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Introduction: The long-term use of topical corticosteroids (TCS) is associated with side effects such as skin atrophy and barrier deterioration. Moisturizers, such as mucopolysaccharide polysulfate (MPS), have been reported to prevent relapses in atopic dermatitis (AD) when used in combination with TCS. However, the mechanisms underlying the positive effects of MPS in combination with TCS in AD are poorly understood. In the present study, we investigated the effects of MPS in combination with clobetasol 17-propionate (CP) on tight junction (TJ) barrier function in human epidermal keratinocytes (HEKa) and 3D skin models. Methods: The expression of claudin-1, which is crucial for TJ barrier function in keratinocytes, and transepithelial electrical resistance (TEER) was measured in CP-treated human keratinocytes incubated with and without MPS. A TJ permeability assay, using Sulfo-NHS-Biotin as a tracer, was also conducted in a 3D skin model. Results: CP reduced claudin-1 expression and TEER in human keratinocytes, whereas MPS inhibited these CP-induced effects. Moreover, MPS inhibited the increase in CP-induced TJ permeability in a 3D skin model. Conclusion: The present study demonstrated that MPS improved TJ barrier impairment induced by CP. The improvement of TJ barrier function may partially be responsible for the delayed relapse of AD induced by the combination of MPS and TCS.

To improve the specific surface area (SSA) of steam activated carbon that has been prepared from spent coffee grounds (SCG), a demineralization of the SCG was conducted. As the ash content of the SCG decreased, fine micropores developed during the activation, leading to a significant increase in the SSA. An electric double layer capacitor was assembled and then evaluated, with the evaluation results indicating that the capacitance per electrode weight, the capacitance retention in relation to the current density, and the internal resistance were superior for activated carbon with a higher SSA. However, the capacitance per electrode volume had a maximum value under certain conditions, which were considered well balanced in terms of the SSA and electrode density.

特集 植民地主義の歴史と現在, Special issue: Colonialism past and present

Introduction Stiff-person syndrome (SPS) is a rare autoimmune neurological disorder. Paraneoplastic SPS associated with malignant tumors such as thymoma occurs in approximately 5% of all SPS cases. We present a rare case of thymoma accompanied by SPS successfully treated using surgery. Presentation of case A 26-year-old woman presented with lower limbs convulsions and gait disturbance and complained of leg pain. Cerebrospinal fluid and blood test results showed a high level of anti-glutamic acid decarboxylase (GAD) antibodies. Computed tomography showed anterior mediastinal tumor suggestive of a thymoma. She underwent extended thymectomy, and her symptoms gradually improved after surgery. No evidence of recurrent thymoma and SPS has been observed over 44 months. Conclusion Surgical treatment would be effective for patients with SPS and thymoma.

PURPOSE The aim of this study was to evaluate the usefulness of combining post-processing scatter correction (IG) and an anti-scatter grid (RG) in chest radiography. METHOD To determine the combination protocol (Hyb) that was closed to RG 12:1 (RG12), we measured the content rate of scattered radiation for each combination (RG12, IG12, RG3-12+IG3-12). Task-based modulation transfer function (MTF_Task) and SDNR were evaluated using RG12, IG12, and Hyb. Additionally, seven radiologists performed visual evaluation by using chest phantom. RESULT The protocol of Hyb was RG8+IG3. In SDNR, Hyb (RG8+IG3) was equal to or higher than RG12, and MTF_Task was equal in all grid systems. Hyb (RG8+IG3) was significantly superior to RG12 in visual evaluation. CONCLUSION The combining post-processing scatter correction should be useful for improving inspection throughput and reducing the risk of grid's damage.

In April 2011, the International Radiological Protection Committee recommended that "The equivalent dose of the crystalline lens should not exceed 20 mSv/year, averaged over defined periods of 5 years, with no single year exceeding 50 mSv". Based on this recommendation, it is predicted that the equivalent dose limit of our crystalline lens can be lowered in the near future. Therefore, it is important to grasp the current situation of radiation exposure. The purpose of this study is to measure the crystalline lens of surgeons by focusing on the CT-fluoroscopy guided interventional radiology's (IVRs). We also examined whether the exposure dose of the crystalline lens can be correctly evaluated by measuring the unequal exposure dose of the neck, which is usually used for the unequal exposure measurement. Results of the analysis of 200 CT-fluoroscopy guided IVR procedures showed that the unequal exposure dose of the neck was significantly correlated with the exposure dose of the crystalline lens which was measured near the left eye ball (R=0.83). However, the exposure dose of the crystalline was 33% lower than those of the neck. Therefore, although the individual dosimeter worn on the neck can be used as the useful index of the exposure dose of the crystalline lens, the results can be overestimated.

In many facilities, the displayed dose of dose-area product (DAP) is used for the dose management of interventional radiology. In this study, we investigated the measured dose at the patient entrance reference point (interventional reference point) and the displayed dose on each angiography systems. Also, we investigated the calibration method of each DAP. The errors of the measured dose and the displayed dose were less than 35%, but that dispersion was wide between the systems. The calibration methods varies according to a system. And even in the same manufacturer, the calibration methods were different. Therefore, to use the displayed dose of DAP for patient dose management, we need to compare that with the measured dose regularly. The differences of calibration methods induce the wide dispersion of the errors of the measured and the displayed dose. So the standardization of the calibration method in each manufacturer is expected.

Low-grade neuroendocrine carcinoma of the skin (LGNECS) was proposed in 2017 as a new primary cutaneous neoplasm with neuroendocrine differentiation; however, it is not yet well known due to its rarity. Herein, we perform a detailed clinicopathologic analysis of 13 cases as well as panel DNA sequencing in three cases. The study included 12 males and 1 female with a median age of 71 (43–85) years. All lesions occurred on the ventral trunk. The mean tumor size was 2.2 (0.8–11.0) cm. The histopathology resembled that of well-differentiated neuroendocrine tumors (NETs) in other organs, but intraepidermal pagetoid spreading was seen in 8 (61.5%) cases and stromal mucin deposits in 4 (30.8%). Immunoreactivity for CK7, CK19, EMA, BerEP4, CEA, chromogranin A, synaptophysin, INSM1, GCDFP15, GATA3, ER, and bcl-2 were present in varying degrees in all tested cases. PTEN c.165-1G>A splice site mutation was detected by panel sequencing in one case, and GATA3 P409fs*99 and SETD2 R1708fs*4 in another case. Lymph node metastasis was seen significantly in cases with tumor size >2.0 cm [8/8 (100%) vs. 1/5 (20%)]. All three cases with size >3.0 cm were in unresectable advanced-stage [3/3 (100%) vs. 1/10 (10%)], and two of the three patients succumbed to the disease. The two cases of death revealed mild nuclear atypia (mitosis: 1/10 HPFs) and moderate nuclear atypia (2/10 HPFs). Thus, tumor size would be a better prognostic factor than nuclear atypia, mitotic count, and Ki67 index, unlike in NETs. These clinicopathologic and immunohistochemical features would represent the characteristics as skin adnexal tumors with apocrine/eccrine differentiation rather than NETs; therefore, we rename it as sweat-gland carcinoma with neuroendocrine differentiation (SCAND).

The purpose of this study is to compare the detectability of diseases the new image processing and the conventional image processing by receiver operating characteristic (ROC) analysis and to show the usefulness of the new image processing. Radiographs with and without nodular cancer models in the chest phantom were used for observation samples. Totally 200 radiographs were evaluated by 10 radiological technologists (each readers had over 20 years or under 4 years of experience). The mean area under the curve (AUC) calculated from the over 20 years group was 0.754 for the new processing and 0.771 for the conventional processing (p value=0.651, 95% confidence interval=-0.084/0.049 (lower bound/upper bound)). On the other hand, the average AUC calculated from under 4 years group was 0.819 for the new processing and 0.678 for the conventional processing (p value= 0.041, 95% confidence interval=0.019/0.262 (lower bound/upper bound)). New image processing provides high detectability in less than 4 years group compared to conventional processing.

Owing to their excellent optical properties, organolead halide perovskite nanocrystals (PeNCs) have gained significant attention. Considering their industrial contribution, exploring practical production of high-quality PeNCs is of major importance. In this work, we demonstrate continuous-flow synthesis of ultrahigh luminescent PeNCs with high color purity using a forced thin film reactor. We successfully demonstrate the effectiveness of this reactor as a crystal growth environment. The photoluminescence quantum yields were improved to 94% as a result of the unique mixing process. After film formation, this reactor enabled the application for perovskite light-emitting diodes.

Bamboo-derived activated carbon prepared by superheated steam (BAC) exhibited performance for utilization as an electric double layer capacitor (EDLC) electrode. Pore structure and EDLC performances were investigated by comparison with phenol resin-derived activated carbon (MSP-20), which is commercially available and often used for the purpose. The nitrogen adsorption isotherm showed that BAC had a large BET-specific surface area of 1268 g/m2 with a developed pore structure, especially of the mesopore, in comparison with MSP-20. It is considered that inherent ash in bamboo promoted activation, in addition to physical activation by superheated steam. Capacitance per electrode volume (CV) was 52 F/cm3 with BAC. Because the density of BAC is high (0.78 g/cm3) compared with that of MSP-20 (0.58 g/cm3), sufficient CV for usage was obtained, although the capacitance per electrode mass (CM) at 5 mA/cm2 itself of BAC (67 F/g) was lower than that of MSP-20 (126 F/g). With IR drop, the resistance value of BAC (9.7 Ω) was lower than that of MSP-20 (10.5 Ω). Especially, the diffusion resistance of BAC disclosed to be smaller than that of MSP-20. These results indicated that BAC produced by steam activation is a promising material with a pore structure suitable for ion transfer in EDLC.

We present two cases of an HIV-associated parotid gland cyst. One case was a 36-year-old HIV infected woman. She was diagnosed with HIV infection and presented with slowly enlarged parotid gland cysts together with elevation of HIV viral RNA copies/mL in her serum. She was performed parotid gland biopsy under the general anesthesia. The histopathologic analysis revealed negative HIV p24-antigen in her parotid gland tissue. The other case was a 43-year-old man found his parotid gland swelling shortly after highly active antiretroviral therapy (HAART). He was diagnosed with HIV infection 2 years previously. He had started HAART several days before. He showed exceeding elevation of IgE in his serum. We treated him with medication using anti-histamic drugs for his cyst. A computed tomography scan revealed a complete response of his parotid gland cyst 4 weeks after the medication. His serum IgE level was decreased to half of the level before the medication. These findings suggested that the parotid gland swelling associated with HIV was due to various factors including immune reconstitution inflammatory syndrome (IRIS). In case such a parotid gland swelling, we could avoid invasive treatments.

Marked fluid retention occurs in Ballantyne syndrome, but few reports are available on changes in cardiac morphology in this syndrome. A woman with generalized edema, dyspnea, fetal hydrops (skin edema and ascites), thickened placenta, and elevated plasma B-type natriuretic peptide level (344 pg/mL) was admitted to our hospital at gestational week (GW) 20+3 . Blood pressure remained within the normal range. However, acute increases in left atrial volume index, pulmonary artery systolic pressure, and hyperdynamic left ventricular function (as evidenced by increased left ventricular ejection fraction to 74% with cardiac index of 5.1 L/min/m2 ) occurred preceding fetal death at GW 21+4 in the presence of increased inferior vena cava diameter (23 mm) and relatively low systemic vascular resistance of 752 dyn·s/cm5 . These findings suggested life-threatening heart failure and required cesarean delivery at GW 21+5 resulting in complete recovery. The placenta suggested cytomegalovirus infection.

The present case involved a 27-year-old woman, who presented to a nearby physician with chief complaints of fever and dyspnea and hospitalized with a diagnosis of right lobar pneumonia on the same day. The patient was treated with antibiotics (aminobenzylpenicillin/sulbactam); however, exacerbation of respiratory status occurred with hypotension, and she was transferred to the authors’ hospital under tracheal intubation. The right superior lobe exhibited a wide range of infiltrative shadows with air bronchograms. Vasopressor and continuous hemodiafiltration were initiated to address overall exacerbation, and antibiotics (ciprofloxacin) were added. However, ventilation could not be maintained due to the large quantity of respiratory secretions; consequently, extracorporeal membrane oxygenation (ECMO) was initiated 5 h after admission to the intensive care unit. Due to the large quantity of Gram-negative bacilli confirmed by gram stain of respiratory secretions, amikacin was added. Although oxygenation was improved after initial ECMO induction, the patient died on day 2 of admission, despite being revived from sudden cardiac arrest. Pseudomonas aeruginosa was detected in respiratory secretions, blood cultures, and all lung tissues at autopsy, and the illness was believed to be a fulminant form of community-acquired pneumonia caused by the organism. This is a rare case and autopsy finding and, as such, contributes to the scarce literature.

The tetramethylammonium salts of diplatinum(II) complexes composed of mono-lacunary Keggin-type silico and germanotungstates, [(CH3)4N]4[α-SiW11O39{cis-Pt(NH3)2}2]·13H2O (TMA-Si-Pt) and [(CH3)4N]4[α-GeW11O39{cis-Pt(NH3)2}2]·11H2O (TMA-Ge-Pt), were synthesized and crystallized. Single crystals of a tetramethylammonium salt of Keggin-type diplatinum(II)-coordinated phosphotungstate [(CH3)4N]3[α-PW11O39{cis-Pt(NH3)2}2]×10H2O (TMA-P-Pt) were also obtained. The X-ray structural analyses revealed that the two cis-platinum(II) moieties, [cis-Pt(NH3)2]2+, were each coordinated to two oxygen atoms in a mono-vacant site of [XW11O39](12-n)- (Xn+ = Si4+, Ge4+, P5+). FTIR spectra of TMA-Si-Pt and TMA-Ge-Pt also suggested that the two platinum(II) moieties were coordinated to the vacant site of [SiW11O39]8- and [GeW11O39]8-. The 1H NMR spectra in DMSO-d6 of TMA-Si-Pt and TMA-Ge-Pt showed signals assigned to the two sets of NH3 ligands coordinated to the platinum sites. These three platinum compounds showed hydrogen evolution from aqueous triethanolamine solution under visible light irradiation (λ ≥ 400 nm) in the presence of eosin Y, α-Keggin mono-aluminum-substituted silicotungstate, and titanium dioxide. The catalytic activities were influenced by the central atoms, and TMA-P-Pt showed the highest activities among the three platinum compounds.

We sought to develop a surgical navigation system using magnetic resonance angiography (MRA) and a three-dimensional (3D) printer for robot-assisted radical prostatectomy (RARP). Six patients with pathologically proven localized prostate cancer were prospectively enrolled in this study. Prostate magnetic resonance imaging (MRI), consisting of T2-weighted sampling perfection with application-optimized contrasts using different flip-angle evolutions (SPACE) and true fast imaging with steady-state precession (true FISP), reconstructed by volume rendering, was followed by dynamic contrast-enhanced MRA performed with a volumetric interpolated breath-hold examination (VIBE) during intravenous bolus injection of gadobutrol. Images of arterial and venous phases were acquired over approximately 210 seconds. Selected images were sent to a workstation for generation of 3D volume-rendered images and standard triangulated language (STL) files for 3D print construction. The neurovascular bundles (NVBs) were found in sequence on non-contrast images. Accessory pudendal arteries (APAs) were found in all cases in the arterial phase of contrast enhancement but were ill-defined on non-contrast enhanced MRA. Dynamic contrast-enhanced MRA helped to detect APAs, suggesting that this 3D system using MRI will be useful in RARP.

研究ノート

Primary pulmonary osteosarcoma is a rare entity, with only a few cases reported in the literature to date. Moreover, secondary extraskeletal osteosarcoma of the lung following chemoradiotherapy is extremely rare and, to the best of our knowledge, this is the first reported case. We herein present the case of an 80-year-old male patient with small-cell lung cancer (SCLC), who developed what it was initially considered as recurrence of the tumor after chemoradiotherapy. The patient eventually succumbed to the disease, and on autopsy it was discovered that the lung tumor was not in fact SCLC, but rather a secondary osteosarcoma. Osteosarcoma metastasis to the lung is very rare, but must be considered in the differential diagnosis when there is relapse following treatment for primary SCLC.

Skin concentrations of topically administered compounds need to be considered in order to evaluate their efficacies and toxicities. This study investigated the relationship between the skin permeation and concentrations of compounds, and also predicted the skin concentrations of these compounds using their permeation parameters. Full-thickness skin or stripped skin from pig ears was set on a vertical-type diffusion cell, and lidocaine (LID) solution was applied to the stratum corneum (SC) in order to determine in vitro skin permeability. Permeation parameters were obtained based on Fick's second law of diffusion. LID concentrations at each depth of the SC were measured using tape-stripping. Concentration-depth profiles were obtained from viable epidermis and dermis (VED) by analyzing horizontal sections. The corresponding skin concentration at each depth was calculated based on Fick's law using permeation parameters and then compared with the observed value. The steady state LID concentrations decreased linearly as the site became deeper in SC or VED. The calculated concentration-depth profiles of the SC and VED were almost identical to the observed profiles. The compound concentration at each depth could be easily predicted in the skin using diffusion equations and skin permeation data. Thus, this method was considered to be useful for promoting the efficient preparation of topically applied drugs and cosmetics.

Two unique pressure-sensitive adhesive (PSA) tapes (PSA-A, -B) with different adhesive properties of commercial PSAs were prepared and evaluated for their usefulness as a pretreatment material prior to the application of transdermal therapeutic systems or topical drug formulations and also as a peeling agent against excess layers of the stratum corneum. In the present study, in vitro permeation experiments were conducted using vertical type diffusion cells and excised hairless rat or porcine skin from which the stratum corneum had been stripped several times with PSAs. The results obtained revealed that PSA-A and -B had higher stripping or peeling effects than those of the marketed PSAs. Marked changes were observed in skin barrier function before and after stripping using PSAs, and the enhancement effect on the skin permeation of drugs achieved by stripping the stratum corneum was markedly different between the PSAs. PSA-A, in particular, markedly improved skin permeation and the skin concentration of topically applied chemical compounds because it removed many layers of the stratum corneum when skin was stripped only a few times. In contrast, when PSA-B was used to pretreat the skin surface, the extent of skin permeation and concentration of drugs was safely increased because only a few layers of the stratum corneum were removed, even with repeated stripping. The enhancement effect achieved by PSA-B was not as high as that by PSA-A. Thus, stripping with PSA-A can be used as a penetration enhancement tool, whereas PSA-B can be used as a peeling material against excess layers of the stratum corneum.

Three middle‐aged male patients were admitted to our hospital complaining of dry cough, dyspnoea, and fever. All three of them had cleaned a refrigerator at a Chinese noodle mill using paint remover containing dichloromethane (90%) the previous day. Chest X‐rays revealed bilateral diffuse infiltrative shadows on the lungs. We performed transbronchial lung biopsies and bronchoalveolar lavage (BAL) via bronchoscopy for each patient. Bronchoalveolar lavage showed increased total cell count as well as lymphocyte and neutrophil fraction. Transbronchial lung biopsy revealed Masson bodies and slight lymphocyte infiltration into the alveolar septa. We diagnosed all three patients with hypersensitivity pneumonitis and acute lung injury caused by exposure to the paint remover containing dichloromethane. Two of these patients ultimately went into respiratory failure, requiring the administration of a corticosteroid. The third patient improved without the need of steroid therapy.

Soft tissue tumor is a rare disease in the head and neck regions which is difficult to diagnose and treat. We report on a case of unresectable soft tissue tumor in the head and neck. The patient was a 41-year-old man who noticed some swelling on the right side of his neck which had started three months prior to presenting. A tumor was found in the right neck surrounding his common carotid artery which was judged unresectable because of its location and size. The differentiated diagnosis between a synovial sarcoma and a malignant peripheral nerve sheath tumor (MPNST) was difficult. The patient underwent carbon ion radiotherapy as an initial treatment in the Hyogo Ion Beam Medical Center. There was a partial response from the tumor in his neck tumor, but it metastasized to the lung and bone and the patient died of pulmonary failure nine months after the initial treatment.

Objective This study was to clarify the neuropathological findings of acute encephalomyelopathy with Sjogren's syndrome. Methods We examined an autopsied case of acute encephalomyelopathy with Sjogren's syndrome. Case Report A 40-year-old woman developed acute myelopathy and brainstem dysfunction. Magnetic resonance imaging (MRI) revealed high-intensity lesions on T2-weighted axial images (T2WI) in the medulla oblongata and cervical spinal cord. We established a diagnosis of Sjogren's syndrome (SjS) according to the European Community criteria. The patient was treated with intravenous methylprednisolone (500 mg/day) for three days, followed by oral prednisolone. Although her neurological symptoms improved, her general condition deteriorated after the onset of acute colonic pseudo-obstruction and she died of multiple organ failure associated with hemophagocytosis. Results Autopsy showed atrophy of the secretory glands and an accumulation of lymphocytes around the ducts, confirming the diagnosis of Sjogren's syndrome. Neuropathological examination revealed multifocal lesions in the cervical spinal cord and medulla, along with scattered perivascular lymphocytic infiltration. In addition, there was demyelination, spongy change and axonal swelling in the white matter, but no remarkable vasculitic changes were seen in the central nervous system. Conclusion Although the steroid therapy may have had a significant influence, the main pathological finding in this case was not vasculitis, but rather axonal degeneration with spongy change and axonal swelling.

Papular elastolytic giant cell granuloma (PEGCG) is a rare variant of annular elastolytic giant cell granuloma (AEGCG). Since Kato et al. [1] reported the first case of PEGCG, only eight additional cases have been reported. Herein, we report a case of PEGCG and review the literature of reported cases.A 75-year-old Japanese man presented with multiple pruritic eruptions on his back that recurred for 2 months. Past medical history included hypertension and hyperlipidemia. Physical examination disclosed [...]

70歳, 女性。45歳時に左小指爪下の悪性黒色腫に対して, 指切断術を行った (Stage IA)。 術後10年間の経過観察中に局所再発や転移は認められなかった。術後24年目に左乳房に出現した腫瘤を, 当院外科で摘出したところ悪性黒色腫であった。当科へ転科して全身検索を行った結果, 左腋窩リンパ節, 両鼠径リンパ節, 全身の皮下脂肪織, 肺, 肝への転移を認めた。治療はDAC-Tam療法を3コース行った。各リンパ節転移, 皮下脂肪織転移巣および肺転移巣は縮小あるいは消失した。肝転移に対しては, TAEおよびCDDPとIFN-βの肝動注を行ったが, 不変であった。その後の経過中に脳への多発転移が出現し, 不幸な転帰をとった。

Tight junctions are intercellular junctions adjacent to the apical end of the lateral membrane surface. They have two functions, the barrier (or gate) function and the fence function. The barrier function of tight junctions regulates the passage of ions, water, and various macromolecules, even of cancer cells, through paracellular spaces. The barrier function is thus relevant to edema, jaundice, diarrhea, and blood-borne metastasis. On the other hand, the fence function maintains cell polarity. In other words, tight junctions work as a fence to prevent intermixing of molecules in the apical membrane with those in the lateral membrane. This function is deeply involved in cancer cell biology, in terms of loss of cell polarity. Of the proteins comprising tight junctions, integral membrane proteins occludin, claudins, and JAMs have been recently discovered. Of these molecules, claudins are exclusively responsible for the formation of tight-junction strands and are connected with the actin cytoskeleton mediated by ZO-1. Thus, both functions of tight junctions are dependent on the integrity of the actin cytoskeleton as well as ATP. Mutations in the claudin14 and the claudin16 genes result in hereditary deafness and hereditary hypomagnesemia, respectively. Some pathogenic bacteria and viruses target and affect the tight-junction function, leading to diseases. In this review, the relationship between tight junctions and human diseases is summarized.