference in Tre and deep thigh temperature throughout each conditions. These results indicate that wearing a new type of cooling vest during HT significantly improves intermittent exercise performance in the heat with decreased neck and mean skin temperature and improved subjective responses.

Gold and silver nanoparticles were prepared from the green tea and black tea extracts of the leaves of Camellia sinensis. The metal nanoparticle solutions were obtained by reacting HAuCl 4 or AgNO 3 aqueous solutions with aqueous NaHCO 3 and tea leaf extracts, which were obtained from used tea leaves at low temperature, under ambient conditions. The nanoparticles were stable at room temperature and had a uniform particle size (Au: ∼10 nm, Ag: ∼30 nm). Nanoparticle-immobilized cotton cloths were then prepared, which displayed high antibacterial activity and a characteristic color, thereby showing potential application as antimicrobial pigments. This study provides a means of utilizing used tea leaves, which would otherwise be considered waste products., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Fibromuscular dysplasia (FMD) mainly develops in medium-sized arteries, including renal, extracranial, and extremity arteries, but it rarely causes abdominal aortic aneurysm (AAA). A 69-year-old woman with AAA diagnosed on ultrasonography by a home doctor visited our hospital. Contrast-enhanced computed tomography revealed a saccular aneurysm of terminal abdominal aorta. We performed abdominal aortic replacement and resected the section with aneurysm. Pathological examination of the wall tissue of the resected aneurysm revealed findings that are consistent with FMD. We report this case of AAA caused by aortic FMD because of its rarity.

We previously reported that ice slurry ingestion reduced forehead skin temperature, thereby potentially reducing brain temperature (T brain ). Therefore, in the current study, we investigated the effect of ice slurry ingestion on T brain using proton magnetic resonance spectroscopy, which is a robust, non-invasive method. Eight male participants ingested 7.5 g/kg of either a thermoneutral drink (37 °C; CON) or ice slurry (-1 °C; ICE) for about 5 min following a 15-min baseline period. Then, participants remained at rest for 30 min. As physiological indices, T brain , rectal temperature (T re ), mean skin temperature, nude body mass, and urine specific gravity were measured. Subjective thermal sensation (TS) and thermal comfort (TC) were measured before and after the experiment. T brain and T re significantly reduced after ingestion of ICE compared with after ingestion of CON, and there was a significant correlation between T brain and T re . The other physiological indices were not significantly different between beverage conditions. TS and TC were significantly lower with ICE than with CON (p < 0.05). These results indicate that ice slurry ingestion can cool the brain, as well as the body's core.

Aspergillus luchuensis is a kuro (black) koji fungus that has been used as a starch degrader for the awamori- and shochu-making industries in Japan. In this study, we investigated the effect of ion beam irradiation on A. luchuensis RIB2601 and obtained a high starch-degrading mutant strain U1. Strain U1 showed reduced growth rate, whereas it showed higher α-amylase, glucoamylase, and α-glucosidase activities on a mycelial mass basis than the wild type (wt) strain both on agar plates and in rice koji. In addition, strain U1 showed higher N-acetylglucosamine content in the cell wall and higher sensitivity to calcofluor white, suggesting a deficiency in cell wall composition. Interestingly, produced protein showed higher expression of acid-labile α-amylase (AmyA) and glucoamylase (GlaA) in strain U1, although real-time RT-PCR indicated no significant change in the transcription of the amyA or glaA gene. These results suggested that the high amylolytic activity of strain U1 is attributable to a high AmyA and GlaA production level, but the elevated production is not due to transcriptional regulation of the corresponding genes. Furthermore, RNA-seq analysis indicated that strain U1 shows transcriptional changes in at least 604 genes related to oxidation-reduction, transport, and glucosamine-containing compound metabolic processes, which may be involved in the deficient cell wall composition of strain U1.

Persistent sciatic artery (PSA) is a rare anomaly that may cause various symptoms, such as aneurysm, rupture, thromboembolism, and sciatica. Direct surgery can be performed to treat PSA aneurysm (PSAA), but is associated with complications; e.g., anatomical problems such as sciatic nerve injury. Herein we report a case of a 74-year-old woman with acute limb ischemia that developed from a distal embolism caused by a thrombus in the left PSAA; favorable results were obtained for her by treatment with a stent-graft after rapid anticoagulation therapy for limb salvage.

A total synthesis of (±)-hyptinin was achieved via a convergent route using the key phosphonate, cyclic ketone, and aryl Grignard components. The 1 H and 13 C NMR spectra of natural hyptinin did not agree with those of the synthesized compound. In particular, there were considerable differences between the signals assigned to the protons and carbons surrounding the lactone carbonyl group for the natural and synthesized compounds. The NMR data strongly suggested that the naturally occurring compound, hyptinin, was a structural isomer of the synthesized compound. The structure of the natural compound was eventually established as (+)-β-apopicropodophyllin, based on the synthesis results.

It has been demonstrated that precooling with ice slurry ingestion enhances endurance exercise capacity in the heat. However, no studies have yet evaluated the optimal timing of ice slurry ingestion for precooling. This study aimed to investigate the effects of varying the timing of ice slurry ingestion for precooling on endurance exercise capacity in a warm environment. Ten active male participants completed 3 experimental cycling trials to exhaustion at 55% peak power output (PPO) after 15min of warm-up at 30% PPO at 30°C and 80% relative humidity. Three experimental conditions were set: no ice slurry ingestion (CON), pre-warm-up ice slurry ingestion (-1°C; 7.5gkg -1 ) (PRE), and post-warm-up ice slurry ingestion (POST). Rectal and mean skin temperatures at the beginning of exercise in the POST condition (37.1±0.2°C, 33.8±0.9°C, respectively) were lower than those in the CON (37.5±0.3°C; P<0.001, 34.8±0.8°C; P<0.01, respectively) and PRE (37.4±0.2°C; P<0.01, 34.6±0.7°C; P<0.01, respectively) conditions. These reductions increased heat storage capacity and resulted in improved exercise capacity in the POST condition (60.2±8.7min) compared to that in the CON (52.0±11.9min; effect size [ES]=0.78) and PRE (56.9±10.4min; ES=0.34) conditions. Ice slurry ingestion after warm-up effectively reduced both rectal and skin temperatures and increased cycling time to exhaustion in a warm environment. Timing ice slurry ingestion to occur after warm-up may be effective for precooling in a warm environment., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Preparation, characterization, and stability evaluation of gold nanoparticles stabilized by ω-sulfonylated alkylsulfanylaniline have been described. The particle solution was obtained by the spontaneous reaction of HAuCl 4 and ω-sulfonylated alkylsulfanylaniline in boiling water. It showed a deep red color, owing to surface plasmon resonance of the resulting gold nanoparticles. The size and shape of the nanoparticles were pH-dependent, and pH 8 was found to be the most suitable condition to prepare stable nanoparticles with an average size of 11.2 ± 5.9 nm. The resulting particle solution was stable for a wide range of pH (3-13) and in phosphate-buffered saline (PBS) solution. The nanoparticles were storable as dried powder for at least two weeks, and were redispersible in water or PBS to give almost the same absorption spectra as the freshly prepared solution. Nanoparticle modification was achieved by simply adding thiol molecules to the particle solution.

Internal body cooling by ingesting ice slurry has recently attracted attention. Because ice slurries are ingested through the mouth, it is possible that this results in conductive cooling of the facial skin and brain. However, no studies have investigated this possibility. Thus, the aim of this study was to investigate the effects of ice slurry ingestion on forehead skin temperature at the point of conductive cooling between the forehead skin and brain. Eight male subjects ingested either 7.5g/kg of ice slurry (-1°C; ICE), a cold sports drink (4°C; COOL), or a warm sports drink (37°C; CON) for 15min in a warm environment (30°C, 80% relative humidity). Then, they remained at rest for 1h. As physiological indices, rectal temperature (Tre), mean skin temperature, forehead skin temperature (Thead), heart rate, nude body mass, and urine specific gravity were measured. Subjective thermal sensation (TS) was measured at 5-min intervals throughout the experiment. With ICE, Tre and Thead were significantly reduced compared with CON and COOL conditions (p<0.05). The results of the other physiological indices were not significantly different. TS with ICE was significantly lower than that with CON and COOL (p<0.05) and was correlated with Tre or Thead (p<0.05). These results indicate that ice slurry ingestion may induce conductive cooling between forehead skin and brain, and reduction in core and forehead skin temperature reduced thermal sensation., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

This report describes the successful endovascular treatment of a rare case of aortogastric tube fistula with massive gastrointestinal haemorrhage. The patient's history included oesophageal reconstruction for oesophageal carcinoma using a gastric tube. Emergent angiography revealed extravasation from the thoracic aorta into the thinner aortogastric tube fistula. A microcatheter was inserted into the aortogastric tube with the aortic approach for embolisation with a mixture of n-butyl cyanoacrylate and iodised oil to enable fluoroscopic visualisation. Aortography confirmed the complete absence of extravasation after embolisation, after which a stent graft was placed. This procedure demonstrated that transcatheter embolisation of the aortogastric tube fistula was possible, and that the technique can be used as an emergency option. CT imaging was performed 21 days after the procedure, and revealed no trace of extravasation or inflammation. There were no complications during the 14 months following the endovascular treatment; the patient remains in stable condition., (2015 BMJ Publishing Group Ltd.)

A 54-year-old woman presented with sudden epigastralgia and left back pain. She had no significant history. Laboratory data showed mild inflammation and no liver or renal dysfunction. Abdominal CT showed left adrenal enlargement and haemorrhage. Hydrocortisone therapy was started to prevent adrenal insufficiency before laboratory findings for ACTH (adrenocorticotropic hormone) and cortisol levels. On the second hospital day, abdominal CT showed additional right adrenal enlargement and haemorrhage. The serum cortisol level suggested adrenal insufficiency. No specific findings were detected by bilateral adrenal angiography. 6 to 12 months later, abdominal CT showed decreased bilateral adrenal haemorrhage. This case illustrates the importance of prompt diagnosis and treatment of acute adrenal insufficiency, and shows sequential changes in the size of bilateral adrenal haemorrhage. Rapid corticosteroid replacement is important if acute adrenal insufficiency is suspected. In a case with unilateral adrenal haemorrhage, the possibility of additional adrenal haemorrhage on the opposite side should also be considered.

Silica gel was found to be an excellent medium for some useful organic transformations under organic solvent-free conditions, such as (1) the Friedel-Crafts-type nitration of arenes using commercial aqueous 69% nitric acid alone at room temperature, (2) one-pot Wittig-type olefination of aldehydes with activated organic halides in the presence of tributyl- or triphenylphosphine and Hunig's base, and (3) the Morita-Baylis-Hillman reaction of aldehydes with methyl acrylate. After the reactions, the desired products were easily obtained in good to excellent yields through simple manipulation.

We performed quantitative trait locus (QTL) analyses for egg production traits, including age at first egg (AFE) and egg production rates (EPR) measured every 4 weeks from 22 to 62 weeks of hen age, in a population of 421 F(2) hens derived from an intercross between the Oh-Shamo (Japanese Large Game) and White Leghorn breeds of chickens. Simple interval mapping revealed a main-effect QTL for AFE on chromosome 1 and four main-effect QTL for EPR on chromosomes 1 and 11 (three on chromosome 1 and one on chromosome 11) at the genome-wide 5% levels. Among the three EPR QTL on chromosome 1, two were identified at the early stage of egg laying (26-34 weeks of hen age) and the remaining one was discovered at the late stage (54-58 weeks). The alleles at the two EPR QTL derived from the Oh-Shamo breed unexpectedly increased the trait values, irrespective of the Oh-Shamo being inferior to the White Leghorn in the trait. This suggests that the Oh-Shamo, one of the indigenous Japanese breeds, is an untapped resource that is important for further improvement of current elite commercial laying chickens. In addition, six epistatic QTL were identified on chromosomes 2, 4, 7, 8, 17 and 19, where none of the above main-effect QTL were located. This is the first example of detection of epistatic QTL affecting egg production traits. The main and epistatic QTL identified accounted for 4-8% of the phenotypic variance. The total contribution of all QTL detected for each trait to the phenotypic and genetic variances ranged from 4.1% to 16.9% and from 11.5% to 58.5%, respectively., (© 2011 The Authors, Animal Genetics © 2011 Stichting International Foundation for Animal Genetics.)

Aortic complications after esophageal cancer surgery are rare and usually fatal. Here, we report three patients who underwent thoracic endovascular aortic repair (TEVAR) for aortic complications after esophagectomy for cancer. In the first case, aortic rupture was caused by pyothorax due to residual tumor after esophagectomy. In the second case, aortic rupture was caused by pyothorax due to anastomotic leakage. In the third case, a pseudoaneurysm was caused by surgical injury during esophagectomy. TEVAR was safe and effective for severe aortic complications when graft infection was avoided. The first case died of sepsis on the 84th postoperative day, and the other two cases have survived 4 years and 2 years to date., (© 2011 Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.)

Purpose: We reviewed our experience with homemade stent grafts in the repair of a variety of thoracic aortic lesions. The objective of this study was to assess the early and mid-term outcomes of this therapy., Methods: From 1999 to 2007, homemade stent grafts were inserted in 88 patients with an atherosclerotic aneurysm, dissection, pseudoaneurysm, trauma, or rupture in the thoracic aorta. The endoprostheses were stainless steel Z-stents covered by a polyester graft, and were custom-designed for each patient., Results: Placement of stent grafts was technically successful in 81 of the 88 patients (92%). Within 30 days after treatment, 3 patients died, 3 had a cerebral infarction, and 3 had onset of paraplegia or paraparesis. Primary endoleaks were observed in 8 patients (9%). During the mean follow-up period of 32 ± 26 months, 7 patients had persistent endoleaks and 7 had stent-graft migration. The aneurysm-related mortality rate was 7%. The rate of freedom from open-surgery conversion at 32 months was 89.0%., Conclusions: Our early experience with elective and emergency thoracic endovascular aortic repair using homemade stent grafts provided therapeutic benefits to high-risk patients. Endoleaks and stent-graft migrations were the factors most commonly responsible for secondary intervention in the mid-term period. Careful follow-up of patients treated with this approach is needed to avoid major complications in the long term.

Objectives: The objective of this study was to evaluate and compare our perioperative outcomes for open abdominal aortic aneurysm (AAA) between the pre-endovascular aneurysm repair (pre-EVAR) and EVAR eras and to analyse whether the AAA that was excluded from EVAR could affect the perioperative outcome., Materials and Methods: The Kurume University Hospital vascular registry was reviewed to identify all patients undergoing an elective open AAA repair from January 2004 through November 2006 (pre-EVAR era, n = 99) and from December 2006 through June 2010 (EVAR era, n = 125). The early clinical outcomes between the two groups were compared., Results: In the EVAR era, the proportion of EVAR in all elective AAA repairs was 43.4%. The EVAR era had a significantly higher proportion of very elderly patients over 80 years of age (23.2% vs. 11.1%, P = 0.0391). The morbidity rates were similar between the two groups (22.3% vs. 24,8%) and the mortality rate was 0% for both., Conclusion: Despite the increased complexity of OAR in the EVAR era, we believe that OAR remains a valid procedure for AAA repair., (Copyright © 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.)

We reviewed our experience with homemade stent-grafts in the repair of thoracic aortic lesions. The objective of this study was to assess the long-term outcomes of this therapy. From 1999 to 2008, homemade stent-grafts were inserted in 94 patients with various thoracic diseases. The endoprostheses were stainless steel Z-stents covered with polyester graft and were custom designed for each patient. Placement of the stent-grafts was technically successful in 85 of the 94 patients (90%). Within 30 days after the treatment, 4 patients died, 3 had cerebral infarction, and 3 had the onset of paraplegia or paraparesis. Primary endoleaks were observed in 10 patients (11%). During the mean follow-up period of 43 +/- 29 months, 10 patients had endoleaks and 8 had stent-graft migration. The aneurysm-related mortality rate was 12%. Our early outcomes of elective and emergency thoracic endovascular aortic repair with homemade stent-grafts demonstrated their therapeutic effectiveness in high-risk patients with various thoracic diseases. Endoleaks and migration were, however, the factors most responsible for secondary intervention in the mid-term period. Careful follow-up of the treated patients is needed to avoid the major complication in the long-term period.