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Background Although the opportunity to treat subcentimeter lung cancers has increased, the optimal surgical methods remain unclear. We performed a retrospective study to examine the clinical outcome of subcentimeter lung cancers. Patients and Methods In total, 118 patients who underwent curative resection for subcentimeter lung cancer from January 2005 to December 2013 were analyzed. Multivariate Cox proportional hazards models were used to calculate the hazard ratio to identify independent predictors of recurrence-free survival (RFS) and overall survival (OS). Results Anatomical resections were performed for 64 patients (59 lobectomies and 5 segmentectomies) and wedge resections for 54 patients. Recurrence developed in six patients who had consolidation-predominant tumors (consolidation/tumor [C/T] ratio of >0.5) and underwent wedge resections. The first recurrence patterns were regional recurrences in three patients, both regional and distant in one, and distant in two. Seventeen patients died of other causes. The multivariate analysis revealed that the C/T ratio was the independent predictor of RFS (p = 0.008) and OS (p = 0.011). Conclusion Patients with subcentimeter lung cancer rarely developed recurrence. The C/T ratio was the independent prognostic factor, and all relapsed patients received wedge resections. Even for subcentimeter lung cancers, we should select the extent of pulmonary resection after thoroughly considering whether wedge resection (less invasiveness) is a reasonable alternative to anatomical resection (superior oncologic efficacy) considering the C/T ratio of the lesion. [ABSTRACT FROM AUTHOR]

Purpose: While surgery is an effective treatment for secondary spontaneous pneumothorax (SSP), it can be difficult, because affected patients are usually in a poor general condition. The present study investigated the risk factors of postoperative complications after surgery for SSP. Methods: Eighty-eight patients with SSP who underwent surgery from January 2006 to March 2018 were investigated. Clinical data were reviewed, and a multivariate analysis was performed. Results: Eighty-four patients (95%) were males, and the median patient age was 72 years. Underlying lung diseases were chronic obstructive pulmonary disease in 58 patients (65.9%), interstitial pneumonia in 26 (29.5%), and others in 4 (4.5%). Postoperative complications developed in 21 patients (24%). Hospital mortality/prolonged length of stay occurred in 6 patients (7%). A multivariate analysis showed that the preoperative performance status (performance status 0–2 vs. 3, hazard ratio: 6.570, 95% confidence interval: 1.980–21.800) was an independent predictor of postoperative complications. Conclusion: Surgery for SSP contributed to early chest tube removal and favorable outcomes. However, rare fatal events occurred, and the patient performance status was a risk factor for postoperative complications. A careful evaluation of each patient's performance status is needed to determine the need for surgical intervention for SSP. [ABSTRACT FROM AUTHOR]

Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever in China, Korea, and Japan. Japanese spotted fever (JSF), which belongs to spotted fever group rickettsioses, is also endemic to Western Japan. Patients with SFTS and those with JSF display many of the same clinical manifestations. Sudden fever, rash, tick bite, and neurological and gastrointestinal symptoms may be seen in both infections, but the frequency and severity of each disease have not been compared and studied. Because laboratory confirmation of pathogens takes time, it is important to predict diagnosis of SFTS vs JSF based on the features of the clinical characteristics at the initial presentation, particularly in primary care settings. Methods We conducted a case series review at 4 medical facilities in Miyazaki, Japan. Based on the medical records, clinical and laboratory characteristics were compared between patients with SFTS and those with JSF. Results Eighty-one patients were enrolled in this study, including 41 with SFTS and 40 with JSF. The absence of rash (P  < .001), leukopenia (P  < .001), and normal C-reactive protein (CRP) levels (P  < .001) were the variables distinguishing SFTS from JSF. Normal CRP levels (≤1.0 mg/dL) had a 95% sensitivity (84%–99%) and 97% specificity (87%–100%) for SFTS, with a positive likelihood ratio of 37.1 (5.35–257). Conclusions Normal serum CRP levels were shown to differentiate SFTS from JSF with a very high probability. [ABSTRACT FROM AUTHOR]

Invasive mucinous adenocarcinoma (IMA), which is a relatively rare lung adenocarcinoma, is considered a high‐grade subtype and is associated with a poor prognosis. IMA is difficult to diagnose by computed tomography because it requires differentiation from inflammatory diseases, such as atelectasis, infectious pneumonia, and organizing pneumonia. Thus far, no reports of radial endobronchial ultrasonography (EBUS) findings in IMA have been published. This article presents a case of IMA with a characteristic shadow, snowball‐like appearance on radial EBUS in a 67‐year‐old Japanese man. [ABSTRACT FROM AUTHOR]

Background: Pulmonary wedge resection is an option for lung cancer patients with limited cardiopulmonary preservation. As the impact of underlying lung status on the prognosis of such patients remains unclear, we assessed this issue. Methods: A total of 149 borderline surgical candidates with localized lung cancer who had undergone wedge resection were retrospectively investigated. Clinical variables related to perioperative morbidity, local control rate, and oncological outcomes based on underlying lung disease were analyzed. Results: According to the risk analysis of postoperative complications, underlying lung disease did not influence the surgical morbidity. Postoperative recurrence occurred in 65 patients (locoregional recurrence in 36, distant metastasis in 12, and both simultaneously in 17). Multivariate analysis revealed that emphysema on computed tomography (CT) [hazard ratio (HR) 0.45; 95% confidence interval (CI) 0.21–0.99] was an independent indicator of locoregional recurrence. Forty-four patients died of lung cancer and 29 of other causes. Multivariate analysis demonstrated that interstitial lung disease on CT (HR 1.98; 95% CI 1.01–3.89) was a predictor of poor prognosis. Conclusion: Pulmonary wedge resection can be safely undergone by lung cancer patients regardless of pulmonary comorbidity, although underlying lung disease may influence the prognosis after wedge resection. [ABSTRACT FROM AUTHOR]

Nontuberculous mycobacterial lung disease sometimes causes pneumothorax and empyema, which are often intractable because of patients’ background factors. Biological products used in the treatment of rheumatoid arthritis have caused the problem of an increase in infection rates as a side effect, one of which is nontuberculous mycobacteriosis (NTM). On the basis of past experience, we report the case of a patient who had a history of undergoing treatment with biological products against rheumatoid arthritis. The patient was treated for NTM-induced pyopneumothorax by endoscopic bronchial occlusion therapy using endobronchial Watanabe spigots. [ABSTRACT FROM AUTHOR]

Presents a study that investigated the composition dependence of photoinduced and thermally induced bleachings of amorphous germanium-sulfur and germanium-sulfur-silver. Experimental details; Results of the study; Conclusions.

Deals with a study which determined quantitatively the composition dependence of silver (Ag) photodoping into amorphous germanium-sulfur films. Background to the study; Sample preparation and exposure; Evaluation of the amount of photodoped Ag; Discussion of results.

Presents a study which prepared bulk glasses in the (As[sub0.4S[sub0.6][sub100-x] gold (Au)[subx] system by melt-quenching in air. Experimental procedures; Results and discussion; Conclusions.

Focuses on a study on the optical, electrical, and structural properties of evaporated amorphous (Ge[sub0.3]S[sub0.7])[sub100-x]Ag[subx] and (Ge[sub0.3]Se[sub0.7])[sub100-y]Ag[suby] films. Maximum silver (Ag) contents for amorphous films; Description of the photoinduced surface deposition (PSD) of metallic Ag; Analysis of the differences in PSD phenomenon between the S- and Se-based systems; Information on the x-ray diffraction patterns of the as-deposited films for the S-based system.

Presents a study which examined the photoinduced surface deposition of metallic silver in silver-arsenic-sulfur glasses. Experimental methods; Results; Discussion.

We describe our technique of minimally invasive chest wall resection for primary lung cancer. We used this technique to perform two lobectomies combined with chest wall resection using thoracoscopic assistance. The intercostal muscles and vessels were divided using a vessel-sealing device, which was easy to maneuver through the access incision, achieving reliable hemostasis. In one patient, adding the utility port just over the dorsal edge of the chest wall proved useful for dissecting the distal area of the chest wall. This approach required only minimal incision without cutting the uninvolved extrathoracic musculature of the chest. [ABSTRACT FROM AUTHOR]

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease in China, Korea and Japan caused by a novel bunyavirus, SFTS virus (SFTSV). Although central nervous system manifestations are common in SFTS patients, the pathogenesis has not been elucidated; and there are few reports of myocardial dysfunction. Here we report an elderly Japanese patient with reversible myocardial dysfunction and encephalopathy. A previously healthy 65-year-old male engaged in forestry got a tick bite and developed fever and fatigue in 3 days. Three days after onset, he presented to a local hospital where the diagnosis of SFTS with hemophagocytotic syndrome was made. The blood test showed leukopenia and thrombocytopenia as well as elevated levels of alanine aminotransferase and aspartate aminotransferase. Marked hemophagocytosis was found on bone marrow smear. Peripheral blood was positive for SFTSV gene by reverse-transcription polymerase chain reaction. On day 7, the patient was transferred to our hospital. We observed disturbance of consciousness, Kernig sign and myoclonus to face and limbs. Decreased blood flow of whole cerebral cortex was detected by single photon emission computed tomography (SPECT). Chest X-ray revealed cardiomegaly and electrocardiography (ECG) showed abnormal T waves. These data suggested acute encephalopathy and myocardial dysfunction. We treated him with corticosteroid and blood transfusion, which resulted in the complete recovery of the above abnormal symptoms and laboratory data including the findings in SPECT and ECG in about a month. This case demonstrated transient myocardial dysfunction and encephalopathy can occur in addition to typical clinical manifestation of SFTS. [ABSTRACT FROM AUTHOR]

Abstract: Tartrate-resistant acid phosphatase (TRAP) consists of 2 structurally related isoforms, 5a and 5b, and the latter has been characterized as containing a sugar moiety devoid of sialic acid(s). We provide evidence of a greater difference between the sugar moieties of the two isoforms than the presence of sialic acid(s) in TRAP 5a. TRAP 5a and 5b were highly purified from human blood and femur extracts, respectively, and after purifying the TRAPs by successive chromatography on a series of lectin affinity columns, we used the chromatographs obtained to estimate the composition of their sugar chain structure and found that both TRAP 5a and 5b had contained the heterogenous sugar chains. More specifically, TRAP 5a mainly contained a high-mannose-type sugar chain, while TRAP 5b had multi-antennary complex-type sugar chain. These results indicate that the differences between TRAP 5a and 5b consist not only of a difference in modification by sialic acid but differences in other sugar chain structures. These differences are involved in an extraordinary enzyme maturation process since the carbohydrate chains cover the repressive loop where the proteolytic site is located. [Copyright &y& Elsevier]

Abstract: Photodoping of Ag metal (photodissolution), photoinduced surface deposition (PSD) of Ag deposits and photoinduced chemical modification (PCM) of the Ag concentration have been reported for Ag-containing chalcogenide glasses. These phenomena are closely related to the thermodynamic metastability of the glasses, since Ag+ migration by illumination causes the structural change. For photodoping of Ag/As–S sample, the solid-state reaction between Ag metal and As–S glass decreases the total free energy of the system (unstable→ stable). The segregation of Ag metal by PSD decreases the total free energy and the process is also represented by ‘unstable→stable’. Inversely, PCM increases the total free energy and the process is ‘stable→unstable’, in contrast to the other phenomena. The results agree with the data that photodoping and PSD are irreversible reactions but PCM is reversible. The other basic data can also be explained in a coherent way from the photoinduced free-energy change. [Copyright &y& Elsevier]

There are specific points at which the X-ray (neutron) scattering intensity of solutes is independent of the electron density (scattering density) contrast between solutes and solvent. These points are referred to as "isoscattering points". They have been observed in the X-ray small-angle scattering data of globular particles such as micelles and bacteriophages. The condition for the appearance of an isoscattering point is briefly reported. The nature of the isoscattering point is described in view of the application to analysis of solute structures. [ABSTRACT FROM AUTHOR]

Investigates the radius of gyration and scattering function of torus in cylindrical coordinates. Derivation of gyration scattering curves by numerical calculation; Observation of first minimum in the low-angle region; Importance of derivations for small-angle scattering studies.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tickborne infectious disease in China, Korea, and Japan caused by the SFTS virus (SFTSV). SFTS has a high mortality rate due to multiorgan failure. Recently, there are several reports on SFTS patients with mycosis. Here, we report a middle-aged Japanese SFTS patient with invasive pulmonary aspergillosis (IPA) revealed by an autopsy. A 61-year-old man with hypertension working in forestry was bitten by a tick and developed fever, diarrhea, and anorexia in 2 days. On day 4, consciousness disorder was appearing, and the patient was transferred to the University of Miyazaki Hospital. A blood test showed leukocytopenia, thrombocytopenia, as well as elevated levels of alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and creatine kinase. The SFTSV gene was detected in serum using a reverse-transcription polymerase chain reaction. On day 5, respiratory failure appeared and progressed rapidly, and on day 7, the patient died. An autopsy was performed that revealed hemophagocytosis in the bone marrow and bleeding of several organs. IPA was observed in lung specimens. SFTSV infection may be a risk factor for developing IPA. Early diagnosis and treatment of IPA may be important in patients with SFTS. [ABSTRACT FROM AUTHOR]

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever in China, Korea, and Japan. To date, no standardized treatment protocol for SFTS has been established. Corticosteroids (CS) may be administered to patients with SFTS and hemophagocytic syndrome, but its effectiveness and safety are still debatable. We conducted a retrospective case series review at four medical facilities in Miyazaki, Japan. Based on the medical records, clinical data, including the patients background, symptoms, physical findings, laboratory data at initial presentation, treatment, and outcome, were compared between the CS-treated and the non-CS-treated group. A total of 47 patients with confirmed SFTS in each hospital were enrolled in this study; there were 14 fatal cases and 33 nonfatal cases. The case fatality ratio was 29.8%. After adjusting patients' background by propensity score matching, the case fatality ratio was higher (p = 0.04) and complications of secondary infections, including invasive pulmonary aspergillosis, tended to be more frequent (p = 0.07) in the CS-treated group than in the non-CS-treated group. These data suggested that administration of CS to patients with SFTS should be carefully considered. [ABSTRACT FROM AUTHOR]

The histopathologic diagnosis of poorly differentiated cutaneous angiosarcoma can be challenging. We report a case of cutaneous epithelioid angiosarcoma with numerous multinucleated giant cells (MGCs) developing pulmonary metastasis. A 79‐year‐old man presented with a red–purple plaque on the scalp. A skin biopsy revealed epithelioid cell proliferation, admixed with numerous MGCs, and background hemorrhage. Vascular spaces were focally present and lined by atypical endothelial cells, including MGCs. Immunohistochemically, tumor cells, including MGCs, were positive for CD31, D2‐40, and ERG. The patient received radiation therapy and chemotherapy, after which a follow‐up CT scan revealed symptomless pneumothorax and pulmonary metastases. The patient received palliative partial lung resection, and the specimen revealed histopathological and immunohistochemical features similar to the primary cutaneous lesion. Our report expands the morphologic spectrum of cutaneous epithelioid angiosarcoma. Cutaneous angiosarcoma is an aggressive neoplasm; thus, awareness of this rare manifestation is important. [ABSTRACT FROM AUTHOR]

Abstract: Respiratory management of tracheal injuries is a crucial key to successful treatment. We present herein a patient with a traumatic tracheal transection in whom we confronted difficulty in airway management after false intratracheal intubation. No associated injuries were seen in the patient, then, primary repair of the trachea was carried out under ventilatory support via percutaneous cardiopulmonary support system (PCPS). For a short period in the application of PCPS, the use of a heparin-coated circuit made systemic heparinization unnecessary during and after operation, and the outcome was satisfactory. In a carefully selected patient, ventilatory support via PCPS is useful. [Copyright &y& Elsevier]

Background: Luteibacter jiangsuensis is a gram-negative aerobic bacillus that was first isolated from soil samples at a pesticide factory in China and reported in 2011. Here, we describe the first case of L. jiangsuensis infection in human. Case presentation: A 59-year-old Japanese woman undergoing treatment for Crohn's disease was admitted to our hospital with fever. Clinical examination indicated catheter-related bloodstream infection. The catheter was removed and meropenem was initiated. Morphologically identical glucose non-fermentative gram-negative bacilli were detected from two sets of aerobic blood culture and catheter-tip cultures. MALDI-TOF mass spectrometry failed to identify the bacterium, which was later identified as L. jiangsuensis by 16 S rRNA gene sequencing. Antimicrobial susceptibility test revealed that the isolate was resistant to carbapenem, therefore meropenem was switched to intravenous levofloxacin (500 mg/day). After 14 days of treatment with levofloxacin, the patient was discharged. Conclusions: This is the first case of L. jiangsuensis infection in human. The strain was identified by 16 S rRNA gene sequence analysis. [ABSTRACT FROM AUTHOR]

Examines the scattering curve and radius of gyration of a straight chain of identical spheres. Radius of the sphere; Usefulness of zeros; Average of the square modulus of the form factor of a composite particle.

Primary pulmonary diffuse large B‐cell lymphoma is a rare entity. We describe a case of pulmonary lymphoma with multiple nodules mimicking metastases in a treated patient with rheumatoid arthritis. A 73‐year‐old man was diagnosed with rheumatoid arthritis at the age of 30. He was treated with leflunomide. He was followed up for a nontuberculous mycobacterial infection. He underwent percutaneous coronary intervention for acute myocardial infarction at the age of 70. In April 2022, routine follow‐up revealed new‐onset multiple nodules on chest computed tomography (CT). A position emission tomography/CT scan with 18F‐fluorodeoxyglucose showed a low‐high maximum standardized uptake value by multiple nodules. Pathologic examination of a video‐assisted thoracic surgical biopsy revealed pulmonary diffuse large B‐cell lymphoma. Systemic chemotherapy with rituximab, cyclophosphamide, vincristine, and prednisolone reduced and eliminated multiple nodules. Pulmonary lymphoma should be considered as a differential diagnosis in the case of multiple nodules on a chest CT. [ABSTRACT FROM AUTHOR]

The study aims to assess the usefulness of human T-cell leukemia virus type 1 (HTLV-1)-infected cell analysis using flow cytometry (HAS-Flow) as a monitoring method for adult T-cell leukemia (ATL) development in HTLV-1-positive patients with rheumatoid arthritis (RA) under treatment with antirheumatic therapies. A total of 13 HTLV-1-negative and 57 HTLV-1-positive RA patients participated in this study, which was used to collect clinical and laboratory data, including HAS-Flow and HTLV-1 proviral load (PVL), which were then compared between the two groups. CADM1 expression on CD4+ cells in peripheral blood (PB) was used to identify HTLV-1-infected cells. The population of CADM1+ CD4+ cells was significantly higher in HTLV-1-positive RA patients compared to HTLV-1-negative RA patients. The population of CADM1+ CD4+ cells was correlated with HTLV-1 PVL values. There were no antirheumatic therapies affecting both the expression of CADM1 on CD4+ cells and PVLs. Six HTLV-1-positive RA patients who indicated both high HTLV-1 PVL and a predominant pattern of CADM1+ CD7neg CD4+ cells in HAS-Flow can be classified as high-risk for ATL progression. HAS-Flow could be a useful method for monitoring high-risk HTLV-1-positive RA patients who are at risk of developing ATL during antirheumatic therapies. [ABSTRACT FROM AUTHOR]

The photosensitivity of the photosurface deposition (PSD) effect and the durability in air of Ag[sub x](Ge[sub 0.3]S[sub 0.7])[sub 100-x] films (40≤x≤83) with thicknesses of 50–700 nm have been studied. Films of 60–65 at. % Ag and 200–300 nm thick were found to be optimal for applications in optical recording devices. Crystallized samples have been examined to obtain structural information on the Ag-rich films. It is suggested that excess Ag[sup +] ions, which contribute to the PSD, exist in a disordered Ag[sub 8]GeS[sub 6] phase of the Ag-rich films. © 1998 American Institute of Physics. [ABSTRACT FROM AUTHOR]

Single-cell RNA-sequencing (scRNA-seq) is valuable for analyzing cellular heterogeneity. Cell composition accuracy is critical for analyzing cell–cell interaction networks from scRNA-seq data. However, droplet- and plate-based scRNA-seq techniques have cell sampling bias that could affect the cell composition of scRNA-seq datasets. Here we developed terminator-assisted solid-phase cDNA amplification and sequencing (TAS-Seq) for scRNA-seq based on a terminator, terminal transferase, and nanowell/bead-based scRNA-seq platform. TAS-Seq showed high tolerance to variations in the terminal transferase reaction, which complicate the handling of existing terminal transferase-based scRNA-seq methods. In murine and human lung samples, TAS-Seq yielded scRNA-seq data that were highly correlated with flow-cytometric data, showing higher gene-detection sensitivity and more robust detection of important cell–cell interactions and expression of growth factors/interleukins in cell subsets than 10X Chromium v2 and Smart-seq2. Expanding TAS-Seq application will improve understanding and atlas construction of lung biology at the single-cell level. Terminator-assisted solid-phase cDNA amplification and sequencing (TASseq) uses a terminator, terminal transferase and bead-based platform to improve generation of single-cell RNA-seq libraries. [ABSTRACT FROM AUTHOR]

Recently, immune response to coronavirus disease (COVID-19) has attracted attention where an association between higher antibody titer and worsening disease severity has been reported. However, our experiences with severe COVID-19 patients with low antibody titers led to hypothesizing that suppressed humoral immune response may be associated with poorer prognosis in severe COVID19. In this study, antibody titers in severe COVID19 patients were measured at 7, 10, 12, and 14 days after onset. Patients were divided into survivors and non-survivors. SARS-CoV-2 IgM in survivors and non-survivors were 0.06 AU and 0.02 AU (P = 0.048) at 10 days, 0.1 AU and 0.03 AU (P = 0.02) at 12 days, and 0.17 AU and 0.06 AU (P = 0.02) at 14 days. IgG in survivors and non-survivors were 0.01 AU and 0.01 AU (P = 0.04) at 7 days, 0.42 AU and 0.01 AU (P = 0.04) at 12 days, and 0.42 AU and 0.01 AU (P = 0.02) at 14 days. Multivariate analysis showed better survival among patients with IgM positivity at 12 days (P = 0.04), IgG positivity at 12 days (P = 0.04), IgM positivity at 14 days (P = 0.008), and IgG positivity at 14 days (P = 0.005). In severe COVID-19, low antibody titers on days 12 and 14 after onset were associated with poorer prognosis. [ABSTRACT FROM AUTHOR]

Background: Postoperative respiratory insufficiency (PRI) in myasthenia gravis (MG) often occurs within several days after thymectomy and remains problematic. In limited studies reporting that preoperative steroids prevented PRI in patients with MG, high doses of steroids were used and detailed information on the use of steroids is limited. Because high-dose steroids significantly increase the risk of adverse effects, we studied 37 patients with generalized MG to investigate whether low-dose steroids might prevent PRI. Methods: The low-dose steroids were started orally, and the dose was gradually increased to the maximum level (30 mg/day). Immediately before thymectomy, patients received the maximum dose of oral steroids daily. PRI was defined as the development of restrictive dysfunction requiring mechanical ventilation within 3 days after thymectomy and total postoperative mechanical ventilation support time of >24 h. Results: The rate of PRI in the low-dose steroid use group was significantly lower than that in the no-steroid use group. The postoperative stay in the intensive care unit was shorter in the steroid use group. Conclusions: Extended thymectomy is a well-accepted surgical treatment for selected patients with MG. However, PRI remains problematic. Our results suggest that not only preoperative high-dose steroid treatment, but also low-dose steroid treatment can prevent PRI. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Aims: Sensory–perceptual abnormalities, which include hyper- and hyposensitivity, have been identified by numerous researchers as prevalent in individuals with pervasive developmental disorders (PDD). Hypersensitivity has a greater impact on PDD patients' daily lives than hyposensitivity. The purpose of the present study was to clarify the relationship of hypersensitivity to anxiety, depression and other psychopathology in children with PDD. Methods: Sixty-four children were divided into a hypersensitivity group (HG; n = 43) and a non-hypersensitivity group (non-HG; n = 21), and compared for anxiety, depression and other psychopathology on the Child Behavior Checklist (CBCL), State–Trait Anxiety Inventory for Children (STAIC) and Children's Depression Inventory (CDI). Results: The HG group had significantly higher scores than the non-HG group in Total, Internalizing, and Somatic complaints on the CBCL. On STAIC, the mean sore of Total Score, State Score and Trait Score in the HG group tended to be higher than in the non-HG group, but the difference was not significant. The score on the CDI in the HG group was significantly higher than that in the non-HG group. Conclusion: PDD children with hypersensitivity have more serious psychopathologies, especially internalizing symptoms including depression. [ABSTRACT FROM AUTHOR]

Background. Parental overweight has been reported to be a risk factor predicting obesity of their children. However, the effect of changes in parental overweight on the changes in children''s overweight is not yet characterized.Methods. Six hundred five children of 9–10 years underwent physical examinations and a survey concerning parents'' body mass index (BMI) with a 3-year follow-up.Results. In families where both parents'' BMI was above 25 at baseline, when either parents'' BMI decreased to less than 25 kg/m2, children improved their adiposity, atherosclerosis index (AI), and systolic blood pressure (SBP). No such improvement was observed in children both of whose parents maintained BMI ≥25 kg/m2.Conclusions. Improving parental overweight possibly reduced the risk of overweight in their children. Changes in parental overweight status were associated with changes in overweight status of their children. [Copyright &y& Elsevier]

Study objectives: Solitary fibrous tumors of the pleura (SFTPs) are slow-growing neoplasms. Approximately 800 cases have been reported in the literature to date. The aim of this study was to address our experience with the management of SFTPs and to evaluate the advantage of video-assisted thoracoscopic surgery (VATS) in SFTP treatment. Design: Retrospective analysis of our experience. Setting: Department of Thoracic and Cardiovascular Surgery, Nara Medical University. Patients: From January 1992 to August 2002, 13 patients with a SFTP were referred to us for surgical resection after VATS was adopted in our hospital. The study group consisted of seven men and six women with a mean age of 49.8 years (age range, 37 to 72 years). Results: Surgical excision was performed with VATS only in nine patients, with VATS plus a small thoracotomy in three patients, and by a posterolateral thoracotomy without VATS in one patient. The mean chest-drain duration was 1.3 days (range, 1 to 3 days), and the mean duration of hospital stay was 8.6 days (range, 3 to 30 days). Eleven tumors, originating from the visceral pleura, were pedunculate, and 2 tumors from the parietal pleura were not pedunculate. Two cases were focally characterized by a mitotic count in excess of four mitoses per 10 high-power fields and by cellular pleomorphism. Follow-up periods ranged from 6 to 120 months, with a mean of 49.7 months and a median of 42 months. All patients have remained well with no recurrence or metastasis. Conclusions: Complete surgical resection is the treatment of choice for SFYPs. For the pedunculate tumors, therefore, VATS is a powerful and useful approach. Even when it is necessary to perform a small thoracotomy in addition to VATS for the removal of a large tumor, VATS may play an important role in reducing the size of the thoracotomy incision, which results in less invasive surgery. To minimize postoperative morbidity, VATS may be the most promising surgical approach for the resection of SFTPs. [ABSTRACT FROM AUTHOR]

Patients with immune thrombocytopenia have increased risks of bleeding and thrombosis. The acute‐phase treatment for venous thromboembolism complicated with severe immune thrombocytopenia involves a "platelet dilemma" in therapeutic decision‐making. [ABSTRACT FROM AUTHOR]

Background: The transphosphorylating accepter buffers (2-amino-2-methyl-1-propanol, AMP; N-methyl-d-glucamine, MEG; diethanolamine, DEA and 2-ethylaminoethanol, EAE) have been widely used for the measurement of serum total alkaline phosphatase activity (ALP) in clinical laboratories, and the individual isozyme are activated differently by respective buffers. Materials and methods: We examined the activity of serum ALP using four buffers with levels of both high molecular weight intestinal alkaline phosphatase (HIAP) and normal molecular weight intestinal alkaline phosphatase (NIAP). We classified 80 healthy subjects into two groups of blood group B or O secretors (n=36) and other blood groups (n=44). Results: The mean ALP activities at fasting in blood group B or O secretors from AMP, MEG, DEA and EAE methods were 15.5%, 24.0%, 11.0% and 22.1% higher than those in other blood groups, respectively. The reference ranges of ALP activity at fasting with the AMP method in blood group B or O secretors and other blood groups were 63.5±17.4 U/l (mean±S.D.) and 55.0±14.5 U/l (mean±S.D.), respectively. The difference between the reference ranges of ALP activity in blood group B or O secretors and other blood groups was statistically significant (p<0.01). HIAP and NIAP in serum at fasting only appeared in blood group B or O secretors, and the activities of HIAP and NIAP were 4.7±3.4 U/l (mean±S.D.) and 2.2±1.2 U/l (mean±S.D.), respectively. The activity of ALP−(HIAP+NIAP) in blood group B or O secretors was 56.6±15.1 U/l (mean±S.D.), and this reference range was approximately the same as the ALP activity (55.0±14.5 U/l) of other blood groups. The same results were observed with MEG, DEA and EAE methods. Conclusions: These results suggested that the differences in ALP activity in blood group B or O secretors and other blood groups were closely related to the HIAP and NIAP levels. [Copyright &y& Elsevier]

Background: CD4-positive T cells are the main target of human T-cell leukemia virus type 1 (HTLV-1). Interferon-γ release assays rely on the fact that T-lymphocytes release this cytokine when exposed to tuberculosis-specific antigens and are useful in testing for latent tuberculosis infection before initiating biologic therapy, such as anti-tumor necrosis factor agents. However, the reliability of interferon-γ release assays in detecting tuberculosis infection among HTLV-1-positive patients with rheumatoid arthritis (RA) remains unclear. The present study aimed to evaluate the use of the T-SPOT.TB assay in HTLV-1-positive RA patients. Methods: Overall, 29 HTLV-1-positive RA patients and 87 age- and sex-matched HTLV-1-negative RA patients (controls) were included from the HTLV-1 RA Miyazaki Cohort Study. Results of the T-SPOT.TB assay for latent tuberculosis infection screening were collected from medical records of patients. Results: Approximately 55% of the HTLV-1-positive RA patients showed invalid T-SPOT.TB assay results (odds ratio: 108, 95% confidence interval: 13.1–890, p < 0.0001) owing to a spot count of >10 in the negative controls. HTLV-1 proviral load values were significantly higher in patients with invalid results compared with those without invalid results (p = 0.003). Conclusion: HTLV-1 infection affects T-SPOT.TB assay results in RA patients. Assay results in HTLV-1 endemic regions should be interpreted with caution when screening for latent tuberculosis infection before initiation of biologic therapy. [ABSTRACT FROM AUTHOR]

Cunninghamella is a member of the class Zygomycetes. Cunninghamella species include ubiquitous filamentous fungi; infections caused by Cunninghamella species are less frequent but have higher mortality rates than infections caused by Mucorales group members such as Rhizopus and Mucor. Herein, we reported a rare fatal case of endobronchial metastasis from breast cancer accompanied with Cunninghamella bertholletiae tracheobronchial mycetoma. A 73-year-old female with a history of right-sided breast cancer who had undergone mastectomy 11 years previously and had no recurrence presented to our emergency department with a 1-week history of left-sided back pain. Chest X-ray revealed left lung atelectasis; bronchoscopy revealed an endobronchial mass lesion in the left main bronchus. Pathological examination revealed fungal mycetoma but malignant lesions were not detected. Endobronchial and lung mycetoma caused by Cunninghamella bertholletiae were initially diagnosed; liposomal amphotericin B was administered, but her condition deteriorated. Rigid endoscopy showed growth of hemorrhagic tissue occupying the left main bronchus just under the carina. Pathological examination of the shaved lesion revealed metastasis from breast cancer covered with abundant necrotic tissue. No mold was observed in the necrotic tissue; this was probably due to liposomal amphotericin B treatment. To our knowledge, this is the first case of endobronchial metastasis from breast cancer accompanied with Cunninghamella bertholletiae mycetoma. Distinguishing endobronchial metastases from breast cancer and atypical presentations of Cunninghamella endobronchial mycetomas can be very difficult. Repeated bronchoscopies maybe helpful in establishing an accurate diagnosis when clinical prognosis does not match the initial diagnosis. [ABSTRACT FROM AUTHOR]

Human granulocytic anaplasmosis (HGA) is caused by Anaplasma phagocytophilum. Indirect immunofluorescence assay (IFA) is generally used for HGA serodiagnosis. A. phagocytophilum immunodominant P44 major outer membrane proteins are encoded by p44/msp2 multigene family, responsible for IFA reactivity. However, because multiple P44-related proteins may involve immunoreactivity in IFA, the available diagnostic antigens remain obscure. In this study, we identified 12 B-cell epitopes on triple P44-related proteins using peptide array that reacted with 4 HGA patients' sera. Then, peptide spot immunoassay using 14 synthetic peptides derived from those 12 epitopes as antigens was applied for the detection of antibody to A. phagocytophilum from patients with fever of unknown origin. The sensitivities and diagnostic efficiencies of this immunoassay were higher than those of Western blot analysis using 3 recombinant proteins previously developed. Thus, the immunoassay using our epitope-derived antigens, which has higher diagnostic performances, may have significant benefit for HGA serodiagnosis. [ABSTRACT FROM AUTHOR]

Stage I non-small cell lung cancer (NSCLC) is a localized disease without metastasis; therefore, it can be treated effectively with local therapies. Pulmonary resection is the most frequent treatment, performed as pulmonary wedge resection, segmentectomy, lobectomy, or pneumonectomy. Some retrospective clinical studies of pulmonary wedge resection suggest that its outcome may be inferior to that of anatomical pulmonary resection, whereas other recent studies, which assess surgical margin status, leveled acceptable outcomes. Since the outcome of pulmonary wedge resection for lung cancer may depend on tumor size, distance from the surgical margin to the tumor, tumor size/margin distance ratio, and margin cytology results, a prospective study assessing these parameters is ongoing. This will allow us to identify the clinical implications of these factors and predict which patients are likely to have a good outcome. [ABSTRACT FROM AUTHOR]

A 60-year-old woman experienced fever, headache, rash, and altered vision after returning to Japan from India. Testing detected elevated antibody titers to spotted fever group rickettsia; PCR on blood yielded positive results for the rickettsial outer membrane protein A gene. We isolated a unique rickettsial agent and performed a full-genome analysis. [ABSTRACT FROM AUTHOR]

Background: Intestinal alkaline phosphatase (IAP) isozymes in the healthy human serum samples appears in two isoforms: normal-molecular-weight IAP (NIAP) and high-molecular-weight IAP (HIAP). We have demonstrated that the reference range for serum alkaline phosphatase (ALP) activity is higher in blood group B and O antigen secretors than in the tested other blood groups, for the appearance of these isoforms is depended on blood group B or O antigen secretors. Methods: We assessed a diethanolamine-L-phenylalanine (DEA-Phe) method for measuring tissue non-specific alkaline phosphatase (TNAP). This assays the sum of liver alkaline phosphatase and bone alkaline phosphatase activities as determined by an inhibiting IAP activity method with Phe. We classified 420 healthy subjects into two groups, a group of subjects who had blood group B or O antigen secretors (n = 184) and a group of subjects who had other blood groups (n = 236). Results: ALP activity was higher in the B or O secretor group than in the other group: 20.9% higher (P<0.001) by the N-methyl-D-glucamine method, 13.7% higher (P<0.002) by 2-amino-2-methyl-1-propanol method, and 9.6% higher (P<0.05) by the diethanolamine method, but there was no significant difference in TNAP activity between the two blood group when measured by the DEA-Phe method. Conclusions: These results of this study support the expectation that the DEA-Phe method would be specific for TNAP activity. In addition, the reference range for TNAP activity did not vary with the differences in the tested all blood groups. [ABSTRACT FROM AUTHOR]

Abstract: This study examined the relationships between serum adiponectin (AD) and leptin (LP) levels, and obesity using a population-based cohort consisted of 315 (9–10 year olds: G1) and 308 (12–13 year olds: G2) school children. Serum AD, LP and other markers were compared according to the presence of obesity. The prevalence rates of obesity were 14.9% in G1 and 9.4% in G2. The medians of serum AD (μg/dl: non-obese/obese) were statistically lower in obese children (9.6/8.3 in G1, p <0.05; 8.9/6.6 in G2, p <0.05), and the medians of serum LP (ng/dl) were statistically higher in obese children (3.7/12.5 in G1, p <0.05; 2.9/8.4 in G2, p <0.05). The serum LP levels were significantly positively correlated with percent overweight (POW) irrespective of age and sex, and the serum AD levels were significantly negatively correlated with POW except for boys in G1. Multivariate regression analyses revealed that LP, LDL-cholesterol and gender in G1, and LP, AD, blood pressure and gender in G2 were significantly correlated with POW. A large-scale, population-based study revealed that AD was lower and LP higher in obese children, and that the obese status in G2 was related to a worse metabolic profile than the case in G1. [Copyright &y& Elsevier]

Abstract: Objective: Lung volume reduction surgery (LVRS) in well-selected patients with severe emphysema results in postoperative improvement in symptoms and pulmonary function. Experience with LVRS suggests that predicted postoperative FEV1.0 may be underestimated after lobectomy in patients with lung cancer and emphysema. As most of the patients with lung cancer have more or less emphysematous changes in the lungs, we assumed that lobectomy would achieve the same effect as LVRS even in patients without chronic obstructive pulmonary disease on the pulmonary function test. We assessed changes in pulmonary function in terms of ‘volume reduction effect’ after lobectomy for lung cancer. Methods: Forty-three patients underwent right upper lobectomy (RUL), 38 patients left upper lobectomy (LUL), 39 patients right lower lobectomy (RLL), and 38 patients left lower lobectomy (LLL). Pulmonary function tests were performed preoperatively and 6 months to 1 year after surgery. Results: Percent change in FEV1.0 after lobectomy was −6.9±16.1% in RUL group, −11.2±16.9% in LUL group, −14.7±9.8% in RLL group, and −12.8±9.5% in LLL group. We evaluated the correlation between a preoperative FEV1.0% of predicted and percentage change in FEV1.0 after lobectomy. There were no significant relationships between these variables in RLL or LLL group. In contrast, there were significant negative relationships between these variables in RUL and LUL groups. Correlation coefficients were r =−0.667, p <0.0001 for RUL and r =−0.712, p <0.0001 for LUL. In RUL and LUL groups, patients with a higher preoperative FEV1.0% of predicted had a more adverse percentage change in FEV1.0 after surgery. In addition, all 13 patients with a preoperative FEV1.0% of predicted <60% in RUL and LUL groups had an increase in FEV1.0 postoperatively. Patients with a lower preoperative FEV1.0% of predicted had a greater ‘volume reduction effect’ with an increase in FEV1.0 after upper lobectomy. Conclusion: Upper lobectomy might have a volume reduction effect. [Copyright &y& Elsevier]

Abstract: The current study evaluates the indices of glucose control for diabetics (i.e., glycated albumin (GA), hemoglobin A1c (HbA1c), plasma glucose (PG) and immuno-reactive insulin (IRI)) in non-diabetic children from a population-based cohort, and compares those values according to the presence of obesity to examine any differences in these indices. GA, HbA1c, casual PG and casual IRI in obese children (n =209) were compared to those of non-obese children (n =1060) in Ina town, Saitama Prefecture, in 2002–2003. In obese children, the levels of HbA1c, PG and IRI were statistically higher when compared to those of non-obese children. In contrast, the median and intra-quartile range (IQR) of GA of obese children (13.6%: 12.6–14.7) was statistically lower when compared to that of non-obese children (14.3%: 13.5–15.4, p <0.001). The low GA (%) in obese children is mainly due to the low absolute value of GA (g/dl) rather than a higher albumin value (g/dl). This is the first report to reveal that GA levels are low in obese, non-diabetic children. Additional data collection and an experimental approach are necessary to reveal the reasons behind lower GA levels in obese children. [Copyright &y& Elsevier]

• Diagnosis of SFTSV infection. • Detection of anti-SFTSV-NP antibody during the acute phase of SFTSV infection. • Double-antigen ELISA and immuno-chromatography for measuring anti-SFTSV-NP antibody. Severe fever with thrombocytopenia syndrome (SFTS) is a life-threatening febrile illness that is caused by the SFTS virus (SFTSV). The diagnosis of SFTS is usually performed by detecting viral RNA. However, it has been reported that viral RNA is no longer detectable at 6–12 days after the onset of disease. In the current study, we have constructed a plasmid to express the recombinant nuclear protein (NP) based on the Japanese strain of SFTSV (J1). We developed a double-antigen enzyme-linked immunosorbent assay (ELISA) and immunochromatography (IC) assay using recombinant NP to detect antibody against SFTSV-NP. When we tested time-sequential samples from four patients with SFTS, antibody to SFTSV-NP were detectable not only during the recovery phase (days 10–622) but also during the acute phase (days 4–7) of the disease using both of a double-antigen ELISA and IC assay. SFTSV-RNA was detected until 8–11 days after onset, thus suggesting the coexistence of the virus and antibody during the acute phase of SFTS. These data suggest that assays for detecting antibody against SFTS-NP described in the current study may be applicable not only for the epidemiological studies but also for the diagnosis of SFTS. [ABSTRACT FROM AUTHOR]

Abstract: Waist circumference, not BMI, is one of the factors in the definition of metabolic syndrome in adults. In children, waist circumference is also a well known predictor of metabolic syndrome. However, waist circumference measurement is not as commonly recorded as weight and height measurements in physical examinations in schools. This means BMI data is available for every child, but waist circumference is not. Therefore, we investigated whether there is an alternative way to estimate waist circumference even in those children whose waist circumference measurement has not been taken. We evaluated the relationship between BMI and the waist circumference of schoolchildren using a relatively large-scale population-based cohort in Japan. There was a significant linear relationship between BMI and waist circumference noted in each age- and sex-divided group [9–10-year-old boys: waist=13.99+2.63BMI (r =0.940, p <0.001), 9–10-year-old girls: waist=15.09+2.61BMI (r =0.933, p <0.001), 12–13-year-old boys: waist=23.67+2.22BMI (r =0.880, p <0.001), 12–13-year-old girls: waist=23.83+2.15BMI (r =0.859, p <0.001)]. This means it is possible to estimate waist circumference from height and weight, at least among those age groups of children in Japan. This estimation could be an alternative way and useful in detecting childhood metabolic syndrome or obesity disease in which a waist circumference figure is necessary. [Copyright &y& Elsevier]

Background: A patient’s ability to clear secretions and protect the airway with an effective cough is an important part of the pre-extubation evaluation. An increase in intra-abdominal pressure (IAP) is important in generating the flow rate necessary for a cough. This study investigated whether an increase from baseline in IAP during a coughing episode induced by routine pre-extubation airway suctioning is associated with extubation outcome after a successful spontaneous breathing trial (SBT).Methods: Three hundred thirty-five (335) mechanically ventilated patients who passed an SBT were enrolled. Baseline IAP and peak IAP during successive suctioning-induced coughs were measured with a fluid column connected to a Foley catheter.Results: Extubation was unsuccessful in 24 patients (7.2%). Unsuccessful extubation was 3.40 times as likely for patients with a delta IAP (ΔIAP) of ≤ 30 cm H2O than for those with a ΔIAP > 30 cm H2O, after adjusting for APACHE II score (95% CI, 1.39-8.26; p = .007).Conclusion: ΔIAP during a coughing episode induced by routine pre-extubation airway suctioning is significantly associated with extubation outcome in patients with a successful SBT.Trial registration UMIN-CTR Clinical Trial, UMIN000017762. Registered 1 June 2015. [ABSTRACT FROM AUTHOR]

Aim This study aimed to evaluate the effects of nursing interventions using minimally invasive or non-invasive methods conducive to frequent use in order to assess patients in a persistent vegetative state ( PVS). Methods We provided three nursing interventions-sitting the patient in an upright position, footbath care, and oral care-to PVS patients ( n = 11) and elderly bedridden subjects with consciousness ( n = 6) for 3 weeks in addition to ordinary nursing treatments. The Kohnan Score, plasma cortisol and adrenaline levels, General Well- Being Schedule score, and facial expression assessments were used as evaluation methods. Results The Kohnan Score of PVS patients declined significantly, indicating that the interventions increased patients' consciousness levels, but none of the other parameters showed significant change in either group. The change in Kohnan Score showed dependent trends for facial expression at baseline, cortisol change during the intervention, and the term of PVS. Conclusions The data suggest three indices for predicting intervention efficacy in individuals and for assessing an intervention's contribution to quality of life improvement. Among the multiple evaluation methods, Konan Scores was the most effective. Ultimately, the three nursing interventions used in this study and Konan Score led to the optimization of nursing home care and rehabilitation for PVS patients. [ABSTRACT FROM AUTHOR]