The efficacy of diaphragmatic plication (DP) has been proven in many studies. However, there are few reports on DP for patients with severe respiratory conditions requiring mechanical ventilation. ...The study aim was to demonstrate the efficacy of DP for patients with severe respiratory insufficiency after cardiothoracic surgeries.
We retrospectively reviewed 10 patients who underwent DP for severe respiratory insufficiency due to postoperative diaphragmatic paralysis; eight of them required mechanical ventilation, and two needed high-flow oxygen therapy prior to DP. The symptoms, lung function, and elevation of the diaphragm were assessed before and after DP.
All patients were successfully withdrawn from mechanical ventilation after DP and discharged without the need for oxygen therapy. The mean perioperative Medical Research Council (MRC) dyspnea scale (ATS/ERS 2004) score improved in 30 days (from 4 to 1.8) and in 90 days (from 4 to 0.6) after DP. Lung dynamic compliance was also ameliorated (mean improvement: 41.9 to 60.7 mL/cmH2O). Radiography revealed improved elevation of the diaphragm (mean improvement of 1.8 intercostal spaces, range, 1-2). Mean hospital stay after DP was 65.5 days (range, 25-187 days). One patient who underwent DP with endostapler-only suturing required re-operation because of staple line ruptures.
DP was found to be an effective form of treatment for patients with severe respiratory insufficiency after cardiothoracic surgery.
Background/Aims: We applied a back light system (BLS) with a magnifying glass to improve the ability to assess the adequacy of specimen sampling using endosonography. We conducted this study to ...evaluate the efficacy of the BLS in sampling of specimens by endoscopic ultrasound-guided fine needle aspiration of solid pancreatic masses.
Methods: This was a prospective, randomized, crossover, single-center clinical trial. An endosonographer evaluated adequacy on gross visual inspection and identified whitish specimen sampling sites with and without the BLS according to a randomization sequence in the first and second passes with a 25-G needle. On cytological evaluation, the presence of well-defined pancreatic ductal epithelium was evaluated by a cytopathologist who was blinded to any clinical information.
Results: A total of 80 consecutive patients were eligible during the study period. Adequacy was observed for 52 specimens (65%) with the BLS and 54 (68%) without the BLS (p=0.88). In assessment of specimen adequacy on gross examination, only fair agreement was observed both with and without BLS (kappa score 0.40 and 0.29, respectively).
Conclusions: The BLS did not influence the ability to identify specimen sampling sites or reliable assessment of specimen site adequacy using gross visual inspection. Clin Endosc 2019;52:334-339
Food allergy (FA) is a common allergic disease without any currently available effective drug therapies. Mucosal mast cells (MMCs) play a particularly important role in FA, and the increase in their ...cytosolic Ca^sup 2+^ concentration (Ca^sup 2+^^sub cyt^) is considered to be a principal component of the degranulation process. However, the mechanisms governing Ca^sup 2+^ influx remain poorly understood in MMCs. Recent reports have highlighted the functions of the transient receptor potential melastatin 2 (TRPM2) channel in immunocytes, including its role in monocyte chemokine production and macrophage phagocytic activity. Although TRPM2 gene expression has been demonstrated in mast cells, the significance of such expression remains virtually unknown. In this study, we found that antigen-stimulated degranulation was significantly reduced in mucosal-type bone marrow-derived mast cells (mBMMCs) prepared from TRPM2-knockout (TRPM2-KO) mice (TRPM2-KO mBMMCs) and was suppressed following the administration of three TRPM2 inhibitors with different chemical structures, including econazole, flufenamic acid (FFA), and 2-aminoethoxydiphenyl borate. Furthermore, the antigen-stimulated increase in Ca^sup 2+^^sub cyt^ was significantly decreased in TRPM2-KO mBMMCs and was also suppressed by the TRPM2 inhibitors econazole and FFA. In addition, thapsigargin-induced increase in Ca^sup 2+^^sub cyt^ was significantly decreased in TRPM2-KO mBMMCs. These results suggest that TRPM2 may participate in antigen-induced extracellular Ca^sup 2+^ influx and subsequent degranulation. In addition, TRPM2 inhibitors were shown to improve food allergic reactions in a mouse model. Together, these results suggest that TRPM2 inhibitors suppress MMC degranulation via regulation of the increase in Ca^sup 2+^^sub cyt^. Thus, TRPM2 may play a key role in degranulation by modulating intracellular Ca^sup 2+^ in MMCs.PUBLICATION ABSTRACT
The fate of grafted neuroepithelial stem cells in the normal mature brain environment was assessed both morphologically and electrophysiologically to confirm their feasibility in the functional ...repair of damaged neural circuitry. The neuroepithelial stem cells were harvested from the mesencephalic neural plate of transgenic green fluorescence protein-carrying rat embryos, and implanted into the normal adult rat striatum. The short- and long-term differentiation pattern of donor-derived cells was precisely monitored immunohistochemically. The functional abilities of the donor-derived cells and communication between them and the host were investigated using host-rat brain slices incorporating the graft with whole-cell patch-clamp recording. Vigorous differentiation of the neuroepithelial stem cells into mostly neurons was noted in the short-term with positive staining for tyrosine hydroxylase, suggesting that the donor-derived cells were exclusively following their genetically programmed fate, together with gamma-aminobutyric acid (GABA) and glutamate expression. In the long-term, the large number of donor-derived neurons was sustained, but the staining pattern showed expression of dopamine- and adenosine 3′:5′-monophosphate-regulated phosphoprotein 32, suggesting that some neurons were following environmental cues, together with the appearance of some cholinergic neurons. Some donor-derived astrocytes were also seen in the graft. Many action potentials indicating the presence of both dopaminergic and non-dopaminergic patterns could be elicited and recorded in the donor-derived neurons in addition to spontaneous glutamatergic and GABAergic post-synaptic currents which were strongly shown to be of host origin. Neuroepithelial stem cells are therefore an attractive candidate as a source of donor material for intracerebral grafting in functional repair.
Recentry, various types of mud samplers have been used for collecting bottom sediment. Usually, Smith-Mclntyre sampler or Ekman grab sampler are used for take sediment sample. However, these ...conventional mud samplers are very heavy, and sometimes become danger operation in rough sea condition. The other hand, only about same volume as one spoon as, is need for analysis sediment component. Therefore, we tried to develop a new compact mud sampler which can be operated by a rod and an electric reel, and evaluated its usefulness compared with conventional grab type mud sampler. As the result, we can make one prototype compact mud sampler, which size has 1.6 kg weight in the air, L=5 cm, B=4 cm, D=7 cm and sampling volume is 140 cm3. And, we carried out actual sea experiment (Sea depth was ranged 3 m to 76 m). From this experiment, we can say that new type compact mud sampler is usefulness in many cases. However, sometimes different sample was obtained, in case actual sedimentation particle size is more than 150 µm, but nothing to do with the sea depth.
Neonatal disseminated herpes simplex virus (HSV) infection with acute liver failure (ALF) and neonatal hemophagocytic lymphohistiocytosis (HLH) are severe diseases. We recently experienced a male ...infant with HLH and ALF induced by HSV type 1 (HSV-1). The infant, born at 39 weeks of gestation by normal delivery, developed a fever on day 4. On day 9, laboratory investigations showed progressive liver dysfunction and coagulopathy, and the serum ferritin was excessively elevated. Furthermore, the blood levels of interleukin (IL)-6, IL-10, and interferon-gamma were also elevated. HSV-1 DNA was detected in the serum and cerebrospinal fluid by the real-time PCR method. A diagnosis of HLH was established based upon the following criteria: fever, splenomegaly, cytopenia (two cell lines), serum ferritin (> 500 μg/l) and hypofibrinogenemia (< 150 mg/dl). High-dose acyclovir therapy, steroid pulse therapy using methylprednisolone, high-dose gamma globulin therapy and a blood transfusion were given. The patient recovered without neurological deficit. Neonatal disseminated HSV infections may be complicated by the development of HLH and hypercyokinemia. If HLH is suspected, not only high-dose acyclovir therapy but also anti-cytokine therapy should be considered.
A stable inversion technique has been developed for three-dimensional (3D) interpretation of magnetotelluric (MT) data. The inversion method was based on the Gauss-Newton (linearised least-squares) ...method with smoothness regularisation. Static shifts were also treated as unknown parameters in the inversion. The forward modelling was done by using the staggered-grid finite difference method. The Akaike Bayesian information criterion (ABIC) was applied to the search for the optimum trade-off parameters while the minimising the data misfit, model roughness, and static shifts. The inversion method was then applied to a large volume MT dataset obtained in the Ogiri geothermal area, southwestern Japan. The inversion was performed stably, resulting in a good fit between the observed and computed apparent resistivities and phases. The 3D resistivity structure recovered was generally similar to that obtained by a two-dimensional (2D) inversion in previous work, although the deeper portion of the 3D model seemed to be more realistic than that of the 2D one. The 3D model was also in a good agreement with the geological interpretation of the geothermal reservoirs. These results indicated the necessity for 3D interpretation in geothermal exploration and in other applications in complicated geological environments. Exploration Geophysics 37(3) 223 - 230 doi:10.1071/EG06223
Fulminant type 1 diabetes mellitus (FT1DM) is a subtype of type 1 diabetes mellitus characterized by an abrupt onset and a rapid and complete functional loss of islet β cells. It is a very rare ...disease generally associated with ketoacidosis and the absence of circulating pancreatic islet-related autoantibodies. Diabetic ketoacidosis with normal blood glucose levels has been reported during sodium-glucose co-transporter 2 (SGLT2) inhibitor therapy.
The patient was a 43-year-old woman that consulted a medical practitioner for malaise, thirst, and vomiting. Blood analysis showed high blood glucose levels (428 mg/dL), a mild increase of hemoglobin A1c (6.6%), and increased ketone bodies in urine. The patient was diagnosed with type 2 diabetes mellitus. The patient was initially treated with insulin, which was subsequently changed to an oral SGLT2 inhibitor. Antibodies to glutamic acid decarboxylase were negative. Four days after receiving oral SGLT2 inhibitor, she consulted at Mie University Hospital, complaining of fatigue and vomiting. Laboratory analysis revealed diabetic ketoacidosis with almost normal blood glucose levels. The endogenous insulin secretion was markedly low, and the serum levels of islet-related autoantibodies were undetectable. We made the diagnosis of FT1DM with concurrent SGLT2 inhibitor-associated euglycemic diabetic ketoacidosis. The patient's general condition improved after therapy with intravenous insulin and withdrawal of oral medication. She was discharged on day 14 with an indication of multiple daily insulin therapy.
This patient is a rare case of FT1DM that developed SGLT2 inhibitor-associated diabetic ketoacidosis with almost normal blood glucose levels. This case report underscores the importance of considering the diagnosis of FT1DM in patients with negative circulating autoantibodies and a history of hyperglycemia that subsequently develop euglycemic diabetic ketoacidosis following treatment with a SGLT2 inhibitor.
In this study, the effects of sputtering gases on the damage to an organic layer (aluminum (III) bis(2-methyl-8-quninolinato)-4-phenylphenolate (BAlq)) were investigated in the deposition of ...indium–tin oxide (ITO) films by using a facing target sputtering (FTS) system. Only a small improvement in the PL intensity of the BAlq layer was observed when the sputtering gas was changed from Ar to Kr gas. It was also found that suppression of the high-energy γ-electron bombardment to the substrate is very important to reduce the damages in the BAlq layers. In addition, a remarkable improvement in the PL intensity was observed by the increase in the sputtering gas pressure from 0.3 to 1.3
Pa. These results suggest that bombardment of reflected neutral gas atoms is not the main source of the damage that BAlq layer has, but the bombardment of high-energy sputtered atoms plays an important role for the remnant damages caused by the sputter-deposition of the ITO film at a low gas pressure, since the decrease in the PL intensity was almost totally suppressed by increasing the sputtering gas pressure above 1.1
Pa. Finally, low-damage sputter-deposition of ITO film with low resistivity on BAlq layer was achieved by completely suppressing the bombardment of high-energy particles, including γ-electrons, negative oxygen ions and high-energy sputter-emitted particles.
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