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Introduction/Background* Concurrent chemoradiotherapy (CCRT) has limited therapeutic efficacy for stage III-IV cervical cancer. We aimed to identify a subgroup of patients with stage III-IV cervical cancer who benefit from CCRT with additional treatment. Methodology We retrospectively reviewed 120 patients with stage III-IV cervical cancer who were treated with CCRT from 2002 to 2018. We compared overall survival between patients treated with CCRT alone and those who received CCRT with additional conventional treatments (systemic chemotherapy before and/or after CCRT and/or extended-field radiation). Prognostic factors were statistically analyzed. Result(s)* Overall, 44 (36.7%) and 21 (17.5%) patients were radiologically diagnosed with pelvic and para-aortic lymph node enlargement, respectively. The median tumor diameter was 5.7 cm. Sixty-nine (57.5%) patients received no additional treatment, and 51 (42.5%) received additional treatment. Cox regression analysis identified the following prognostic factors: histological non-squamous cell carcinoma (hazard ratio [HR], 3.9; 95% confidence interval [CI], 1.8–8.2), tumor diameter of ≥6 cm (HR, 2.1; 95% CI, 1.2–3.7), radiological pelvic lymph node enlargement (HR, 2.1; 95% CI, 1.1–4.0), and radiological para-aortic lymph node enlargement (HR, 2.1; 95% CI, 1.1–4.1). Even in the lowest risk group (no risk factors), the 5-year overall survival rate was lower in the additional treatment group than in the CCRT alone group (78.7% vs. 80.9%, respectively; log-rank test, P = 0.79). Conclusion* Addition of conventional treatments to CCRT might not improve survival in patients with advanced cervical cancer. Novel treatment strategies including immune checkpoint inhibitors should be considered for such patients.

BackgroundIn cases of systematic lupus erythematosus (SLE) that lead to surgery due to the development of heart diseases such as valvular disease, ischemic heart disease and aortic aneurysm, early detection and careful monitoring are important. An absence of background diseases or immunopathological examination of the myocardial tissue in SLE cases with cardiovascular lesions demonstrates the lack of knowledge in this area. In recent years, however, there have been reports of neutrophil extracellular traps being involved in the fulminant onset of SLE.ObjectivesThis study aimed to analyze clinically and immunohistopathologically the pathophysiology of heart diseases associated with SLE.MethodsWe performed left atrial appendage resection in 34 patients, including patients with cardiovascular lesions, who underwent heart surgery for SLE complications from 2012 to 2021. Tissue analysis was conducted in 9 cases. The left atrial appendage, in cases of non-collagen valvular disease, was used as the control. Tissue staining of cardiomyocytes was carried out by adding anti-neutrophil extracellular(NE) antibodies(Abs) to anti-human IgG antibody (Ab), anti-IgM Ab and anti-C3 Ab.ResultsOf the 34 SLE patients 14 had valvular disease, 8 had ischemic heart disease and 12 had aneurysms. Preoperative SLE activity was relatively stable with only 1 patient below the CH50 standard and 6 patients above the anti-DNA Ab standard. The Ab positivity rate for the patients in this study was higher than that of the 687 SLE patients who were previously tested in 2019. The presence of anti-CL Abs was 55.6%, which was higher than the 25.5% observed in previous SLE patients. In this study, anti-SS-A and anti-RNP Abs tended to be relatively numerous. An example of immunohistochemical staining of IgG in the left atrial appendage is presented (Figure 1a). IgG deposits were not observed on the left side of the myocardial fibers in the control group, whereas IgG deposits were observed on the right side in the SLE group. Deposits were also observed in tissues that were not located in the affected areas. The presence or absence of tissue deposition in the myocardial fibers and clinical findings in 2 cases of the control group and 9 cases of the SLE complication group are reported in Table 1. IgG deposits were found in the myocardial fibers of 6 of the 9 patients in the SLE complication group, and deposits were found in the left atrial appendage tissue regardless of the type of heart disease, suggesting a potential change in the heart tissue. In the SLE group, 5 cases were positive for antiphospholipid (APS) Abs, while 7 cases were positive for either anti-SS-A or anti-RNP Abs. Only 2 cases had elevated preoperative anti-DNA Ab and complement reduction. Of the SLE complication group, 2 of the 9 cases were negative for all Abs but IgG deposits were observed in a case. Of these 4 cases were selected and stained with anti-IgM, anti-C3 and anti-NE Abs. However IgM and C3 deposits were only observed in one patient who developed myocardial infarction at the age of 39 and was triple positive for APS, anti-SS-A and anti-RNP Abs (Figure 1b). There were also no NE deposits in any of the cases. Even if complement and anti-DNA Ab levels in the serum are normal, attention should be paid to heart disease complications during the long-term observation of SLE patients. In particular, attention should be paid to various autoantibody-positive cases such as APS, anti-SS-A Ab and anti-RNP Ab. The anti-NE Ab was not stained in this study because the tissue was different from the lesion site and because it occurred during the chronic course.ConclusionIn SLE patients who developed cardiovascular lesions and required surgery, immunological abnormalities may occur in the myocardial tissue even if serum complement and anti-DNA Ab levels are stable.References[1]Stephane Zuily et al. Valvular Curr Rheumatol Rep (2013) 15:320.[2]Zawadowski GM et al. Lupus. 2012;21(13):1378-84.[3]Daniel Appelgren et al. Autoimmunity 2018,vol51,No.6,310-318.Disclosure of InterestsNone declared

Objective This study aimed to establish intraoperative diagnostic criteria of sentinel lymph node (SLN) micro-/macrometastasis on the basis of tissue rinse liquid-based cytology (TRLBC) in gynecological cancer. Methods We enrolled 214 patients with gynecological cancer who underwent rapid diagnosis of SLN metastasis on the basis of TRLBC from a total of 490 SLNs. For slides that were classified as positive for atypical cells on cytological inspection, we counted the number of clusters (an atypical cell mass consisted of three or more cells) and the number of single cells (an atypical cell other than clusters). Receiver operating characteristic (ROC) analysis was applied to determine the efficiency of predicting SLN micro-/macrometastasis. Results On cytological inspection, 36 slides were classified as positive for atypical cells, while 21 slides (4.3%) were true positive, 15 (3.1%) were false positive, and 454 (92.6%) were true negative. There were no false negative results in this study. The area under the ROC curve for the number of cluster was superior to that for the number of single cells for distinguishing micro-/macrometastasis from negative/isolated tumor cells (0.86 vs. 0.67, P = 0.032). The optimum cut-off value of the number of clusters was 5 for distinguishing these two categories. Conclusions TRLBC is a highly sensitive alternative for detecting SLN metastasis as a rapid intraoperative diagnosis. Counting the number of atypical cell clusters might be useful for distinguishing micro-/macrometastasis from isolated tumor cells.

Objective The objective of this study was to verify the feasibility of laparoscopic hysterectomy in patients with stage IA1 cervical cancer. Methods This retrospective study was carried out using data for 103 patients with stage IA1 cervical cancer at Hokkaido Cancer Center from January 2000 to December 2016. Study outcomes including operation time, estimated blood loss, blood transfusion, recurrence, and survival were compared between conization group (n=36) and hysterectomy group (n=67). Among patients in the hysterectomy group, those outcomes were compared between non-laparoscopic hysterectomy group (n=31) and laparoscopic hysterectomy group (n=36). Results In the present study, there was only one patient with cancer recurrence who underwent cervical conization. The rate of cases of cancer recurrence in the conization group tended to be higher than in the hysterectomy group (2.8% vs. 0%, P=0.18). Estimated blood loss in the laparoscopic hysterectomy group was significantly less than in the non-laparoscopic group (213 g vs. 46.5 g, P=0.0017). The rate of patients who received blood transfusion in the laparoscopic hysterectomy group tended to be higher than in the non-laparoscopic group (9.7% vs. 0%, P=0.056). Conclusion It is highly possible that laparoscopic hysterectomy is a safe operative procedure in stage IA1 cervical cancer when performed by experienced surgeons in tertiary centers.

Objective This study evaluated outcomes of laser vaporization of the cervix for women with cervical intraepithelial neoplasia (CIN)-2 or 3. Methods We retrospectively reviewed 300 consecutive patients with CIN2/CIN3 who were treated with cervical laser vaporization between January 2008 and December 2014. At each follow-up visit, histologically confirmed CIN2/CIN3, and invasive carcinoma were defined as treatment failures, as were high-grade squamous intraepithelial lesion (HSIL) or atypical squamous cells that cannot exclude HSIL (ASC-H) with subsequent treatment or lost to follow-up. Primary endpoints included long-term follow-up (at least five years of regular hospital visits) and treatment failure rate. Treatment failure rates were estimated by the Kaplan–Meier method. Results Patients’ median age was 32 years old. Median follow-up period was 70 months (interquartile range: 51 – 84 months). Eighty-seven patients had CIN2 and 213 CIN3. Over 5 years, 72.0% continued their follow-up visits, but significantly more patients aged ≥ 35 years did so (78.9%) than did those aged ≤ 34 years (66.9%). Treatment failure was observed in 23 patients (2 CIN2 and 21 CIN3), 3 of whom progressed to invasive cancer (1.1%). Four (21.1%) initial failures occurred after the first 5 years. Cumulative treatment failure rates were 2-year: 96.0%, 5-year: 93.6%, and 8-year: 89.6%. Conclusions The importance of ≥ 5 years of regular hospital visits should be emphasized to patients with CIN2/3 who are candidates for cervical laser vaporization, especially those aged ≤ 34 years.

A new species of the freshwater genus Haltidytes (Gastrotricha) was discovered in an urban lagoon in Brazil. Haltidytes pseudosquamosus sp. nov. has a unique arrangement of trunk spines in comparison to its congeners, as well as a rare cuticle covered with smooth rhombic scales. The phylogenetic reconstruction including all known Haltidytes species exhibited one well-resolved cladogram supporting monophyly of the genus. Moreover, an internal clade comprising the Neotropical species was revealed. The presence of a dorsal body covered by cuticle ornamentation appears as synapomorphic for the Neotropical species. An updated identification key is also provided.

Introduction/Background The aim of this study was to verify the feasibility of laparoscopic approach for sentinel lymph node (SLN) surgery in endometrial cancer. Methodology This retrospective study was carried out using data for 118 patients with endometrial cancer who had undergone SLN mapping. Technetium colloid (Tc99m) and/or indocyanine green (ICG) was injected into the uterine cervix and a gamma-detecting probe and/or photodynamic eye camera system was used intraoperatively to locate hot spots. SLN detection rate (unilateral or bilateral) and incidence of complications were compared between open approach (O group, n=65) and laparoscopic approach (L group, n=53). Results Patients‘ median age was 60 years. One hundred and nine (92%) had FIGO Stage I disease. There was no difference in patients‘ age, BMI, FIGO stage, and histology between the two groups. SLN mapping with a combination with two kinds of tracers (Tc99m and ICG) was performed more frequently in the L group than in the O group (49% vs. 20%, P=0.0008). Successful bilateral or unilateral mapping occurred in 91 patients (77%) and 19 (16%), respectively. There was no difference in SLN detection rate between the two groups (P=0.73). Perioperative complication rate tended to be lower in the L group (6% vs. 19%, P=0.051) Conclusion Laparoscopic approach might obtain a SLN detection ability equal to open approach without increasing the number of perioperative complication despite limitation of the present study, i.e. a combination with two kinds of tracers might have given the L group an advantage over the O group. Disclosure Nothing to disclose.

Introduction/Background The aim of this study was to evaluate the feasibility of robotic radical hysterectomy (RRH) in patients with early stage cervical cancer. Methodology This retrospective study was carried out using data for 166 patients with T1b1/2a1, N0 cervical cancer who underwent radical hysterectomy at Hokkaido Cancer Center from January 2010 to April 2018. Study outcomes including operation time, estimated blood loss (EBL), number of lymph nodes harvested, hospital stay, surgical morbidity, recurrence, and survival were compared between open radical hysterectomy (O group, n=134) and RRH (R group, n=32). Results There was no difference in age, body mass index, stage, histology, lymph node metastasis, and tumor diameter between the two group. RRH was significantly associated with longer operation time (268 min vs. 415 min, P Conclusion If RRH was strictly applied to cases of T1b1/2a1, N0 cervical cancer, it could be feasible in early stage cervical cancer. In addition, RRH might decrease occurrence of severe neurogenic bladder compared to open radical hysterectomy. Disclosure Nothing to disclose.

The Brazilian Atlantic forest is a tropical rainforest recognized as a hotspot of biodiversity, with high species richness and endemicity. This forest extends over a wide latitudinal range, bordering the entire Brazilian coastline, from sea level to high mountains over 2000 m.a.s.L., and presents a variety of environmental conditions and forest physiognomy. Despite many years of intense studies on animal biodiversity in the biome, there is a lack of information on meiofauna taxa causing several shortfalls in biodiversity knowledge of these tiny organisms. In this study, we address some of these shortfalls by describing a new species of Neogossea (Gastrotricha: Chaetonotida) from a lentic ecosystem in southeastern Brazil, surrounded by fragments of Atlantic Forest by using an integrative approach combining different morphological techniques and molecular data. We also point out new hypotheses of homologous structures due to scanning electron microscope observations of the new species. Additionally, we used two numerical methods to assess distribution patterns and historical regionalization of four freshwater meiofaunal taxa (Gastrotricha, Rotifera, Copepoda and Cladocera). For the first time, we accessed the areas of endemism in this biological hotspot based on aquatic fauna with a very peculiar life history. Due to sampling issues and meiofauna species being widespread, our results raise incongruences with previous endemism analyses on vertebrates and arthropods. Finally, we performed the first total-evidence phylogenetic analyses of benthic and semiplanktonic gastrotrichs based on 59 morphological characters and three molecular markers, employing a parsimony approach. The phylogenetic reconstruction supports the hypothesis of a single origin of semiplanktonic gastrotrichs, and both Dasydytidae and Neogosseidae families are monophyletic taxa as well as four non-monotypic genera.

Background:Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown etiology that affects mostly young women. Multiorgan complications and prolonged treatment significantly cause physical and mental stress in patients. Improving patients’ quality of life (QOL) in SLE treatment is essential. We examined the treatment effects on disease activity and QOL of SLE patients.Objectives:In recent years, lupus low disease activity state (LLDAS) has been proposed as a treatment target for SLE. Patients who achieve LLDAS have a low recurrence rate for lupus and a low risk of serious complications (1). The aim of this study is to investigate whether achieving LLDAS reduces not only recurrence rate and complications of SLE but also improves patients’ QOL.Methods:A total of 104 SLE patients were enrolled in our prospective SLE registry study (Juntendo, Multi-center, Prospective cohort for investigation of clinical course and outcome in SLE: JUMP) conducted at our institution. SLE was diagnosed using the American College of Rheumatology (ACR) 1982 criteria (revised in 1997). QOL was evaluated using the standard version of the 36-item short form health survey version 2 (SF36v2). Participants were divided into the LLDAS achievement and non-achievement groups, and the characteristics of each group including results of SF36v2 were examined.Results:This study included 104 SLE patients, 94 female and 10 male, and the average age and disease duration were 46.4±13.8 and 14.5±11.3 years, respectively. The average corticosteroid dose was 8.0±17.4 mg/day in terms of prednisolone, and anti-dsDNA antibody titer was 16.8±38.5 IU/ml. Of the 104 patients, 57 achieved LLDAS. The subscale’s standard scoring using SF36v2 for role physical (RP) was 78.9±24.0 and 64.6±27.6 (P50. However, in the LLDAS non-achievement group, all categories were Conclusion:Results of examining the association between LLDAS and QOL using SF36v2 in SLE patients showed that patients who achieved LLDAS had significantly better standard statistical scores in many subscale categories. Thus, LLDAS achievement as a treatment target for SLE patients greatly contributes to improving patients’ QOL.References:[1]Franklyn K, et al. Definition and initial validation of a Lupus Low Disease Activity State (LLDAS).Ann Rheum Dis. 2016 Sep;75(9):1615-21.Disclosure of Interests:None declared

Background SLE is characterised by alternate occurrences of flares and remissions throughout its course. During these flares, immune complexes are excessively produced and deposited in affected tissues. Previous reports suggest that immune complexes deposited in the blood vessels, atrioventricular valves, and other associated components of the heart cause disorders in these tissues. Although, the characteristics of patients in whom tissue injuries progress and ultimately require surgery have not been clarified. 1 Objectives Heart diseases are categorised into valvular disease, ischaemic heart disease, and aortic aneurysm. This study was conducted to determine whether there was a correlation between the activity of SLE and the progress and aggravation of heart disease in each category. Methods Of the 2707 patients who were diagnosed with SLE at Juntendo University Hospital from 2012–2017, 35 underwent cardiac surgery. Six patients met the exclusion criteria, and thus, 29 patients were included. Patients with infectious endocarditis and those in whom SLE had not been diagnosed prior to surgery were excluded. Indices for SLE activity were anti-DNA Ab and CH50. Peak and bottom values of these indices before surgery were recorded, and the values obtained during the pre-surgery 180 day period were compared with those that had been determined prior to this period. Results The mean disease duration at the time of cardiac surgery was 24.2 years. The cardiac diseases were heart valve disease (V) in 10, ischaemic heart disease (I) in 7, and aortic aneurysm (A) in 12 patients. The integrated values obtained by the activity indices, anti-DNA Ab, and disease duration were 14 020 for V, 32 966 for I, and 29 444 for A. Thus, there was a tendency for values to be slightly lower in the heart valve disease category. The peak/bottom values for CH50 and anti-DNA Ab in the pre-surgery 180 day period were no different from those obtained prior to this period. Investigation of anti-phospholipid antibodies indicated that the rates of positive result for either CLβ 2 GPI, anti-CL antibodies, or LA were 60% for V, 28% for I, and 33% for A, and thus, higher in the heart valve disease category. All patients were treated with steroids, and five patients (17.2%) of the 29 used immunosuppressants. This rate tended to be lower than the previous frequency of the combined use of immunosuppressive drugs at our hospital (onset:18.4%, first flare 33.3%). 2 Conclusions There is a possibility that the long-term duration of SLE may lead to cardiac disease requiring surgery. The integrated value for DNA Ab was lower in the heart valve disease category; therefore, the presence of anti-phospholipid antibodies may be a risk factor for valvular disease. The low frequency of combined use of immunosuppressants in SLE patients with cardiovascular manifestations requiring surgery, suggest the possibility that treatment with a single steroid may require heart surgery. References [1] Yasuhiro Sakaguti, Sachio Kawai, Ryozo Okada, et al. Immunohistochemical study of the endomyocardial biopsy of Systemic Lupus Erythematosus. Journal of Cardiology. 1995;25:181–188 [2] Kentaro Minowa, Hirofumi Amano, Yoshinari Takasaki, et al. Disease flare patterns and predictors of systemic lupus erythematosus in a monocentric cohort of 423 Japanese patients during long-term follow-up: The JUDE study. Mod Rheumatol. 2017;27:72–76 Acknowledgements none Disclosure of Interest None declared

Efinaconazole is a new triazole antifungal for topical treatment of onychomycosis. The reproductive and developmental toxicity of efinaconazole was characterized in fertility and early embryonic development (rat), embryo-fetal development (rat and rabbit), and peri/post-natal development (rat) studies in accordance with current ICH guidances. In the fertility study, maternal reproductive toxicity was noted as estrous cycle prolongation (NOAEL = 5 mg/kg/day) but there were no male reproductive effects even in the presence of paternal toxicity (NOAEL = 25 mg/kg/day). Rat embryo-fetal and perinatal pup lethality was the most sensitive (NOAEL = 5 mg/kg/day) efinaconazole developmental toxicity and was noted at maternally toxic doses. Efinaconazole did not affect rabbit embryo-fetal development at maternally toxic doses (NOAEL = 10 mg/kg/day). No malformations were induced by efinaconazole in rats or rabbits. When compared with systemic exposures observed in onychomycosis patients, embryo-fetal toxicity in rats was noted at high (>100-fold) multiples of systemic exposure.

The aim of this study is to compare phosphocreatine (PCr) concentrations of human masseter and medial pterygoid muscles by a recently developed localized magnetic resonance spectroscopy (MRS) method, chemical shift imaging (CSI). The characteristic spectra of phosphorous metabolites including PCr and beta-ATP from the superficial part of the masseter (SM) and the deep part of the masseter (DM) and the medial pterygoid muscles (MPt) from 11 volunteers, 20-27-year-old were obtained. The study clearly demonstrated higher PCr/beta-ATP in the SM and MPt than in the DM both in mean values (P < 0.01) and in individual subjects. The results indicate that SM and MPt are power producers. There were no significant differences in the mean values of the PCr/beta-ATP ratios in SM and MPt, however, the PCr/beta-ATP ratios varied individually and the subjects could be divided into three distinct groups: values of MPt higher than SM (group A, 4 subjects); values of MPt almost equal to SM (group B, 3 subjects); and values of MPt lower than SM (group C, 4 subjects). There appears to be a close relationship between the PCr content as determined in the groups here and occlusal guidance.

In order to apply an optical shallow defect analyzer (OSDA) to wafer inspection effectively, we investigated the correspondence of the sizes and depths of the grown-in defects measured by OSDA in CZ-Si to those measured by TEM. A focused-ion-beam (FIB) microsampling technique was used for preparing cross-sectional TEM specimens from a plan-view TEM specimen. Both plan- and cross-sectional views of the identical defect were obtained. The defect depths measured by OSDA coincide with those estimated by stereo observation within an error of ±0.1 μm. The ratio of the OSDA-measured defect size to that estimated from the TEM image varies from 0.68 to 1.80. The variation of the ratio may be caused by the dependency of scattering intensity on incident beam angle to the defect. We also observed the grown-in defects in an epitaxial wafer. Lattice strains were found, which might be caused by particles stuck on the wafer surface during epitaxial growth.

We tried to depict the brain activity of mastication (two types of movement) with functional MRI (FID type EPI with fat saturation on 1.5T). Thirteen of 16 volunteers (81.3%) showed proper signal changes on primary motor cortex. The active sites changed according to the type of masticating movement. We concluded that functional MRI can be used investigate the control of mastication in the CNS.

Background Although the prognosis for systemic lupus erythematosus (SLE) has greatly improved, many patients experience the disease flare-up. Little is known about the disease flare-up patterns and predictors in a long-term follow up. Objectives The aim of this study was to clarify the outcomes and predictors for disease flare-up in a monocentric cohort of Japanese patients with SLE. Methods Among 2390 SLE patients registered in our JUDE (Juntendo University Database of Erythematosus) study, diagnosed between 1964 and 2004, 423 for whom long-term follow-up was possible between 1973 and 2012 were investigated. Disease activity patterns were defined using the SLE Disease Activity Index-2000 (SLEDAI-2K) 1 .Disease flare-up was defined according to the SELENA-SLEDAI flare composite 2 . SLE patients were included if they fulfilled the ARA 3 or ACR 4 criteria for SLE. Data on disease activity, severe flare-up and treatment were collected, and the initial clinical manifestations of disease flare-up were analyzed. The censoring period for analysis was May to October 2013. Results The mean follow-up duration was 25.9 years. During follow-up, 118 (27.9%) of the 423 patients experienced at least once flare-up after initial treatment with corticosteroid or corticosteroid plus immunosuppressant. More than half (58.5%) of the patients who suffered flare-up were accumulated within 5 years, irrespective of the initial therapy. Comparison of the age at onset among patients who suffered flare-up more than twice in 10 years after the initial therapy showed that teenage onset accounted for a greater proportion than patients who developed SLE in their thirties and beyond. The most common manifestation associated with flare-up was thrombocytopenia. Cluster analysis showed that renal disturbance was distinct from arthritis among manifestations of both onset and flare-up. Conclusions This long-term monocentric cohort follow-up study of 423 Japanese SLE patients revealed that 27.9% suffered flare-up after the initial therapy, irrespective of the initial treatment regimen. References Gladman DD, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002 29(2):288-91. Petri M, Kim MY, Kalunian KC, Grossman J, Hahn BH, Sammaritano LR, Lockshin M, Merrill JT, Belmont HM, Askanase AD, McCune WJ, Hearth-Holmes M, Dooley MA, Von Feldt J, Friedman A, Tan M, Davis J, Cronin M, Diamond B, Mackay M, Sigler L, Fillius M, Rupel A, Licciardi F, Buyon JP; OC-SELENA Trial. Combined oral contraceptives in women with systemic lupus erythematosus. N Engl J Med. 2005 15;353(24):2550-8. Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, Schaller JG, Talal N, Winchester RJ. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 25(11):1271-7. Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997 40(9):1725 Disclosure of Interest None declared

B cells in patients with rheumatoid arthritis (RA) are hyperactivated. Although B cell receptor signal transduction may be affected by various response regulators, CD22 plays an important role as a response regulator of B cells. Therefore, we investigated and examined CD22 expression on peripheral blood B cells of patients with RA. Thirty-two RA patients and 16 controls were enrolled in this study, and CD22 expressions on B cells were analyzed by flow cytometry. In patients with RA, CD22(+) B cells significantly decreased in comparison to the controls (ratio: P0.05). However, there was no correlation between this decrease and the clinical data. Interestingly, CD5(+) CD22(-) B cells significantly increased in RA patients. The decrease in CD22(+) B cells and increased in CD5(+)CD22(-) B cells play critical roles in the pathogenesis of RA mediated by the activation of B cells.

A new physiological model is proposed for geometrical illusion phenomena in human vision and is implemented by artificial neural networks. According to the model, illusion is a result of nonuniform bending in visual space whose Riemannian metric tensor is determined by lateral excitatory-inhibitory dynamics of the retina neurons.

A novel physiological model is proposed for the geometrical illusion phenomenon in human vision. This model assumes that the illusion is a result of nonuniform bending in visual space whose Riemannian metric tensor is determined by the excitatory state of the lateral inhibitory neural network. It can be easily implemented by artificial neural networks. The neural network model was used to realize (qualitatively, but it can be fine-tuned) the Ebbinhaus illusion, the Zollner illusion 1, the Hering illusion 2, the Wundt illusion, the Muller-Lyer illusion, the Helmholtz vertical illusion, and the concentric circle illusion, and to settle the notorious paradox of displacement for Hering 7 and the Wundt illusion. >

A model is proposed for global representation and cognition of 3D objects, and a global self-organizing learning method using Kohonen's local topology conserving maps is presented. A 3D object is represented by a set of sheets (subnets). Each of the sheets is mapped onto a part of the surface of the subject by a locally converging Kohonen map. The adjacency of the overlapped sheets is also defined over the whole surface of the objects. Thus, these adjoining subsets will eventually converge to a global atlas representation of any closed surface (as a combinatorial manifold), the Kohonen maps on each part become the local coordinate (or chart) maps. The proposed model is able to represent the objects distributively and can easily accommodate local features. >

It was dicovered that the pressboard immersed in positively charged oil were highly charged up. The experiments to evaluate the charge density and the charge distribution in the pressboard were carried out to investigate the mechanism of charge accumulation. In the experiment, positive charges generated by oil flow were supplied to the pressboard sample. Charge densities in oil and pressboard were evaluated from the potential measurement. Charge distribution in pressboard was estimated from the current-time characteristics at DC voltage application to the pressboard.

Many reports have demonstrated significant region-dependent differences in the fiber-type composition of the human masseter muscle. Therefore, it is considered that there is intramuscular heterogeneity of metabolic activity in the muscle. The present study was carried out, with two-dimensional Chemical Shift Imaging, to detect differences between the deep and superficial parts of the human masseter muscle at rest. Masseter muscle from 11 volunteers, from 20 to 27 years old, was examined, and characteristic spectra of the inorganic phosphate (Pi), phosphocreatine (PCr), and a-, β-, and γ-adenosine triphosphate (ATP) from each part of the muscles were obtained. In this study, the deep and superficial parts of the masseter muscle were distinguished by the existence of aponeurosis. The Pi/PCr, PCr/β-ATP, and Pi/β-ATP ratios as well as the pH in the deep and superficial parts were calculated from the peak spectra. Compared with the deep part, the Pi/PCr of the superficial part was lower (p < 0.05) and the PCr/β-ATP was higher (p < 0.01). The Pi/β-ATP and pH showed no significant differences between the two parts. The results indicate that the superficial part of the masseter muscle contains more PCr than the deep part, and this may be related to functional differences between these two parts. In future examinations of the metabolic activity of the human masseter muscle, the deep and superficial parts must be measured separately.

Intrahepatic portosystemic venous shunt is a rare clinical entity; only 33 such cases have been reported. It may be congenital, or secondary to portal hypertension. Five patients with this disorder are presented, each of whom was diagnosed by color Doppler imaging, including waveform spectral analysis. One patient with clinical evidence of cirrhosis and portal hypertension had episodes of hepatic encephalopathy and elevated blood levels of ammonia. This patient had a large tubular shunt between the posterior branch of the portal vein and the inferior vena cava. Shunts of this type are considered to be collateral pathways which develop in the hepatic parenchyma as a result of portal hypertension. The other four patients had no evidence of liver disease, and all four evidenced an aneurysmal portohepatic venous shunt within the liver parenchyma. Shunts of this type are considered congenital. The diagnosis of intrahepatic portosystemic venous shunts was established by color Doppler imaging, which demonstrated a direct communication of color flow signals between the portal vein and hepatic vein, in addition to the characterization of the Doppler spectrum at each sampling point from a continuous waveform signal (portal vein) to a turbulent signal (aneurysmal cavity), and finally, to a biphasic waveform signal (hepatic vein). As demonstrated by the five patients, color Doppler imaging is useful in the diagnosis of an intrahepatic portosystemic hepatic venous shunt, and the measurement of shunt ratio may be useful in the follow-up and determining the therapeutic option.

Two cases of farmer's lung disease in siblings are reported. A 54-year-old male farmer, who had been engaged in stock work for 20 years, presented to our clinic for the second episode of fever, productive cough and shortness of breath. Chest roentgenogram revealed diffuse micronodular pattern, and mild hypoxemia was recognized on arterial blood gas analysis. Cytology obtained from BALF showed lymphocytosis, with especially increased OKT3, OKT4 positive cells and OKT4/8 ratio. The diagnosis was confirmed by highly positive reaction of precipitins to Thermoactinomyces vulgaris and granulomatous interstitial pneumonitis on histopathological examination. The second case was a 51-year-old female patient, the sister of the first case, who also worked as a stock farmer of another farm for 20 years. She presented with an episode of similar symptoms to the first case, one and a half years after the onset of her brother's symptoms. The findings of roentgenogram, BALF analysis, precipitins to T. Vulgaris and pathology were similar to those of the first case. The finding of high OKT4/8 ratio on BALF analysis in both cases is characteristic of formers lung disease, in contrast to the summer-type hypersensitivity pneumonitis which usually shows low OKT4/8 ratio in BALF. To our knowledge, this is the first report of farmer's lung disease in an area other than the northern part of Japan. Thus we conclude that farmer's lung disease may occur in Japan under any environmental conditions, and that some genetic factor may take part in the onset of this disease.

A lateral cephalogram analysis system has been developed allowing an extended application of the Ricketts analysis to primary dentition. Using this system, we first examined the growth of facial patterns from the BA-NA ratio profilograms. As samples, we used records of children with normal occlusions stored at Nihon University School of Dentistry Department of Pedodontics. We then used the Fuzzy theory to change Vert's formula and obtained facial types. Lastly, we obtained compositional ratios of facial types within each age group. The results were as follows: 1) Facial patterns tended to show three divisions according to three age groups; from 3 to 5-year olds, from 6 to 7-year olds and from 8 to 10-year olds. 2) The Vert's values of the BA-NA ratio profilograms in each age group based on the data of 9-year olds tended to decrease as age increased. The change was mostly restricted to the range of Mesiofacial type. 3) As for the compositional ratio of facial types in each age group, a nearly normal distribution was observed mainly with the Mesiofacial type. 4) From the lateral cephalogram analysis system which has been developed and the profilograms of the average values for each age group which have been obtained by this system, we obtained the standard values for future evaluation of facial patterns of children with malocclusions.

Continually, we determined vitamin contents of the breads for school lunch of 28 schools in Kita-ku, Tokyo. The results are shown in the table.

The meats of two marine animals, that were known to contain high levels of both methylmercury and selenium, were compared with respect to their protective potencies against the neurotoxicity of methylmercury. The organ distributions of selenium and mercury in rats given diets containing these meats was also compared. Weanling rats were fed for 12 wk on a diet containing 17·5 ppm methylmercuric chloride and one of two levels of selenium (0·3 or 0·6 ppm) originating from the meat of sebastes (Sebastes iracundus) or of the sperm whale (Physeter catodon), or from sodium selenite. The protection conferred by sebastes meat was roughly equal to that of the selenite regarding growth rate but was considerably greater with respect to the neurological signs. By both criteria, sperm-whale meat was less effective than sebastes meat and selenite in providing protection. The organ distribution pattern of selenium and mercury showed that selenium in the blood, brain and spinal cord was positively correlated with neurological protection, while total mercury and methylmercury in those organs were negatively correlated with neurological protection. The level of protection (delay of the neurological manifestations by nearly 7 wk) corresponding with the increase in selenium levels in the nervous system (from about 1 50 to 1 10 of the methylmercury levels on a molar basis) indicated that the protective mechanism was not simply direct conjugation of selenium with methylmercury. It has previously been noted that tuna fish containing high levels of selenium provide protection against methylmercury toxicity and it may be that all marine animals rich in both selenium and methylmercury afford this protection.

Adult T-cell leukemia (ATL) is a severe chemotherapy-resistant malignancy associated with prolonged infection by the human T cell-lymphotropic virus 1 (HTLV-1) retrovirus. Epidemiology studies strongly indicate that an increase in HTLV-1 virus load is an important factor during the onset of ATL. Therefore, inhibition of the growth/transmission of HTLV-1 infected cells is a promising strategy in preventing the disease. In our previous study, we revealed that arsenic trioxide (As2O3), a drug used to treat acute promyelocytic leukemia (APL), exerts an inhibitory effect on syncytium formation between HTLV-1 infected cells and HeLa cells via suppression of HTLV-1 envelope protein gp46 expression at low concentrations. In this study, we analyze the mechanism of action of As2O3 using a proteomics approach. Our results suggest that down-regulation of gp46 might be related to As2O3-induced oxidation of the 71-kDa heat shock cognate protein (HSC70) and the 78-kDa glucose-regulated protein (BiP/GRP78). We postulate that AS2O3 exerts an inhibitory effect on HTLV-1 virus transmission via down-regulation of gp46-production, which might be caused by oxidative modification of various proteins such as chaperones.