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Background The arthroscopically assisted Sauvé–Kapandji (S-K) procedure has been described as a safe and promising technique for distal radioulnar joint (DRUJ) arthrodesis. Our purpose was to investigate the advantages and disadvantages of the arthroscopically assisted S-K procedure. Methods Eight patients underwent an arthroscopically assisted S-K procedure. All patients were diagnosed as DRUJ osteoarthritis (OA), including six primary DRUJ OA, one OA following a distal radius fracture, and one rheumatoid arthritis (RA). Arthroscopy was performed in neutral forearm rotation with vertical traction. The surface of the DRUJ was debrided through arthroscopy to expose the subchondral surface, and the DRUJ was fixed with a cannulated screw and Kirschner wire (K-wire) with zero or minus ulnar variance in the same posture. Bone graft was not performed. Results Bone union was achieved at 2 to 3.5 months postoperatively. At an average of 17-month follow-up, the pain intensity on 10-point numerical rating scale (NRS) decreased from 10 preoperatively to 0.4 postoperatively, average range of pronation significantly improved from 77 degrees to 89 degrees, and average grip strength as a percentage of contralateral side improved from 76 to 104%. Conclusion Satisfactory outcomes were achieved with the arthroscopically assisted S-K procedure. Advantages of this procedure included the ability to achieve union without bone grafting, preservation of the extensor mechanism integrity, and easy reduction of the ulnar head due to its wrist positioning. No major complications were encountered. Disadvantages included its required use of arthroscopic technique and potential contraindication for cases with severe deformity at the sigmoid notch. Level of Evidence This is a Level IV, therapeutic study.

We herein report a case of autoimmune pulmonary alveolar proteinosis (PAP) diagnosed after one-time exposure to silica powder. Owing to the misuse of a silica-containing fire extinguisher and the inhalation of large amounts of its powder, the patient experienced prolonged cough and visited our hospital. The findings of chest computed tomography and surgical lung biopsy specimens led to the diagnosis of PAP. Interestingly, the presence of anti-GM-CSF antibody was detected; therefore, both autoimmune characteristics and exposure to large amounts of silica may have caused the development of PAP in this patient. This case provides important insight into the mechanisms leading to the onset of PAP.

Persistent USWP (ulnar sided wrist pain) after healed DRF (distal radius fracture) has mainly been attributed to malunion of the distal radius, TFCC (triangular fibrocartilage complex) injury, and ulnar styloid nonunion. Careful evaluation such as provocative maneuvers, radiography, magnetic resonance imaging, and wrist arthroscopy are often needed to identify the cause of USWP. The incidence of USWP after healed DRF significantly decreases with time after surgery, hence patience will yield high and predictable rates of improvement. If conservative treatment fails, surgical reconstruction would be indicated. Corrective osteotomy is a reliable treatment for malunion, distal radioulnar joint instability is the critical point to determine the surgical indication for TFCC injury and ulnar styloid nonunion. Wrist arthroscopy is helpful in dealing with persistent USWP.

Summary High-mobility group box-1 (HMGB1) protein has been postulated to play a pathogenic role in severe sepsis. Histidine-rich glycoprotein (HRG), a 75 kDa plasma protein, was demonstrated to improve the survival rate of septic mice through the regulation of neutrophils and endothelium barrier function. As the relationship of HRG and HMGB1 remains poorly understood, we investigated the effects of HRG on HMGB1-mediated pathway in endothelial cells, focusing on the involvement of specific receptors for HRG. HRG potently inhibited the HMGB1 mobilization and effectively suppressed rHMGB1-induced inflammatory responses and expression of all three HMGB1 receptors in endothelial cells. Moreover, we first clarified that these protective effects of HRG on endothelial cells were mediated through C-type lectin domain family 1 member A (CLEC-1A) receptor. Thus, current study elucidates protective effects of HRG on vascular endothelial cells through inhibition of HMGB1-mediated pathways may contribute to the therapeutic effects of HRG on severe sepsis., Graphical Abstract, Highlights • HRG inhibited LPS-induced HMGB1 translocation and release from endothelial cells • HRG reduced inflammatory responses in endothelial cells caused by released HMGB1 • CLEC-1A was identified as the receptor for the function of HRG on endothelial cells, Molecular Biology; Cell Biology

Background Idiopathic pulmonary fibrosis (IPF) is the most frequent and severe form of idiopathic interstitial pneumonias. Although IPF has not been thought to be associated with bacterial communities, recent papers reported the possible role of microbiome composition in IPF. The roles of microbiomes in respiratory functions and as clinical biomarkers for IPF remain unknown. In this study, we aim to identify the relationship between the microbial environment in the lung and clinical findings. Methods Thirty-four subjects diagnosed with IPF were included in this analysis. The 16S rDNA was purified from bronchoalveolar lavage fluid obtained at the time of diagnosis and analyzed using next-generation sequencing techniques to characterize the bacterial communities. Furthermore, microbiomes from mice with bleomycin-induced lung fibrosis were analyzed. Results The most prevalent lung phyla were Firmicutes, Proteobacteria and Bacteroidetes. Decreased microbial diversity was found in patients with low forced vital capacity (FVC) and early mortality. Additionally, the diversity and relative abundance of Firmicutes, Streptococcaceae, and Veillonellaceae were significantly associated with FVC, 6-min walk distance, and serum surfactant protein D. Bleomycin-induced lung fibrosis resulted in decrease of diversity and alteration of microbiota in PCoA analysis. These results support the observations in human specimens. Conclusions This study identified relationships between specific taxa in BALF and clinical findings, which were also supported by experiments in a mouse model. Our data suggest the possibility that loss of microbial diversity is associated with disease activities of IPF. Electronic supplementary material The online version of this article (10.1186/s12931-018-0736-9) contains supplementary material, which is available to authorized users.

Impaired Diversity of the Lung Microbione Predicts Progression of Idiopathic pulmonary Fibrosis. Table S1. Overview of DNA sequencing data. Figure S1. Comparison of the total bacterial genes between the AE and non-AE groups. Figure S2. Rarefaction curves were calculated, which suggests that all expected OTUs have been obsreved. Figure S3. the concentration of SP-A in BALF correlates well with the relative abundance of Veillonellaceae, but not serum SP-A. Figure S4. The relative abundance of family Streptococcaceae also correlated with 6MWD. Figure S5. Histopathological assesment and BAL cell counts in mice with the bleomycin-induced lung fibrosis. (PDF 7772Â kb)

Background: Idiopathic pulmonary fibrosis (IPF) is a fatal pulmonary disease with poor prognosis. Pirfenidone, the first antifibrotic drug, suppresses the decline in forced vital capacity (FVC) and improves prognosis in some, but not all, patients with IPF; therefore, an indicator to predict the therapeutic effect of pirfenidone is desirable. Objectives: To clarify whether baseline parameters can be predictors of disease progression and long-term prognosis in patients with IPF treated with pirfenidone. Methods: We retrospectively investigated patients with IPF who started treatment with pirfenidone between December 2008 and November 2014 in our Hospital. Patients who were treated with pirfenidone for more than 6 months were enrolled in this study and were observed until November 2015. We investigated the relationship of clinical characteristics, pulmonary function test results, and blood examination results at the start of pirfenidone with the outcome of patients. Results: Sixty patients were included in this study. In multivariate logistic regression analysis, % predicted FVC and the serum surfactant protein (SP)-D level were predictors of a 10% or greater decline in FVC in the initial 12 months. In the Cox proportional hazards model, these two factors also predicted progression-free survival. Smoking status, % predicted diffusing capacity for carbon monoxide, and the SP-D level predicted overall survival. Conclusions: The serum SP-D level was an independent predictor of disease progression and prognosis in patients with IPF treated with pirfenidone. Thus, responders to pirfenidone can be defined more precisely by measuring the SP-D level.

Background: Idiopathic pulmonary fibrosis (IPF) is a well-known life threatening disease, which the progressive lung fibrosis leads to restrictive ventilatory impairment and diffusion failure. While IPF seems to be uncorrelated with infectious subjects, several papers indicated that microbiome composition correlates with progression of IPF. However, the roles of microbiome against respiratory functions and clinical biomarkers in IPF remain unknown. In this study, we examined the relationship between microbial environment in the lung and clinical findings. Methods: Subjects included in this analysis were IPF patients who visited Sapporo Medical University Hospital with approval of the hospital ethics board retrospectively. 16s rRNA were purified from bronchial alveolar lavage fluids obtained at the time of diagnosis and next generation sequencing techniques were used to characterize the bacterial communities. These data were compared with the clinical data of each patients. Results: As a result of sequencing, the most dominant lung phyla were Firmicutes, Proteobacteria and Bacteroidetes. The bacterial diversity was significantly lower in the unstable group, which the decline in forced vital capacity (FVC) was observed during a year. FVC are inversely proportional to the relative abundance of Firmicutes. Also, Streptococcuceae, the largest family OTU in a member of the Firmicutes, was significantly associated with FVC, 6-minute walk distance and serum KL-6. Conclusions: Our study revealed there were some relationships between specific taxa in BALF and clinical findings. Further study of lung microbiome may provide further insights into its possible contribution to IPF pathogenesis and new biomarker.

Background: Streptococcus pneumoniae infection is responsible for substantial mortality and morbidity among adults aged >65 years or those with underlying chronic or immunosuppressive conditions. Interstitial lung diseases (ILD) are severe respiratory diseases and sometimes develop severe respiratory infections. ILD patients treat using corticosteroid and immunosuppressive agents, however, it is unclear that the medication of ILD influences the response of pneumococcal vaccine. Objectives: We represent the effect of pneumococcal vaccines (PPSV23 and PCV13) against ILD patients under immunosuppressive treatment. Methods: ILD patients regularly followed at the outpatient in Sapporo Medical University Hospital and the patients without pulmonary diseases who visiting SANWA clinic were enrolled from Oct 1st 2014 to Sep 31th 2015. Sera were collected before, 4 weeks and 12 months after vaccination. Serotype-specific IgG concentrations against pneumococcal serotype 19F were measured by ELISA following WHO protocol. Results: IgG concentrations to serotype 19F were increased in all groups in response to vaccination. Both PCV13 and PPSV23 induced IgG concentrations in the first-time immunized patients. The response rates of ILD group were comparable with those of ILD under corticosteroid group. Only idiopathic pulmonary fibrosis (IPF) patients under corticosteroid therapy were significantly lower response. Conclusions: Following immunization with PCV13 and PPSV23, IgG concentrations were increased in ILD patients. Ongoing corticosteroid and/or immunosuppressive agent was not affected the antibody response to pneumococcal vaccination except IPF patients.

In the synthesis of dipeptides (Boc-AA1-AA2-OPac: AA1 and AA2 represent amino acids) protected by phenacyl (Pac) ester, amines and solid bases as the base for the conversion of the trifluoroacetic acid (TFA) salt of the amino component (TFA·H-AA2-OPac) into the corresponding free amino component (H-AA2-OPac) were examined. The synthesis of a dipeptide (Boc-Ala-Gly-OPac) using amines for the conversion afforded an unsatisfactory yield with by-products. On the other hand, the use of neutral alumina-supported Na2CO3 (Na2CO3/n-Al2O3) as a solid base for the conversion provided the dipeptide in a quantitative yield without by-products. The application of Na2CO3/n-Al2O3 to the synthesis of some dipeptides protected by Pac ester gave the desired peptides in excellent yields. Copyright © 2013 European Peptide Society and John Wiley & Sons, Ltd.

We have investigated polyketone (PK)/polyamide 6 (PA) polymer alloys having enhanced Charpy impact energy greater than that of polycarbonate (PC) as a result of moisture absorption. From the results of differential scanning calorimetry (DSC), Raman spectroscopy, and transmission electron microscope (TEM) observation of the polymer alloys, it was found that PK-rich and PA-rich phases exist at the nanometer level in the polymer alloys; however, a microscopic interaction phase formed between the two phases. 3D-TEM observations, electron energy loss spectroscopy, and small-angle X-ray scattering measurements revealed that a co-continuous nanolayer formed from the PA-rich phase and lamella network of the PK-rich phase. Moreover, the interaction and mobility of PK and PA molecular chains were investigated by using a 13C cross polarization/magic angle sample spinning NMR technique. It was found that moisture absorption markedly enhances the mobility of PA molecular chains in PK/PA alloys. This suggests that the wet (moisture-absorbed) PA phase of PK/PA alloys allows quick deformation upon impact stimulation. On the other hand, the results of Charpy impact tests showed that the total impact energy (Etotal) of the wet polymer alloy was much higher than that of the dry one. An examination of the load-displacement curves revealed that the wet samples showed a pronounced increase in displacement compared with the dry ones. From these results, it was concluded that the lamella network of the PK-rich phase sustains the maximum stress and that the large displacement of the PA-rich phase increases the impact energy. © 2010 Wiley Periodicals, Inc. J Appl Polym Sci, 2010

We have already represented that high impact mechanism of polyketone/polyamide alloy (PK/PA) is enhanced by the moisture absorption. It was thought the high impact mechanism depends on ductility caused by the moisture absorption of the alloy. This time we have investigated the nano-meter level phase separation structure of PK/PA alloys by using a TEM, an EELS and a 3D-TEM observation. It is found that the PK rich phase and the PA rich one form their co-continuous structure. Surprisingly, the three-dimensional lamella network structure is extended in the PK rich phase. Next, we have carried out SAXS measurements to evaluate lamella network structure. Moreover, the interaction and the mobility of PK and PA molecular chain of the wet and dry polymer alloy have been investigated by using solid-state high resolution NMR techniques. It was found that the moisture absorption enhances the molecular mobility of PA, and flexibility is given to the polymer alloy. The above-mentioned results revealed that the co-continuous structure and the higher-order structure are closely related to the impact properties.

Background Rehabilitation facilitates the reorganization of residual/regenerated neural pathways and is key in improving motor function following spinal cord injury. Neuromuscular electrical stimulation (NMES) has been reported as being clinically effective. Although it can be used after the acute phase post-injury, the optimal stimulation conditions to improve motor function remain unclear. In this paper, we examined the effectiveness of NMES with alternating currents in the kilohertz (kHz) frequency in gait rhythm stimulation therapy. Methods Tests were performed using 20 mature female Fischer rats. Incomplete spinal cord injuries (T9 level) were made with an IH impactor using a force of 150 kdyn, and NMES was administered for 3 days from the 7th day post-injury. The needle electrodes were inserted percutaneously near the motor point of each muscle in conscious rats, and each muscle on the left and right leg was stimulated for 15 min at two frequencies, 75 Hz and 8 kHz, to induce a gait rhythm. Motor function was evaluated using Basso, Beattie, Bresnahan (BBB) scores and three-dimensional (3D) gait analysis. Rats were divided into four groups (5 rats/group), including the NMES treatment 75-Hz group (iSCI-NMES 75 Hz), 8-kHz group (iSCI-NMES 8 kHz), injury control group (iSCI-NT), and normal group (Normal-CT), and were compared. Results There was no significant difference in BBB scores among the three groups. In 3D gait analysis, compared with the injury control group, the 8-kHz group showed a significant improvement in synergistic movement of both hindlimbs. Conclusion We suggest that kHz stimulation is effective in gait rhythm stimulation using NMES.

A polarization-maintained ultranarrow FBG filter with a linewidth of 1.3GHz has been successfully fabricated by using a 15cm-long phase mask. A maximum reflectance of 65% and a side lobe suppression of 13dB were obtained by employing an apodization technique with slits.

In the synthesis of dipeptides (Boc-AA(1)-AA(2)-OPac: AA(1) and AA(2) represent amino acids) protected by phenacyl (Pac) ester, amines and solid bases as the base for the conversion of the trifluoroacetic acid (TFA) salt of the amino component (TFA·H-AA(2)-OPac) into the corresponding free amino component (H-AA(2)-OPac) were examined. The synthesis of a dipeptide (Boc-Ala-Gly-OPac) using amines for the conversion afforded an unsatisfactory yield with by-products. On the other hand, the use of neutral alumina-supported Na(2) CO(3) (Na(2)CO(3) /n-Al(2)O(3)) as a solid base for the conversion provided the dipeptide in a quantitative yield without by-products. The application of Na(2)CO(3) /n-Al2 O3 to the synthesis of some dipeptides protected by Pac ester gave the desired peptides in excellent yields.

A 33-year-old woman with inappropriate secretion of TSH and a 2-mm pituitary microadenoma is described. She had a high serum free T4 concentration (31 pmol/L) with an inappropriately nonsuppressible serum TSH concentration (0.93 mU/L). The alpha/TSH molar ratio was 2.3 and magnetic resonance imaging with gadolinium enhancement identified an area of low signal intensity in the left lateral pituitary gland. However, TSH secretion was not completely autonomous. There was a significant response to exogenous TRH stimulation and suppression by T3 administration. Therefore, it was difficult to rule out a nonfunctioning pituitary adenoma with concomitant pituitary selective thyroid hormone resistance syndrome. A 2-mm microadenoma was excised via transsphenoidal surgery. The tumor cells were immunoreactive to antisera to alpha-subunit and minimally immunoreactive to antisera to TSHbeta. The patient's thyroid function normalized after surgery without medication. Because the adenoma could become large and intractable if the patient was treated inadequately, early diagnosis and treatment are important in patients with TSH secreting adenomas.

In order to improve rotor-impeller suspension performance of the developing ventricular assist device, axial magnetic bearing with various permanent magnet arrangements are designed and fabricated. Separate permanent magnets type stator shows wide linear range and improved force characteristics.

We propose a new optimization method of a hologram to improve a uniformity of the diffraction peaks in holographic femtosecond laser processing. The hologram is optimized on the basis of a second-harmonic pattern.

In this paper we propose an algorithm, which is an improvement of identification of web communities by [1], to extract research communities from bibliography data. Web graph is huge graph structure consisting nodes and edges, which represent web pages and hyperlinks. An web community is considered to be a set of web pages holding a common topic, in other words, it is a dense subgraph of web graph. Such subgraphs obtained by the max-flow algorithm [1] are called max-flow communities . We then improve this algorithm by introducing the strategy for selection of community nodes. The effectiveness of our improvement is shown by experiments on finding research communities from CiteSeer bibliography data.

We report a polarization-maintaining λ/4-shifted DFB Er-doped fiber laser with a ring cavity configuration. A linewidth as narrow as 6 kHz and relaxation-oscillation-free noise characteristics are achieved with a ring cavity length of 57 m.

In order to investigate the mechanism of deposition of the complement membrane attack complex (MAC) in cardiomyocytes in areas of human myocardial infarction, the 20 kDA homologous restriction factor of complement (HRF20; CD59) and complement components (C1q, C3d and MAC) were analysed immunohistochemically using specific antibodies. Myocardial tissues obtained at autopsy from nine patients who died of acute myocardial infarction were fixed in acetone and embedded in paraffin. The ages of the infarcts ranged from about 3.5 h to 12 days. In cases of myocardial infarction of 20 h or less, MAC deposition was shown in the infarcted cardiomyocytes without loss of HRF20. Where the duration was 4 days or more, the cardiomyocytes with MAC deposition in the infarcted areas also showed complete loss of HRF20. Outside the infarcts, HRF20 in the cardiomyocytes was well preserved without MAC deposition. The present study suggests that the initial MAC deposition in dead cardiomyocytes can occur as a result of degradation of plasma-membrane by a mechanism independent of complement-mediated injury to the membrane. Loss of HRF20 from dead cardiomyocytes may not be the initial cause of MAC deposition, but may accelerate the deposition process of MAC in later stages of infarction.

This paper describes the development and the characterization of a Li+ optical sensor (optode) based on a Li+ selective fluoroionophore (KBL-01-Si), immobilized to a mesoporous silica thin film. KBL-01-Si was synthesized by the formation of a urethane bond between the hydroxyl terminated alkoxy chain of KBL-01 and 3-isocyanatopropyl-triethoxysilane. Li+ optodes with different amounts of KBL-01-Si fluoroionophore were fabricated by changing the grafting time of KBL-01-Si to mesoporous silica thin films with two different pore sizes. When the concentration of KBL-01-Si immobilized to the pore surface of the mesoporous silica thin films was low, response curves following a theoretical 1 : 1 complex formation equilibrium with binding constants for Li+ (log K) between 4.38 and 5.04 were observed. At higher concentrations of immobilized fluoroionophore, the response curves deviated from the fitting curve based on a theoretical chemical equilibrium, and the dynamic response was extended over a broad range from 10−6 to 1 M. In addition, it was observed by XPS depth profiling that KBL-01-Si was mainly localized on pore surface areas close to the channel entrances. These results indicate that not only the design of the fluoroionophore, but also the matrix for immobilization, and the microscale distribution of the fluoroionophore affect the characteristics of an ion sensor.

not Available.