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Thrombocytopenia is widely recognized as a simple surrogate marker of liver fibrosis in non-alcoholic fatty liver disease (NAFLD). Thrombocytopenia of NAFLD has not been compared with that of hepatitis C virus-related chronic liver disease (CLD-C). Here, we examined whether there is any difference in the platelet counts between patients with NAFLD and CLD-C and investigated the underlying mechanisms.A total of 760 biopsy-confirmed NAFLD and 1171 CLD-C patients were enrolled. After stratification according to the liver fibrosis stage, platelet counts between NAFLD and CLD-C patients were compared. The platelet count, spleen size, serum albumin level, serum thrombopoietin level, and immature platelet fraction (IPF) value were also compared after covariate adjustment using propensity score (PS) matching.The median platelet counts (×10NAFLD patients had a significantly higher platelet count than CLD-C patients following stratification according to the liver fibrosis stage. The milder hypersplenism and higher platelet production in NAFLD than CLD-C may have contributed to this difference.

AIM Type IV collagen 7S (T4C7S) is a valuable biomarker for detecting liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). The conventional T4C7S measurement via radioimmunoassay (T4C7S RIA) has shortcomings of radioisotope usage and longer assay periods. We compared T4C7S RIA with a newly developed, fast T4C7S chemiluminescent enzyme immunoassay (T4C7S CLEIA) and examined the diagnostic accuracies of and correlation between the two techniques. METHODS We evaluated 170 biopsy-confirmed patients with NAFLD. T4C7S was measured via both T4C7S RIA and T4C7S CLEIA. The correlation between T4C7S RIA and T4C7S CLEIA was analyzed in 305 total serum samples via exploratory research and 47 validation samples. The diagnostic accuracies of T4C7S CLEIA and T4C7S RIA were compared in the sera of patients with NAFLD and test samples. RESULTS Sera T4C7S levels of T4C7S CLEIA and T4C7S RIA significantly correlated in patients' samples via exploratory (r = 0.914, P = 0.000) and validation (r = 0.929, P = 0.000) research. At a 10% coefficient, T4C7S CLEIA concentration was 0.26 ng/ml in the serum samples, indicating high accuracy at even low concentrations. T4C7S CLEIA revealed distinct changes between each stage and high sensitivity in detecting the F2 stage, indicating a higher sensitivity in detecting low fibrosis stages than T4C7S RIA in patients with NAFLD. CONCLUSIONS The T4C7S CLEIA correlated well with the T4C7S RIA. Favorably, the T4C7S CLEIA has a higher sensitivity and rapid measurement time and requires a small sample volume; thus, it is a promising and popular biomarker for fibrosis stage diagnosis in NAFLD.

Summary All residential homes in Japan have been required to install residential fire alarms since 2006. According to a survey by Tokyo Fire Department in 2011, the installation rate of residential fire alarms per household within the jurisdiction of the Tokyo Fire Department is 80.6%. The authors carried out an analysis of reports of cases, where residential fire alarms successfully worked. The information in these real fire incident reports is very useful for us to understand the actual circumstances as well as the behavior of the people involved in and nearby a fire incident. In many cases of successful activation of fire alarms for fires originating in a living room and bedroom, the occupants were likely to be in sleeping in the room of fire origin and did not become aware of the fire alarm, even if it sounded. By contrast, other family members and/or neighbors outside the room of fire origin were more likely to hear the sound and initiated the response activity to the fire incident. This indicates the potential for persons in the room of fire origin at the time of fire to be saved by others nearby because of the activation of residential fire alarms, even if they are sleeping and do not respond by themselves to the alarm sound. Copyright © 2017 John Wiley & Sons, Ltd.

Anti-N-methyl-d-aspartate receptor (NMDAR) limbic encephalitis is the most common form of paraneoplastic encephalitis that is associated with teratomas. Because tumor removal leads to better clinical outcomes, it is essential to reveal the location of the teratomas. This is the first reported case of anti-NMDAR encephalitis associated with teratoma of the fallopian tube. Salpingo-oophorectomy improved neurological symptoms and immunohistochemical examinations indicated the expression of NMDAR on neuroglial cells within the fallopian tube teratoma. Teratomas of the fallopian tube cause anti-NMDAR encephalitis; the imaging analysis and exploratory laparoscopies of the fallopian tube as well as of the ovary should be considered. Surgical removal of both fallopian tubes and ovaries with a normal appearance should be considered for patients in whom immunotherapy is not effective.

Aim Transient elastography (TE) is a noninvasive method for predicting liver fibrosis. However, there is limited data regarding the performance of TE in Japanese patients with nonalcoholic fatty liver disease (NAFLD). We aimed to evaluate the association between liver stiffness measurement (LSM) by TE and liver fibrosis stage, and define a cut-off value for predicting liver fibrosis. Methods A total of 171 Japanese patients with biopsy-proven NAFLD underwent LSM using TE with FibroScan®. Area under receiver-operating characteristic curve (AUROC) of LSM and other noninvasive markers of liver fibrosis were compared to determine the most accurate method of predicting liver fibrosis. Results LSM significantly correlated with fibrosis stage (p

Aim Non-alcoholic fatty liver disease (NAFLD) can progress to non-alcoholic fatty liver (NAFL) or non-alcoholic steatohepatitis (NASH). We investigated the association among serum type IV collagen level, liver histology, and other fibrosis markers in NAFLD progression. Methods We evaluated 184 patients diagnosed with NAFLD following biopsy, including 89 males and 95 females with an average age of 52.6 and 62.6 years, respectively. Non-alcoholic fatty liver disease was classified as NAFL or NASH using Matteoni's classification, and the grade and stage of NASH were assessed using Brunt's classification. Serum type IV collagen was measured by a rapid and sensitive latex particle-enhanced turbidimetric immunoassay. Results Forty-two patients with NAFL and 142 patients with NASH were included in this study. Compared with patients with NAFL, patients with NASH showed more significant liver function disorder and increased expression of fibrosis markers including type IV collagen, collagen 7S, Mac2-binding protein (M2BP), and hyaluronic acid (HA). Expression of type IV collagen and collagen 7S, but not M2BP and HA, was more significantly elevated in patients with stage 1 NASH than in patients with NAFL, indicating that type IV collagen and collagen 7S may be better discriminators of NASH and NAFL than M2BP and HA at an early stage of fibrosis. When patients were stratified by NAFLD activity score, type IV collagen and collagen 7S were significantly elevated as NAFLD activity score progressed, whereas M2BP and HA expression were not significantly elevated. Conclusion Type IV collagen may be a useful measure of NASH severity as latex particle-enhanced turbidimetric immunoassay-based rapid type IV collagen assay can be carried out routinely.

Aim Although non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome, the clinical association between non-alcoholic steatohepatitis (NASH) and lifestyle-related diseases such as obesity, type 2 diabetes mellitus (DM), hypertension (HT) and dyslipidemia (DL) has not been clarified. We studied the influence of lifestyle-related diseases and age on the development and progression of NAFLD. Methods We enrolled 550 patients with biopsy-proven NAFLD (284 men, 266 women; average age, 52 and 62 years, respectively). The effect of lifestyle-related diseases and age (≤49 vs ≥50 years) on the frequency of NASH and advanced fibrosis (≥stage 3) was studied. Results Prevalence of obesity, DM, HT and DL in male and female NASH patients was 75%/67%, 53%/54%, 66%/77% and 85/79%, respectively. DM patients had a higher frequency of NASH in the older male NAFLD group and a higher frequency of advanced fibrosis in the older female NASH group. With the increasing number of complicating lifestyle-related diseases, the rate of NASH increased in male NAFLD patients. In both sexes, aging resulted in the development of NASH and progression of liver fibrosis. Multivariate logistic regression analysis revealed that age and DM were significantly associated with the development of NASH in male NAFLD patients and progression of fibrosis in female NASH patients. Conclusion Age is strongly associated with the development and progression of NASH. Type 2 DM may play the most crucial role among lifestyle-related diseases in the development and progression of NASH.

Aim Sorafenib is the standard systemic therapy for patients with advanced hepatocellular carcinoma (HCC). We aimed to assess the efficacy and safety of sorafenib therapy in very elderly patients aged 80 years and older with advanced HCC. Methods In a retrospective multicenter study in Japan, we reviewed 185 patients (median age, 71 years; 82% male; 95% Child–Pugh class A) with advanced HCC who received sorafenib therapy. Data were compared between 24 (13%) patients aged 80 years and older and 161 (87%) patients aged less than 80 years. We used propensity score matching to adjust for differences between the two groups. Results Median overall survival was 10.6 months in all patients: 11.7 months in patients aged 80 years and older and 10.5 months in those aged less than 80 years. There were no significant differences in overall survival, tumor response, and frequency and severity of drug-related adverse events between patients aged 80 years and older and those aged less than 80 years in both the entire study cohort and the propensity-matched cohort. Conclusion Sorafenib may be effective and well tolerated, even in patients with advanced HCC who are aged 80 years and older, as well as those aged less than 80 years.

We herein describe a 45-year-old man with posterior neck pain and severe dysphagia secondary to retropharyngeal calcific tendinitis. Brain stem infarction as a result of vertebral artery dissection was suspected, but head magnetic resonance imaging showed no acute ischemic lesion. Sagittal T2-weighted neck magnetic resonance imaging showed a retropharyngeal fluid collection from C2 to C8, and neck computed tomography showed calcification at the tendon of the longus colli muscle. Based on these characteristic imaging findings, retropharyngeal calcific tendinitis was diagnosed. Neurologists should remember that retropharyngeal calcific tendinitis can cause neck pain and severe dysphagia, and mimic brain stem infarction as a result of vertebral artery dissection.

We propose a three-terminal nanometer metal switch that utilizes a solid electrolyte where a nanoscale metal filament is stretched and retracted. Its operating principle is based on electrochemical reaction and ion migration in the electrolyte. The fabricated device is composed of a solid electrolyte layer (Cu2S), a gate (Cu), a source (Cu), and a drain (Pt). After the Cu filament is formed between the source and the drain by applying the drain voltage, repeatable on/off switching in the drain current is obtained by controlling the gate voltage. The on/off current ratio can be as high as 105, and the programmable cycle is around 50. Each state can be kept for up to 40 days. Since the gate is separated from the current path, the switching current can be reduced to 10 μA, which is two orders of magnitude smaller than that of a two-terminal switch. In this paper, we present the operating principle and electrical characteristics of the three-terminal switches, and discuss how suitable they are for reconfigurable circuits. © 2011 Wiley Periodicals, Inc. Electron Comm Jpn, 94(4): 55–61, 2011; Published online in Wiley Online Library (wileyonlinelibrary.com). DOI 10.1002/ecj.10214

The evaluation of cranial nerves in magnetic resonance imaging (MRI) at early developmental stage has not been established in amyotrophic lateral sclerosis (ALS). A 23-year-old man with familial ALS developed peripheral facial nerve palsy, and showed the striking gadolinium enhancement on MRI in those nerves at an early stage. His symptoms progressed rapidly and he died approximately 3 months after onset. We identified a missense mutation in exon 1 of the Cu/Zn superoxide dismutase gene (SOD-1), resulting in a Cys6Gly (C6G) amino acid substitution. Based on the rapid progression and neurotoxicity resulting from SOD-1 protein aggregation, the gadolinium enhancement of facial nerves might be caused by the rapid Wallerian degeneration and blood–brain barrier disruption at the early phase of progression.

We have investigated solid electrolyte switches that utilize electrochemical reactions (deposition and dissolution) of metallic ions. The switch turns off or on when a metallic bridge electrochemically forms or dissolves in the solid electrolyte. Each state is nonvolatile and the switching is repeatable up to 105 cycles. The promising application is a programmable switch in a field programmable logic because of its small size (

We examined food utilization in a community of aphidophagous hoverfly larvae (Diptera: Syrphidae and Chamaemyiidae) in open lands in an urban habitat in central Japan for 3 years. The community consisted of 17 hoverfly species feeding on 20 aphid species occurring on 14 species of dominant herbaceous plants. In terms of larval prey preference, the dominant eight species of hoverfly were categorized into three groups: a polyphagous ‘generalist’ group consisting of four species,Episyrphus balteatus, Betasyrphus serarius, Syrphus vitripennis andSphaerophoria sp.; an oligophagous ‘specialist’ group consisting of three species,Metasyrphus hakiensis, Dideoides latus andParagus hemorrhous; andLeucopis puncticornis, which showed a preference for two aphid species on the plantTorilis scabra. The prey aphids of the second group have behavioral or morphological defense mechanisms that are effective for preventing attacks by generalist hoverflies; two prey aphids are aggressive toward generalist predators and the others are protected by ant-attendance. The specialist hoverflies seem to be adapted to overcome these defense mechanisms. The prey ranges overlapped little between the generalist and the specialist groups, while those within the generalist group overlapped greatly.

The characteristics of heat exchangers with offset-type plate fins for space stations are studied for Reynolds numbers less than 300 based on the hydraulic diameter. A three-dimensional analysis is carried out to study the effects of the following parameters on the heat transfer and the flow characteristics: (a) the thermal boundary layer developing on the bottom plate and on the fins on the plate, (b) the aspect ratio (height/pitch) of the cross section of the flow passage, the fin thickness, the fin length in the direction of the flow, the thermal conductivity of the fluid and the fins, and the Prandtl number of the fluid. The results obtained are as follows. (1) The heat-transfer coefficient on the fin surface is characterized by the thermal-conductivity ratio of fluid to fin material. When the thermal conductivity of the fin material approaches that of the fluid, the heat-transfer coefficient on the fin surface becomes low. (2) The optimum condition of the aspect ratio depends on the value of the thermal-conductivity ratio between the fluid and the fins. (3) When the aspect ratio becomes large or small, the friction factor of offset fins approaches that of fully developed duct flow with the same aspect ratio as the Reynolds number decreases.

Histopathologically, early lesions of primary biliary cirrhosis (PBC) are focal within the liver and there is segmental involvement of the bile ducts. In addition, the development of PBC is variable within the liver. PBC is characterized by the following laparoscopic findings: reddish patch, mesh-like white marking and gentle undulation, etc. In the present study, we analyzed the correlation between the laparoscopic findings and the histological stage as per Scheuer's classification in 22 patients with PBC. The results of this study are summarized as follows: 1) Reddish patch was frequently observed in the early stage of PBC. 2) Mesh-like white marking was observed in cases of stage I, II and III. 3) Gentle undulation was seen in stage II and III. The absence of this finding is useful in the diagnosis of stage I. 4) In stage IV, these three findings were not observed. 5) From these three findings, it was difficult to differentiate stage II or III. But the presence of portal hypertension and increased vascularity of the liver capsule were observed in accordance with the progression of the disease. Indications of portal hypertension were seen even in the early stage and in some asymptomatic cases of PBC. In conclusion, the laparoscopic findings such as reddish patch, mesh-like white marking, gentle undulaion and portal hypertension are very valuable for stage diagnosis and the evaluation of prognosis in patients with PBC.