Background and purpose
Many epidemiological studies of Guillain−Barré syndrome (GBS) and Fisher syndrome (FS) have been conducted in Europe and America. In contrast, epidemiological studies are rare ...in Asia where the GBS subtypes differ from those in Western countries. This study was undertaken to clarify the incidence of GBS and FS in a local area in Japan as well as their seasonal trends.
Method
Seventy‐one GBS and 37 FS patients were recorded from 2006 to 2015 in an area of approximately 1.5 million inhabitants in Japan. The incidence, seasonal trends and clinical features of GBS and FS were examined.
Results
The incidence rate of GBS was 0.42 cases per 100 000 person‐years and that of FS was 0.22 cases per 100 000 person‐years. The incidence of GBS increased with age and FS affected predominantly patients aged from 45 to 64 years old. There was some seasonal clustering of acute motor axonal neuropathy (AMAN) and FS in spring and summer, but it was not significant. AMAN and FS patients had a high frequency of preceding infection (AMAN, 68% gastrointestinal infection; FS, 65% upper respiratory infection). Antecedent respiratory infection was significantly associated with FS as an outcome. Serum antibodies to ganglioside GM1 were detected in 71% of AMAN patients and antibodies to GQ1b were detected in 81% of FS patients.
Conclusions
Our study offers evidence of a lower incidence of GBS and a higher incidence of FS in a local area in Japan than in Western countries.
Abstract
Background
It is unclear how cricoid pressure affects tracheal intubation with the Pentax-AWS Airwayscope
®
(AWS). We conducted a prospective randomized clinical trial in anaesthetized ...patients.
Methods
Sixty patients were allocated to either the cricoid pressure (CP) group (
n
=30) or the sham group (
n
=30). We compared the two groups with regard to intubation time, number of attempts required for insertion of the Intlock blade (disposable blade of the AWS) and tracheal intubation, percentage of glottic opening (POGO) score, and subjective difficulty of both laryngoscopy and passage of a tube through the glottis.
Results
Intubation time was significantly longer in the CP group (
median
45
IQR
40–59 s) than in the sham group (3228–45 s) (
P
=0.003, 95% CI for median difference 5–24 s). The number required for insertion of the Intlock blade did not differ between the groups (
P
=0.08), but the number for tracheal intubation was significantly higher in the CP group (1 attempt in 14 patients, 2 in 7, 3 in 9) than in the sham group (1 attempt in 24 patients, 2 in 6;
P
=0.002). POGO score did not differ significantly between the groups (
P
=0.60), nor did the subjective difficulty of laryngoscopy (
P
=0.06). The visual analogue scale score for passage of a tube through the glottis was significantly higher in the CP group than in the sham group
(P
<0.001).
Conclusions
Cricoid pressure impedes tracheal intubation using the AWS, and is associated with longer intubation time, which can be attributed to increased difficulty in the passage of a tube through the glottis.
Clinical Trial registry number
UMIN000018209.
•We study crystal structure of higher manganese silicide (HMS) at high temperature.•The amount of secondary MnSi phase exceeds that of HMS phase above ∼1133 K.•Thermal expansion coefficients are ...almost the same as some typical metals.•(3+1)-Dimensional superspace approach reveals compositional change of HMS.•The Si composition γ decreases with temperature above 773 K.
The (3+1)-dimensional crystal structure of a higher manganese silicide (MnSiγ) phase is revealed using in situ high temperature powder X-ray diffraction (XRD) above room temperature. The compound consists of two tetragonal subsystems of Mn and Si with an irrational c-axis ratio γ=cMn/cSi. The in situ XRD results show that the MnSiγ phase is stable, in a vacuum of ∼1 Pa, up to 1093 K and partially decomposes into the monosilicide (MnSi) phase with further increase in temperature. Refined a- and cMn-axis lengths increase linearly and the thermal expansion coefficients are comparable with those of typical metallic electrode materials. In contrast, cSi-axis length changes its increment against temperature at TBD ∼773 K. As a result, the temperature dependence of γ starts to decrease gradually above TBD, from 1.7387(1) (at 773 K) to 1.7244(1) (at 1173 K). This finding implies that the MnSiγ phase consecutively changes its irrational composition above TBD, a typical temperature where the silicides exhibit a maximum figure-of-merit. An increase in hole carrier concentration is expected according to the valence electron counting concept. Although the nearest Mn–Mn and Mn–Si distances increase monotonically with temperature, the nearest Si–Si distance much increases by ∼0.05 Åfrom 2.439(4) Åat 773 K to 2.493(7) Åat 1173 K. The latter increase is considered to be caused by the introduction of excited electron carriers into the anti-bonding orbital, due to the bipolar diffusion (BD).
Circulating tumour DNA (ctDNA) is an emerging candidate biomarker for malignancies and may be useful for monitoring the disease status of gastric cancer.
We performed targeted deep sequencing of ...plasma cell-free DNA (cfDNA) by massively parallel sequencing in patients with tumours harbouring TP53 mutations. The quantitative values of TP53-ctDNA during the clinical course were compared with the tumour status.
Three out of ten patients with TP53 mutations in primary tumours showed detectable TP53 mutation levels in preoperative cfDNA. Although the cfDNA concentrations were not always reflective of the disease course, the ctDNA fraction correlated with the disease status.
ctDNA may serve as a useful biomarker to monitor gastric cancer progression and residual disease.
We report the evolution of the mixing state of black carbon (BC) particles in urban plumes measured by an airborne single particle soot photometer. The aircraft observations were conducted over the ...ocean near the coast of Japan in March 2004. The number fraction of coated BC particles with a core diameter of 180 nm increased from 0.35 to 0.63 within 12 hours (h), namely 2.3% h−1, after being emitted from the Nagoya urban area in Japan. BC particles with a core diameter of 250 nm increased at the slower rate of 1.0% h−1. The increase in coated BC particles was associated with increases in non‐sea salt sulfate and water‐soluble organic carbon by a factor of approximately two, indicating that these compounds contributed to the coating on the BC particles. These results give direct evidence that BC particles become internally mixed on a time scale of 12 h in urban plumes.
Semicontinuous measurements of submicron water‐soluble organic carbon (WSOC) aerosol were made simultaneously with organic carbon (OC) and elemental carbon (EC) in the Tokyo urban area in winter, ...summer, and fall 2004. The measurements of WSOC and OC/EC were made every 6 min and 1 hour, respectively, using a particle‐into‐liquid sampler (PILS) with a total organic carbon (TOC) analyzer and with an EC‐OC analyzer using a thermal‐optical technique. The PILS and 12‐hour integrated filter measurements of WSOC agreed to within 12%. The WSOC mass concentrations and WSOC/OC ratio showed diurnal variations with peaks at 1200–1400 LT in summer and later in the afternoon in winter. On average, the WSOC/OC ratio was 0.20 and 0.35 μg C/μg C for winter and summer/late fall, respectively. The difference in the winter and summer frequency distributions of the WSOC/OC ratio suggests that the sampled air masses in summer and fall were more photochemically processed than those in winter. Secondary organic carbon (SOC) concentrations were estimated using the EC‐tracer method. The measured WSOC was highly correlated with the derived SOC (r2 = 0.61–0.79), with WSOC/SOC slopes of 0.67 to 0.75 μg C/μg C for each season. These results suggest that the WSOC and SOC were similar in their chemical characteristics in this study. Water‐insoluble organic carbon (WIOC) ( = OC–WSOC) correlated well with EC and CO (r2 = 0.59–0.73). The diurnally averaged WIOC/EC ratios were nearly constant (1.1 ± 0.1 μg C/μg C) throughout the study periods, suggesting that motor vehicle emissions were an important source of WIOC. A dominant portion (about 90% or more) of the POC was water‐insoluble, consistent with previous studies of POC.
We conducted simultaneous measurements of concentrations and above-canopy fluxes of isoprene and α-pinene, along with their oxidation products in aerosols in a Larix kaempferi (Japanese larch) forest ...in summer 2012. Vertical profiles of isoprene showed the maximum concentration near the forest floor with a peak around noon, whereas oxidation products of isoprene, i.e., methacrolein (MACR) and methyl vinyl ketone (MVK), showed higher concentrations near the canopy level of the forest. The vertical profile suggests large emissions of isoprene near the forest floor, likely due to Dryopteris crassirhizoma (a fern species), and the subsequent reaction within the canopy. The concentrations of α-pinene also showed highest values near the forest floor, with maximums in the early morning and late afternoon. The vertical profiles of α-pinene suggest its large emissions from soil and litter in addition to emissions from L. kaempferi leaves at the forest site. Isoprene and its oxidation products in aerosols exhibited similar diurnal variations within the forest canopy, providing evidence of secondary organic aerosol (SOA) formation via oxidation of isoprene most likely emitted from the forest floor. Although high abundance of α-pinene was observed in the morning, its oxidation products in aerosols showed peaks in daytime, due to a time lag between the emission and atmospheric reactions of α-pinene to form SOA. Positive matrix factorization (PMF) analysis indicated that anthropogenic influence is the most important factor contributing to the elevated concentrations of molecular oxidation products of isoprene- (> 64 %) and α-pinene-derived SOA (> 57 %). The combination of the measured fluxes and vertical profiles of biogenic volatile organic compounds (BVOCs) suggests that the inflow of anthropogenic precursors/aerosols likely enhanced the formation of both isoprene SOA and α-pinene SOA within the forest canopy even when the BVOC flux was relatively low. This study highlights the importance of intra-canopy processes that promote biogenic SOA formation in the presence of significant inflow of oxidants together with anthropogenic aerosols and their precursors.
One of the most used plastics in the world is poly(ethylene terephthalate), PET, which is on the top of the list of recyclable polymers. In this work, it was studied the chemical recycling of PET by ...the alcoholysis reaction using diethylene glycol (DEG) and sodium metasilicate (NaMs) as catalyst. This catalyst was not used before for this kind of reaction and showed an activity as good as the most used compound (zinc acetate). The PET‐polyol was produced with the reaction conditions that showed the higher weight yield and the final product was used in polyurethane (PU) adhesives compositions. The PUs were obtained using PET‐polyol, tolylene diisocyanate (10, 20 or 30% NCOfree) and DEG as chain extender or glycerin (GLY) as crosslinker. The adhesives were poured into Pinus taeda wood and the speciments were taken into mechanical properties evaluation accordingly to ASTM D 2339‐98. The results indicated that the PU adhesives 10% NCOfree with DEG were able to support the highest shear stress force applied (7.5 Mpa).
A high complete remission (CR) rate has been reported in newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) following imatinib-based therapy. However, the overall ...effect of imatinib on the outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) is undetermined. Between 2002 and 2005, 100 newly diagnosed adult patients with Ph+ALL were registered to a phase II study of imatinib-combined chemotherapy (Japan Adult Leukemia Study Group Ph+ALL202 study) and 97 patients achieved CR. We compared clinical outcomes of 51 patients who received allo-HSCT in their first CR (imatinib cohort) with those of 122 historical control patients in the pre-imatinib era (pre-imatinib cohort). The probability of overall survival at 3 years after allo-HSCT was 65% (95% confidence interval (CI), 49-78%) for the imatinib cohort and 44% (95% CI, 35-52%) for the pre-imatinib cohort. Multivariate analysis confirmed that this difference was statistically significant (adjusted hazard ratio, 0.44, P=0.005). Favorable outcomes of the imatinib cohort were also observed for disease-free survival (P=0.007) and relapse (P=0.002), but not for non-relapse mortality (P=0.265). Imatinib-based therapy is a potentially useful strategy for newly diagnosed patients with Ph+ALL, not only providing them more chance to receive allo-HSCT, but also improving the outcome of allo-HSCT.
The safety and efficacy profile of caspofungin and micafungin in Japanese patients with fungal infections were directly compared in this prospective, randomized, double-blind study. The proportion of ...patients who developed significant drug-related adverse event(s) (defined as a serious drug-related adverse event or a drug-related adverse event leading to study therapy discontinuation) was compared in 120 patients caspofungin 50 mg, or 50 mg following a 70-mg loading dose on Day 1 (hereinafter, 70/50 mg) group: 60 patients; micafungin 150 mg: 60 patients. The overall response rate was primarily evaluated in the per-protocol set (PPS) population. The proportion of patients who developed significant drug-related adverse events was 5.0 % (3/60) in the caspofungin group and 10.0 % (6/60) in the micafungin group 95 % confidence interval (CI) for the difference: −15.9 %, 5.2 %. The favorable overall response in the PPS population for patients with esophageal candidiasis, invasive candidiasis, and chronic pulmonary aspergillosis including aspergilloma was 100.0 % (6/6), 100.0 % (3/3), and 46.7 % (14/30) in the caspofungin group, and 83.3 % (5/6), 100.0 % (1/1), and 42.4 % (14/33) in the micafungin group, respectively. In Japanese patients with
Candida
or
Aspergillus
infections, there was no statistical difference in the safety between caspofungin and micafungin. Consistent with other data on these two agents, the efficacy of caspofungin and micafungin was similar.
PDF
