A 45-year-old man who had received his second mRNA COVID-19 vaccination one week earlier was presented to the emergency department with chest discomfort. Therefore, we suspected post-vaccination ...myocarditis; however, the patient showed no signs of myocarditis. After 2 weeks, he revisited the hospital complaining of palpitations, hand tremors, and weight loss. The patient exhibited high free thyroxine (FT4) (6.42 ng/dL), low thyroid-stimulating hormone (TSH) (<0.01 μIU/mL), and high TSH receptor antibody (17.5 IU/L) levels, and was diagnosed with Graves' disease. Thiamazole was administered, and the patient's FT4 levels normalized after 30 days. One year later, the patient's FT4 is stable; however, their TSH receptor antibodies have not become negative and thiamazole has continued. This is the first case report to follow the course of Graves' disease one year after mRNA COVID-19 vaccination.
Tensile shear tests and fatigue tests were performed for dissimilar joints of steels and aluminum alloys fabricated by Dimple Spot Welding (DSW), which is a novel method for dissimilar metal joining. ...In the tensile shear tests, two failure modes of DSW joints were observed, and the tensile shear strength was affected by the strength of base metals. In fatigue tests, failure mode was fretting fatigue, and the fatigue life was not simply determined by the strength of base metals. The both tensile shear strength and fatigue strength were higher in the DSW joint compared with the Self-Pierce Riveting joint.
We report a case of vasospastic angina (VSA) following COVID-19 mRNA vaccination. Despite the widespread occurrence of myocarditis, there have been few reports of post-vaccinal VSA. A 41-year-old ...male patient was referred for chest pain at rest following mRNA vaccination; he had never experienced chest pain prior to vaccination. He was diagnosed by an acetylcholine (Ach) provocation test that showed multivessel vasospasm. After the initiation of treatment with a calcium channel blocker and nitrate, no further exacerbation of chest pain was observed. To our knowledge, this constitutes the first reported case of VSA proven by Ach provocation test after COVID-19 vaccination. The vaccination may increase coronary artery spasticity. VSA should be ruled out in post-vaccine new onset resting chest pain.
Polypharmacy（PP）is associated with an increased risk of adverse drug reactions. In Rheumatoid arthritis（RA）patients, the combination with symptomatic treatment drugs in addition to anti-rheumatic ...drugs is the factor of PP. We investigated PP using a guideline, and the relationship between PP and the kind of drugs in RA. Outpatients at our hospital were retrospectively analyzed using information in electronic medical records. The study included 77 patients with RA aged > 75 years who were being treated with methotrexate（MTX）. We found that the number of drugs was < 5 in 48 patients, 6-9 in 13 patients, and ≥ 10 in 16 patients. The percentages of the drugs requiring careful prescription were 52%, 84% and 100% in each group. The prescription rates of drug are prednisolone（PSL）36%, non-steroidal anti-inflammatory drugs 53%, folic acid 73%, disease modifying anti-rheumatic drugs 9%, and biologics 13%. PP was correlated with the use of supportive care drugs for the prevention of side effects from MTX and PSL. Our data suggest that PP is common in RA patients, and that it is necessary. We pharmacists should monitor the proper use of therapeutic agents based on the guideline. Moreover, early diagnosis and early treatment of RA is necessary for avoidance of the duration of long-term PSL use，and pharmaceutical intervention is also important for that.
Abstract The expulsion of the gastrointestinal parasite Vampirolepis nana was examined in different mouse strains and in immunosuppressed mice infected to different degrees with eggs and ...cysticercoids. To investigate the immunological mechanism that regulates expulsion, surface-bound mouse immunoglobulins were examined on adult worms. The time to spontaneous expulsion of worms was dependent on strain (C57BL, BDF1 , B6C3F1 < BALB/c < CBA < DBA/2 < C3H; all male mice) and on the degree of infection. In mice given immunosuppressants, the expulsion of worms was prevented completely. Immunoenzyme methods showed that IgA was the only detectable surface-bound antibody found on worms obtained from the intestines of mice of various strains throughout the course of infection. There was no evidence of surface-bound immunoglobulins on adult worms obtained from immunosuppressed mice. There was a good temporal correlation between the time-course of expulsion and the appearance of IgA. The data suggest that the expulsion of V. nana is closely associated with the appearance of parasite-specific IgA.
Blastocystis hominis, a parasite of the human intestine, has recently been positioned within stramenopiles by the small subunit rRNA phylogeny. To further confirm its phylogenetic position using ...multiple molecular sequence data, we determined the nucleotide sequences putatively encoding small subunit ribosomal RNA, cytosolic-type 70-kDa heat shock protein, translation elongation factor 2, and the non-catalytic ‘B’ subunit of vacuolar ATPase of B. hominis (HE87–1 strain). Moreover, we determined the translation elongation factor 2 sequence of an apicomplexan parasite, Plasmodium falciparum, that belongs to alveolates. The maximum likelihood analyses of small subunit rRNA and cytosolic-type 70-kDa heat shock protein clearly demonstrated that B. hominis (HE87–1 strain) is positioned within stramenopiles, being congruent with the previous small subunit rRNA analysis, including the sequences of B. hominis (Nand strain) and a Blastocystis isolate from guinea pig. Although no clear resolution among major eukaryotic groups was obtained by the individual phylogenies based on the four molecules analyzed here, a combined analysis of various molecules, including these, clearly indicated that Blastocystis/stramenopiles are the closest relatives of alveolates.
Recently, a new dissimilar mechanical joining method, dimple spot welding (DSW), has been developed for joining steel sheets and aluminum alloys. In this study, tensile shear tests and fatigue tests ...were conducted on four types of dissimilar lap joints, with two types of steel sheets and two types of Al alloys joined by DSW. Both the tensile shear strength and fatigue strength of DSW joints were found equal to or greater than those of a self‐piercing riveting (SPR) joint. In all four types of DSW joints, fatigue cracks were initiated from the Al alloy and were associated with fretting induced by repeated contact and friction. A finite element analysis showed that the tangential stress was mainly governed by the friction coefficient and also affected by the steel sheet strength. Higher‐strength steel led to lower tangential stress, resulting in a longer fatigue life for the DSW joint.
Highlights
A dimple spot welding (DSW) is developed for joining steel sheets and aluminum alloys.
Tensile shear tests and fatigue tests are conducted on DSW joints and SPR joint.
DSW joints shows greater tensile shear strength and longer fatigue lives than SPR joint.
Fatigue cracks in DSW joints were initiated associated with fretting.
Non-traumatic osteonecrosis of the femoral head (ONF) is considered to be a disease that occurs primarily due to ischemia of the femoral head, while its etiology and pathology are not fully ...understood. It is therefore necessary to identify the characteristics of the hemodynamics of the femoral head. In this study, the hemodynamics in the ilium and proximal regions of the femur, including the femoral head, was investigated using positron emission tomography (PET).
The subjects of this study consisted of 8 hip joints of four healthy male adults and 3 hip joints on the contralateral side of a femoral neck fracture, avulsion fracture of the greater trochanter and coxarthrosis (1 case each, all females) for a total of 11 hip joints of 7 subjects. The ages of the subjects ranged from 25 to 87 years (average age: 54 years). Blood flow was measured by means of the H215O dynamic study method and blood volume was measured by means of the 15O-labeled carbon monoxide bolus inhalation method.
Blood flow was determined to be 9.1 +/- 4.8 ml/min/100 g in the ilium and among proximal regions of the femur (femoral head, neck and intertrochanteric region), 1.8 +/- 0.7 ml/min/100 g in the femoral head, 2.1 +/- 0.6 ml/min/100 g in the femoral neck, and 2.6 +/- 0.7 ml/min/100 g in the intertrochanteric region. In addition, blood volume was 4.7 +/- 1.3 ml/100 g in the ilium, and among proximal regions of the femur, 1.1 +/- 0.5 ml/100 g in the femoral head, 2.1 +/- 0.7 ml/100 g in the femoral neck, and 2.6 +/- 0.9 ml/100 g in the intertrochanteric region. The results showed that both blood flow and volume were lowest in the femoral head. Blood flow and volume were significantly lower in the proximal regions of the femur (femoral head, neck and intertrochanteric region) than in the ilium (p < 0.01).
The present study demonstrated that the femoral head is in a hypoemic state as compared with other osseous tissue, indicating that even the slightest exacerbation of hemodynamics in the femoral head can trigger an ischemic condition culminating in ONF.
This paper presents the application, technology and design of recent Flexible AC Transmission System (FACTS) projects in the USA, including a brief overview of three case study examples that describe ...recent FACTS applications. Renewable integration, generation retirement, and applied system reliability standards to the U. S. transmission system are currently the primary drivers for most applications.
