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Cisplatin therapy induces kidney injury as a side effect. Thus, replacement fluid must be administered to prevent kidney injury. In our hospital, we use a Gemcitabine and Cisplatin combination chemotherapy (GC) at a total volume of approximately 500 mL for biliary tract cancer. We investigated the safety of GC with a small amount of replacement fluid. As a result, no serious adverse events and renal injury occurred that required discontinuation of treatment. The median overall survival time was 260 d (95% confidence interval, 154-367 d). This study suggests that GC with a small amount of replacement fluid could be performed tolerability. But we need to be careful about choosing patients such as patients who can drink 1 L orally and patients who can be treated as outpatients.

Background A new platelet (PLT) additive solution, bicarbonated Ringer's solution supplemented with acid-citrate-dextrose Formula A, termed BRS-A, as well as a new automated closed system cell processor for washing PLTs have recently been developed. This study evaluated the in vitro properties of PLTs with the automated system versus the manual method, using the BRS-A additive solution for washing and storage. Methods ABO-identical apheresis PLTs in 100% plasma were pooled and split equally for control (in 100% plasma or a manual method) and test (ACP215 automated system) units. In vitro characteristics of PLTs washed with the automated system were compared to those of PLTs in 100% plasma (Study 1) or washed with a manual method (Study 2) during the 7-day storage. Results In Study 1, hypotonic shock response, aggregation response, mitochondrial membrane potential, adenosine triphosphate, and CD42b mean fluorescence intensity were comparable in the control and test groups during the 7-day storage. CD62P expression was lower in the test group than controls on Days 3 and 7. The level of platelet-derived microparticles (PDMPs) in the test group on Days 1 and 2 were higher than those in controls. In contrast, the levels of soluble CD40 ligand (sCD40L) and regulated upon activation of normal T-cell expressed and secreted (RANTES) in the test units were lower than controls. In Study 2, no significant differences were found in all in vitro properties except for PLT count and the levels of PDMPs in the test units were higher than controls during storage. Conclusion Apheresis PLTs washed with the automated system using BRS-A additive solution maintained in vitro properties during storage. Washing methods influenced PDMP levels but not sCD40L and RANTES.

Background A new platelet (PLT) additive solution, bicarbonated Ringer's solution supplemented with acid-citrate-dextrose Formula A, termed BRS-A, as well as a new automated closed system cell processor for washing PLTs have recently been developed. This study evaluated the in vitro properties of PLTs with the automated system versus the manual method, using the BRS-A additive solution for washing and storage. Methods ABO-identical apheresis PLTs in 100% plasma were pooled and split equally for control (in 100% plasma or a manual method) and test (ACP215 automated system) units. In vitro characteristics of PLTs washed with the automated system were compared to those of PLTs in 100% plasma (Study 1) or washed with a manual method (Study 2) during the 7-day storage. Results In Study 1, hypotonic shock response, aggregation response, mitochondrial membrane potential, adenosine triphosphate, and CD42b mean fluorescence intensity were comparable in the control and test groups during the 7-day storage. CD62P expression was lower in the test group than controls on Days 3 and 7. The level of platelet-derived microparticles (PDMPs) in the test group on Days 1 and 2 were higher than those in controls. In contrast, the levels of soluble CD40 ligand (sCD40L) and regulated upon activation of normal T-cell expressed and secreted (RANTES) in the test units were lower than controls. In Study 2, no significant differences were found in all in vitro properties except for PLT count and the levels of PDMPs in the test units were higher than controls during storage. Conclusion Apheresis PLTs washed with the automated system using BRS-A additive solution maintained in vitro properties during storage. Washing methods influenced PDMP levels but not sCD40L and RANTES.

The objective of this study was to evaluate morphological changes at the articular disc of the temporomandibular joint and capillary of the retrodiscal tissue in a rat model for type 2 spontaneous diabetes mellitus (DM) (i.e., Goto-Kakizaki [GK] rats) compared to normal Wistar rats. A total of 20 experimental rats were used in this study; the rats were categorized into the normal (n = 10 male 8-week-old Wistar rats) and DM (n = 10 male 8-week-old GK rats) groups. Hematoxylin-eosin stained specimens were obtained from 5 rats from each group. Image analyses of the hematoxylin-eosin stained specimens were conducted using light micrographs, which allowed comparisons of the thickness of the anterior, central, and posterior parts of the articular disc. Afterwards, the microvascular corrosion cast specimens were obtained from 5 rats from each group. The diameter of the capillary of the retrodiscal tissue was determined by analyzing scanning electron micrographs of the microvascular corrosion cast specimens. Student's t-test was used to test for statistical significant differences between the 2 groups. Differences were considered significant when p < 0.01. We found that the thickness of the anterior, central, and posterior parts of the articular disc, and the diameter of the capillary of the retrodiscal tissue was significantly lower in the DM vs. normal group. Therefore, we consider that DM-associated the hyperglycemia causes atrophy of the articular disc and microangiopathy of the capillary of the retrodiscal tissue in GK rats.

This is a case report of anterosuperior alveolar distraction using an implant-fixed provisional prosthesis. Osteotomy and placement of a distraction device were performed in a healthy 69-year-old woman. To avoid lingual inclination during the distraction period, the device's rod was buried in the labial side of a provisional prosthesis supported by posterior implants. The mandibular bone was obliquely distracted by 0.3 mm every 2 days. Implant insertion was performed, and a good prognosis was anticipated. Inclination is thought to be caused by soft tissue on the lingual side. Many reports propose methods to avoid inclination, but these methods require established support from the teeth and cannot be adapted for an edentulous case. The method reported here is useful for distraction osteogenesis because it can be adapted for edentulous cases.

This study evaluated the in vitro properties of platelets (PLTs) washed with BRS-A additive solution in the Haemonetics ACP215 automated processing system. Two washing modes, 'manually/automatically adding ACD-A to BRS before/during the washing process', represented the control and test groups, respectively. Outcomes were compared over 7 days of storage (n = 7, for both). PLT recovery following washing processing (26-27 min) was 86·2 ± 1·7% and 86·0 ± 2·2% and plasma protein removal was 98·8 ± 0·3% and 99·0 ± 0·2% in the control and test groups, respectively (not significant). Both groups exhibited comparable in vitro properties.

This report is the case report of a 48-year-old woman who referred to our hospital complaining of a mass at the left maxillary tuberosity and slight trismus. CT and MRI imagings showed a tumor like image with bone absorption of the left maxillary tuberosity. Under general anesthesia, the lesion was excised. Histopathological examination showed low grade mucoepidermoid carcinoma. There is no sign of recurrence or metastasis of the tumor in 5 year after the surgery.

UNLABELLED Nonsyndromic cleft lip with or without cleft palate (NSCLP) is one of the most common birth defects. Despite its frequency, the etiology remains largely unknown. Most likely, both genetic and environmental factors contribute to this malformation. A polymorphic gene family, the major histocompatibility complex class I chain-related gene A (MICA), is located about 40 kb centromeric to the HLA-B gene. In this study, we analyzed the association between MICA gene polymorphisms and NSCLP in Japanese patients. METHODS The (GCT)n polymorphism of the MICA gene was investigated in 94 patients with NSCLP and 180 normal controls using polymerase chain reaction amplification and denaturing polyacrylamide gel electrophoresis. RESULTS Our results demonstrate that there are no differences in microsatellite allele frequency between NSCLP patients and controls. However, the microsatellite allele frequency of the MICA-A6 (p = 0.045) allele was increased in male patients, as compared with controls. Further, the MICA-A5 (p = 0.359) allele was also increased in female NSCLP patients. CONCLUSION These results suggest that the microsatellite allele frequencies of the MICA-A6 allele increased in male NSCLP patients. Although the MICA-A5 allele increased in female NSCLP patients, the increase was not statistically significant. These results suggest that the MICA gene could be one of the candidate genes for NSCLP.

Photolyses of thianthrene sulfilimine derivatives in the presence of several olefins were studied and found to afford the corresponding aziridines in good yields, particularly, in case of 2,8-dibromo-[5-(N-tosyl)imino]thianthrene. This reaction was considered to proceed via generation of nitrene by photolytic S–N bond cleavage of thianthrene sulfilimines. Further, photo-aziridination of olefins by thianthrene sulfilimine derivatives was intensively studied to make clear the ability as nitrene precursors.

Several 1- and 2-substituted thianthrene sulfilimine derivatives were prepared and the selectivity toward oxidation and N-tosylimination under several conditions was studied. In the photolysis of trans-5-(N-p-tosyl)iminothianthrene 10-oxide (trans-10), photo isomerization to cis-10 was observed. Further, photoimino-transfer reaction of sulfilimines and their 10-mono- and -dioxide derivatives to sulfides was intensively studied to make clear the ability as nitrene precursors.

Several hierarchical nanophase-separated structures have been observed for a series of ABC star-shaped terpolymers by transmission electron microscopy (TEM) and electron computerized tomography (3D-TEM). The seven terpolymers synthesized are composed of polyisoprene (I), polystyrene (S), and poly(2-vinylpyridine) (P), their volume fraction ratios of I:S:P are 1:1:X, where X equals 0.2, 0.4, 0.7, 1.2, 1.9, 3.0, and 4.9, respectively, and additional four samples were prepared by blending each two parent terpolymers. From morphological observation by TEM and tomography, a terpolymer with X of 0.2 shows lamellar structure with spheres at the interface, those with X ranging from 0.4 to 1.9 show cylindrical structures with two-dimensional tiling, while those with X of 3.0 and 4.9 show hierarchical cylinders-in-lamella structure. Two the other terpolymer samples with X of 7.9 and 10 were produced by blending a P homopolymer with the terpolymer I1.0S1.0P4.9, and they both exhibited columnar piled disk cylinders in P matrix. From the comparison of the present results with the predictions by the Monte–Carlo simulation, it was confirmed that the observed nanophase-separated structures of the ISP star-shaped terpolymers are mostly in good agreement with the prediction. © 2007 Wiley Periodicals, Inc. J Polym Sci Part B: Polym Phys 45: 2277–2283, 2007

Background and Objectives Volume-reduced washed platelet (PLT) concentrates (PCs) can prevent circulatory overload and allergic reactions in patients undergoing PLT transfusions. For these reasons, they are in demand for paediatric settings and for patients at risk of circulatory overload. Here, we evaluated the quality of volume-reduced washed PCs stored for 5 days in a novel acetate-free PLT additive solution (PAS) containing glucose and bicarbonate (BRS-A) with 98% plasma protein in 100% plasma PCs and yielded an approximately twofold lower mean volume (91 ml) compared to that observed with the control units. Immediately after washing, the mean PLT concentration of the test units was 20·5 × 1011/l, twofold higher than that of the control units. The pH (37°C) levels in the test unit remained above 7·0 for 5 days. Glucose consumption and lactate production rates of the test units on days 1–3 were higher than those of the control units, leading to glucose exhaustion in the test unit by Day 3. Hypotonic shock responses and CD62P and CD42b expression levels in both units were comparable during 5-day storage. Conclusion Considering the pH buffering capacity of BRS-A, a 90-ml volume may be acceptable for maintaining the in vitro quality of washed PLTs for at least 2 days.

In Japan, no platelet (PLT) additive solutions (PASs) are officially approved for clinical use although blood centers often receive requests for washed PLTs to reduce adverse reactions. Recently, we developed a novel PAS called BRS-A based on clinically available bicarbonated Ringer's solution (BRS), Bicanate and acid-citrate-dextrose formula A (ACD-A), which has been shown to maintain the in vitro properties of PLTs in the condition of5% residual plasma during 7-day storage. The aim of this study was to evaluate whether another clinically available BRS, Bicarbon with different electrolyte concentrations can be used as a PAS.Two types of BRS-As were prepared by adding 25 mL of ACD-A to 500 mL of Bicanate or Bicarbon BRSs. Bicanate-based BRS-A and Bicarbon-based BRS-A contain 0.9 or 0.5 mmol/L of magnesium chloride, 95.2 or 100.1 mmol/L of sodium chloride, 4.2 or 5.1 mmol/L of trisodium citrate, and 26.6 or 23.8 mmol/L of sodium bicarbonate, respectively; the other components were identical. Apheresis PLTs stored in these solutions with less than 5% plasma for 7-day storage were compared with regard to their in vitro properties.The pH levels of all units were above 7 throughout storage. The mean PLT volume, hypotonic shock response, glucose consumption, lactate production, swirling, and CD62P and CD42b expression were similar during 7-day storage. The bicarbonate levels in Bicarbon-based BRS-A were lower than those in Bicanate-based BRS-A.Differences in concentrations of electrolytes such as magnesium, sodium, citrate, and bicarbonate salts in BRS-A do not affect the in vitro properties of PLTs during 7-day storage. These results indicate that the use of another type of BRS-A based on Bicarbon as a PAS is feasible. Thus, BRS-A can be used in hospitals that do not stock Bicanate but have Bicarbon.

Characteristic cylindrical structures formed by ABC star-shaped terpolymers were investigated by microbeam small-angle X-ray scattering (SAXS) in addition to transmission electron microscopy (TEM). The polymer samples are composed of polyisoprene (I), polystyrene (S), and poly(2-vinylpyridine) (P); their volume ratios for I:S:P are 1:1:X, where X equals 0.7, 1.2, 1.3, and 1.9. The spotlike diffraction patterns were observed by microbeam SAXS due to scattering from a small number of ordered grains in the polymer samples, where the exact packing manners of the cylinders, or their lattice constants, have been clarified. In short, it has been found that the cross-sectional patterns of these tilings have the features of four Archimedean tiling patterns, i.e., (6.6.6), (4.8.8), (3.3.4.3.4), and (4.6.12). All the four SAXS patterns are quite consistent with the structural observation by TEM with regard to the crystallographic data.

The Archimedean tiling (32.4.3.4) is a regular but complex polygonal assembly of equilateral triangles and squares. This tiling pattern with mesoscopic repeating distance has been found for an ABC star-branched three-component polymer composed of polyisoprene, polystyrene, and poly(2-vinylpyridine). In this structure the environment of a molecule splits into multiple sites and two microdomains with different sizes and shapes are formed for one component. This complexity is the first observation in complex polymer systems and can lead to a new type of mesoscale self-organization. The tiling pattern has been observed for the other materials on much shorter length-scale; therefore, the experimental fact observed in the present study is demonstrating that the complexity is universal over different hierarchies. © 2005 Wiley Periodicals, Inc. J Polym Sci Part B: Polym Phys 43: 2427–2432, 2005

Estimation of the time after death (TAD) is an important aspect of forensic science. The cornea becomes increasingly opaque with an increase in TAD and corneal opacity is used for TAD estimation. However, previous methods are subjective, and there is a risk of human error. To establish an objective method, we propose a new method for TAD estimation. We applied RGB image analysis to the corneal color of cadavers. We then examined if there was a correlation between these color parameters and actual TAD, age, position at death, and environmental temperature. We found that corneal opacity was affected only by TAD. The method described here is objective and easy to use, and TAD can be estimated within a very short period of time, making this method particularly useful. To further increase the accuracy of TAD estimation, other quantifiable parameters could also be evaluated.

I. Economic Instruments for the Reduction and Recycling of Solid Waste : A Comparison Between Dual System and Package Taxation This paper aims to analyze the economic function of Germany's "Dual System" --especially Grune Punkt-- in comparison with a package taxation proposed from an environmental economic theory point of view. Based on the analysis of the cost estimation formula of the optimal tax rate of package taxation for PET bottles, aluminum cans and paper-board packages. This means that the recycling level mandated by German law is inefficient from the viewpoint of static efficiency, because it is higher than the optimal level. Dynamic efficiency is more important than static efficiency for the reduction of waste at the source. It is concluded that the Dual System has an incentive effect for promoting technological improvement and changes in package design for waste reduction. II. Public Choice on Environmental (Carbon) Taxes Global warming and the greenhouse effect have become two of the most important issues in international society. In Japan, environmental taxes as well as other economic instruments became popular with policy-makers, but there is little acceptability of a carbon tax that will abate the emissions of CO2. This study investigates public choice on the introduction of environmental (carbon ) taxes and proposes a tax reform that changes implicit carbon taxes to pure carbon taxes under revenue neutral. In this study, a simple model deals with the conflicts of policy preferences and a Nash equilibrium --a profile of strategies such that each policy-maker's strategy is an optimal response to the other's strategy. The implicit carbon taxes in the Japanese tax system consist of seven taxes on fossil fuels, the revenue from which amounts to about 5 trillion yen. This study examines the effect of the tax reform under the condition of revenue neutral on the reduction of CO2 emissions by assuming that the price elasticities on the demands of the fossil fuels are the same: 0.2 or 0.1. The results of this examination are as follows. In the case that the elasticities are 0.2 (0.1), the pure carbon tax of 18.975 (17.145) per kg carbon can finance the same amount of revenue as the existing implicit carbon taxes and abate CO2 emissions by 70.547 (31.544) million tonnage carbon while the implicit carbon taxes could abate emissions by only 19.265 (8.700) million tonnage carbon. The tax reform may keep the uses of revenue from the implicit carbon taxes. As a consequence, the tax reform could mitigate the movement against the introduction of a carbon tax and effectively abate CO2 emissions.

We here report an autopsy case of a man in his seventies who died from asphyxia due to compression of the trachea caused by postextraction bleeding after extraction of his left mandibular third molar by a dentist in private practice. On the morning after the tooth extraction, he had complained of dyspnea and became unconscious at home. Although he was brought to the emergency room by ambulance, he died 7 days later without regaining consciousness. Autopsy examination revealed that the lingual side of the alveolar bone was fractured at the extraction socket. Moreover, subcutaneous bleeding that extended from the extraction socket to the thyrohyoid ligament in the cervical region and deviation of the epiglottis due to the bleeding were observed. Histological findings revealed liver cirrhosis; there were no significant findings in other organs. On the basis of these findings, we concluded that alveolar bone fracture occurred during the extraction and that the bleeding spread to the cervical region. Thus, the patient had died from asphyxia resulting from airway obstruction caused by cervical subcutaneous bleeding derived from postextraction bleeding. We emphasize that tooth extraction may cause fatal complications in patients with bleeding tendencies, particularly in the elderly.

We describe a case of Ehlers–Danlos syndrome (EDS) type IV in a male in early half in his twenties, who experienced recurrent and eventually fatal pulmonary hemorrhage. EDS type IV is a rare disorder of type III collagen synthesis that is characterized by unusual facies, thin translucent skin with a venous vascular pattern, easy bruising, and hypermobility of the small joints. Autopsy findings showed hypermobility of the joints and distensibility of the skin. Microscopically, the abdominal skin showed substantially decreased dermal thickness. Moreover, the reticular dermis showed fine collagen bundles and large interstitial spaces compared with the skin from a normal control that showed large collagen bundles. Individual elastic fibers were also thicker than those observed in the skin of a normal control. The thoracic aorta showed thin adventitia and a relative increase in elastic fibers. The parenchyma of both the lungs showed markedly diffuse hemorrhage with hemosiderin-laden alveolar macrophages or old thrombi and organized thrombi in the small bronchi. Furthermore, both sections of the lung showed multiple fibrous nodules containing benign metaplastic bone. Vascular wall disruption and tearing of the vessel walls in the lung parenchyma were also observed. We concluded that EDS type IV led to the patient’s death because of pulmonary hemorrhage. Because this syndrome resulted in the patient’s death from arterial and bowel rupture, it is important to consider EDS as a potential cause of sudden death.

Expression of ligands of natural killer group 2D (NKG2D) immunoreceptors, such as major histocompatibility complex class I-related chain A/B (MICA/B), has been proposed to play an important role in tumour immunosurveillance. Soluble forms of MICA/B are increased in sera of cancer patients and are postulated to impair antitumour immune response by downregulating expression of NKG2D immunoreceptors. Serum levels of soluble MICA have been shown to be of diagnostic significance in malignant diseases.The potential of soluble MICB (sMICB) as a marker for oral squamous cell carcinoma (OSCC) was investigated.sMICB levels did not differ significantly from those in normal control individuals. However, the findings indicate that sMICB levels are significantly increased in stage IV OSCC and high sMICB levels are significantly associated with decreased survival rates in patients.

Partial deletion of the long arm of chromosome 13 results in 13q(-) syndrome, and phenotypes of affected patients vary widely. We describe an autopsy case of the sudden, unexpected death of a 17-year-old boy with 13q(-) syndrome. He had severe psychomotor retardation and had been receiving follow-up care. One day he was found dead in his house and autopsy was performed to elucidate the cause of death. Autopsy findings revealed lobulation anomalies of the lungs, hypoplasia of the adrenal and thyroid glands, and apituitarism due to hyperplasia of bone in the hypophyseal fossa. No other pathological lesions were observed. Chromosomal analysis confirmed interstitial deletion from the long arm of chromosome 13. Karyotype was 46,XY, del(13)(q14.3q32). We concluded that the patient died of multi-organ dysfunction due to apituitarism. Autopsy cases of 13q(-) syndrome are rare. Furthermore, lobulation anomalies and apituitarism associated with 13q(-) syndrome have not previously been described. This case report offers novel clues to elucidating critical regions of chromosome 13 associated with malformations of the lungs and pituitary gland.

To evaluate the ability of dibenzothiophene N-substituted sulfilimines as photochemical nitrene sources, their photolyses in the presence of several trapping reagents, such as sulfides, olefins, and phosphorus compounds, were performed. In the reactions, the corresponding imino-transfer compounds, namely sulfilimines, aziridines, and iminophosphoranes, were formed in good yields, indicating dibenzothiophene N-tosyl and N-acylsulfilimines have a potent nature as nitrogen sources.