From late March through April 2021, we experienced a cluster of patients with COVID-19, named “Cluster K”, with rapid severe illness compared with those who were infected before.
Patients with ...COVID-19 who were enrolled in this study were divided into two groups: 66 patients from November 2020 to March 2021 (group A) and 37 patients whose infection links were traced from Cluster K (group B). The primary outcome was mortality rate, and the secondary outcome was maximal oxygen flow rate as the severity of the disease. Viral genome sequences were compared between the two groups.
Mortality rates were 6.1% in group A and 16.2% in group B (odds ratio: 2.97, 95% confidence interval: 0.65–15.38). The patients in group B required high oxygen flow rate (O2 ≥10 l/min) in the earlier clinical course (P = 0.029). Viral genome sequences revealed five amino acid mutations; of these, four were found on three nonstructural proteins (NSPs): one in nsp3 and nsp15, two in nsp6 (one of them is near the potential sites under positive selective pressure). Another one was on the S protein.
This study suggests that mutations in NSPs, especially nsp6, are associated with adverse clinical outcome in patients with COVID-19.
White noise obtained as the chaotic oscillations in a phase-locked loop (PLL) in which the dynamics is compatible with that of a Josephson junction is studied experimentally. Focusing on an analogy ...between the PLL and the washboard model, several types of signals to drive the PLL are examined, and the driving frequency dependence of the appearance of unbounded chaotic oscillations closely related to the white noise is investigated. Consequently, it is considered that the washboard structure in the dynamics of the PLL dominates the white noise generation, and the mathematical function of the driving signal affects its parameter dependence. The frequency characteristics of power spectrum dependence of the power spectrum of the chaotic oscillation in the high frequency region is also discussed. Moreover, a frequency modulated driving signal seems to remarkably broaden the parameter region where the white noise is obtained if compare with periodic driving signals.
Immunoglobulin G4- (IgG4-) related inflammatory abdominal aortic aneurysm (AAA) has been recognized as a manifestation of IgG4-related disease (IgG4-RD). We experienced one patient with multiple ...consecutive manifestations before and after endovascular stent grafting for IgG4-related inflammatory AAA (IAAA). A 71-year-old man was diagnosed with IgG4-RD due to increased IgG4 serum concentration, typical findings of parotid gland biopsy, and periaortitis in another hospital 2 years and 7 months before visiting our hospital. He came to our hospital because of abdominal pain and IAAA. He developed paraplegia after hospitalization and underwent endovascular stent grafting for the IAAA. About one month after stent grafting, he developed perforation of the sigmoid colon due to enteritis. He also had myocardial infarction. Finally, he died of intestinal bleeding. Here, we describe this case with rare, multiple, consecutive manifestations of IgG4-RD, some of which might be caused by IgG4-related IAAA or side effects of treatments rather than by IgG4-RD itself. We report this case because the clinical course seemed rare for IgG4-RD or IgG4-related IAAA. For treating IgG4-RD with IgG4-related IAAA, we should consider factors causing the symptoms and carefully select the proper treatment.
Pseudoaneurysm of the cystic artery is a rare complication of cholecystitis. 34 cases have been reported from 1976 to 2012, searched on MEDLINE and most of the cases have presented with ...gastrointestinal bleeding. We report the third case of an unruptured pseudoaneurysm of the cystic artery associated with calculous cholecystitis. An 85-year-old female presented to the emergency unit with epigastric pain and jaundice. Laboratory data and contrast-enhanced computed tomography (CT) revealed calculous cholecystitis and Mirizzi syndrome accompanied by a pseudoaneurysm in the gallbladder. Color Doppler ultrasonography (US) clearly demonstrated the pulsatile pseudoaneurysm. After biliary drainage and antimicrobial therapy, selective hepatic angiography with the aim of providing transcatheter arterial embolization was performed but the pseudoaneurysm had already thrombosed spontaneously. Open cholecystectomy was successfully carried out. Histological specimens demonstrated the pseudoaneurysm with organized thrombus in the epithelial wall of the gallbladder thickened with severe fibrosis. It is suggested that cholecystitis with unusual symptoms such as gastrointestinal bleeding requires immediate enhanced CT and US with Doppler imaging in order not to overlook a rare but life-threatening pseudoaneurysm.
Dominantly inherited, late‐onset pure cerebellar ataxia is a group of genetically heterogeneous neurodegenerative disorders. Approximately half of these disorders in the Japanese population are ...caused by moderate expansion of a CAG repeat in the coding region of the CACNA1A gene on chromosome 19p13 (SCA6). However, neither the loci nor the specific mutations for the remaining disorders have been determined. We performed systematic linkage analysis in a three‐generation Japanese family with a locus or mutation that differed from those of known spinocerebellar ataxias. The family members with a late onset (≥39 years old) exhibited pure cerebellar ataxia, whereas those with an early onset (≤27 years old) first showed intermittent axial myoclonus followed by ataxia. Other neurological signs were sparse, and neuroimaging studies revealed that atrophy was confined to the cerebellum. Multipoint analysis and haplotype reconstruction ultimately traced this novel spinocerebellar ataxia locus (SCA14) to a 10.2‐cM interval flanked by D19S206 and D19S605 on chromosome 19q13.4‐qter (Zmax = 4.08, corrected for age‐dependent penetrance). Ann Neurol 2000;48:156–163
We have developed wire-grid polarizers with low reflectivity in the visible region. The polarizers consist of a bilayered structure of an absorptive layer and a (transparent) gap layer on ...sub-wavelength pitch gratings made of aluminum. The bilayered structure functions as a highly effective antireflection coating for wire-grid with high reflectance. In order to realize these multilayered wire-grid, the glancing angle deposition technique was used to deposit the absorptive layer just above the Al wire-grid covered with the SiO2 gap layer. Both low reflectance and high transmittance in the desired wavelength range were achieved by optimizing the thickness of each layer.
Evaluation of malignancy using Ki-67 labeling index for gastric stromal tumor Nagasako, Yoshihide; Misawa, Kazuhito; Kohashi, Shigechika ...
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association,
09/2003, Letnik:
6, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Assessment of malignant potential in gastrointestinal stromal tumors (GISTs) is still problematic. The maximum tumor diameter and the mitotic index are generally used as an index of malignancy of ...GISTs. The Ki-67 labeling index has recently been used as an index of cell growth, and the prognosis of GISTs was reported to be significantly poor when the value of this index was 10% or higher.
Clinicopathological and immunohistological factors were analyzed in 15 patients who underwent surgical resection of gastric stromal tumors at our department between April 1997 and July 2002. The patients were divided into "metastasis/recurrence" and "benign" groups. Also, the relationship of changes in the Ki-67 labeling index to the degree of malignancy in recurrent lesions was assessed in an 84-year-old woman who underwent five reoperations because of recurrences in the peritoneum.
Significant differences were noted between the metastasis/recurrence and benign groups in relation to the mean maximum tumor diameter (186.7 +/- 80.8 mm vs 41.3 +/- 22.9 mm), mitotic index (88.3 +/- 5.0/50 high-power fields HPF vs 3.0 +/- 2.9/50 HPF), and the Ki-67 labeling index (11.4 +/- 2.5% vs 0.01 +/- 0.51%). In the patient who had metastasis to the liver 3.5 years after initial operation and underwent five reoperations before death, the intervals until detection of recurrence tended to be shortened gradually. The Ki-67 labeling index varied with each operation, and tended to be higher at the time of reoperations than at the initial operation.
The maximum tumor diameter, mitotic index, and Ki-67 labeling index were useful as an index of malignancy for gastric stromal tumor. The efficacy of surgical resection alone may be insufficient in patients with disseminated metastasis to the peritoneum.
In this study, the consolidated and undrained triaxial compression tests were conducted on relatively low strength slag-clay mixtures with low addition rate, and the results were evaluated and ...discussed together with the triaxial compression properties of the base material clay. The main characteristics obtained were as follows: i) the isotropic consolidation property of the slag-clay mixtures is the existence of consolidation yield stress as with the compressive property of ordinary clays; ii) the ratio of consolidation yield stress to uniaxial compressive strength for slag-clay mixture is 1.4, which is slightly larger than 1.2 for clay; iii) normalizing the relationship between the differential stress and the consolidation pressure by the consolidation yield stress, a failure line with a different slope can be drawn between the overconsolidation and normal consolidation regions; iv) the failure line in the normal consolidation regions is higher than that of the original clay.
In this study, the effects of loading conditions of overburden pressure during curing of clayey soil mixed with steelmaking slag on the dry density and shear strength development were investigated. ...The results show that the later the final overburden pressure acts, the smaller the consolidation settlement and the smaller the dry density. It was found, however, that at 28 days of age, even at such small dry densities, the shear strength due to solidification was dependent on the magnitude of the final overburden pressure. However, the earlier the final overburden pressure is reached, the earlier the increase in shear strength is expected to occur.
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