Aneurysm rupture can result in subarachnoid hemorrhage,a condition with potentially severe consequences,such as disability and death.In the acute stage,early brain injury manifests as intracranial pressure elevation,g...Aneurysm rupture can result in subarachnoid hemorrhage,a condition with potentially severe consequences,such as disability and death.In the acute stage,early brain injury manifests as intracranial pressure elevation,global cerebral ischemia,acute hydrocephalus,and direct blood–brain contact due to aneurysm rupture.This may subsequently cause delayed cerebral infarction,often with cerebral vasospasm,significantly affecting patient outcomes.Chronic complications such as brain volume loss and chronic hydrocephalus can further impact outcomes.Investigating the mechanisms of subarachnoid hemorrhage-induced brain injury is paramount for identifying effective treatments.Stem cell therapy,with its multipotent differentiation capacity and anti-inflammatory effects,has emerged as a promising approach for treating previously deemed incurable conditions.This review focuses on the potential application of stem cells in subarachnoid hemorrhage pathology and explores their role in neurogenesis and as a therapeutic intervention in preclinical and clinical subarachnoid hemorrhage studies.展开更多
Rising atmospheric CO_(2)(carbon dioxide)concentrations and salinization are manifestations of climate change that affect plant growth and productivity.Species with an intermediate C_(3)-C_(4)type of photosynthesis li...Rising atmospheric CO_(2)(carbon dioxide)concentrations and salinization are manifestations of climate change that affect plant growth and productivity.Species with an intermediate C_(3)-C_(4)type of photosynthesis live in a wide range of precipitation,temperature,and soil quality,but are more often found in warm and dry habitats.One of the intermediate C_(3)-C_(4)photosynthetic type is C_(2)photosynthesis with a carbon concentration mechanism(CCM)that reassimilates CO_(2)released via photorespiration.However,the ecological significance under which C_(2)photosynthesis has advantages over C_(3)and C_(4)plants remains largely unexplored.Salt tolerance and functioning of CCM were studied in plants from two populations(P1 and P2)of Sedobassia sedoides(Pall.)Freitag&G.Kadereit Asch.species with C_(2)photosynthesis exposed to 4 d and 10 d salinity(200 mM NaCl)at ambient(785.7 mg/m^(3),aCO_(2)and elevated(1571.4 mg/m^(3),eCO_(2))CO_(2).On the fourth day of salinity,an increase in Na+content,activity catalase,and superoxide dismutase was observed in both populations.P2 plants showed an increase in proline content and a decrease in photosynthetic enzyme content:rubisco,phosphoenolpyruvate carboxylase(PEPC),and glycine decarboxylase(GDC),which indicated a weakening of C_(2)and C_(4)characteristics under salinity.Treatment under 10 d salinity led to an increased Na^(+)content and activity of cyclic electron flow around photosystem I(PSI CEF),a decreased content of K^(+)and GDC in both populations.P1 plants showed greater salt tolerance,which was assessed by the degree of reduction in photosynthetic enzyme content,PSI CEF activity,and changes in relative growth rate(RGR).Differences between populations were evident under the combination of eCO_(2)and salinity.Under long-term salinity and eCO_(2),more salt-tolerant P1 plants had a higher dry biomass(DW),which was positively correlated with PSI CEF activity.In less salt-tolerant P2 plants,DW correlated with transpiration and dark respiration.Thus,S.sedoides showed a high degree of photosynthetic plasticity under the influence of salinity and eCO_(2)through strengthening(P1 plants)and weakening C_(4)characteristics(P2 plants).展开更多
An energy production system consisting of a solar collector, biogas dry reforming reactor and solid oxide fuel cell (SOFC) was assumed to be installed in Kolkata, India. This study aims to understand the impact of cli...An energy production system consisting of a solar collector, biogas dry reforming reactor and solid oxide fuel cell (SOFC) was assumed to be installed in Kolkata, India. This study aims to understand the impact of climate conditions on the performance of solar collectors with different lengths of parabolic trough solar collector (dx) and mass flow rate of heat transfer fluid (m). In addition, this study has evaluated the amount of H2 produced by biogas dry reforming (GH2), the amount of power generated by SOFC (PSOFC) and the maximum number of possible households (N) whose electricity demand could be met by the energy system proposed, considering the performance of solar collector with the different dx and m. As a result, the optimum dx was found to be 4 m. This study revealed that the temperature of heat transfer fluid (Tfb) decreased with the increase in m. Tfb in March, April and May was higher than that in other months, while Tfb from June to December was the lowest. GH2, PSOFC and N in March, April and May were higher than those in other months, irrespective of m. The optimum m was 0.030 kg/s.展开更多
Risk factors of the depression are the occupational stress. The mental health condition of university teachers who participate in the socialization of diverse students is an important issue;however, there are few stud...Risk factors of the depression are the occupational stress. The mental health condition of university teachers who participate in the socialization of diverse students is an important issue;however, there are few studies on depression among university teachers. The purpose of this study is to clarify Japanese university teachers’ depression status assessed by the Patient Health Questionnaire-9 and its influence factors: Japanese university teachers’ depression status depression status, personal background, job situation, social support, and stress coping behavior. The self-administered questionnaire survey was mailed to 924 university teachers in Japan, with a survey return rate of 43.8% (N = 405). A total of 342 surveys were completed and valid. The Patient Health Questionnaire 9 (PHQ-9), Multidimensional Scale of Perceived Social Support (MSPSS), the Japanese version of the Brief Coping Orientation to Problems Experienced (COPE) and the Work Situation Questionnaire (WSQ) were analyzed to clarify the depression status and its influence factors. Multivariate logistic regression analysis was used to examine factors related to the major depression. The subjects included 274 men (80.1%) and 68 women (19.9%), 105 professors (30.7%), 52 associate professors (15.2%), 53 lecturers (15.5%) and 132 assistants (38.6%). The subjects’ mean of age and teaching experiences were 44.1 ± 9.7 years, 15.6 ± 10.1 years. The mean PHQ score was 3.9 ± 4.1, and 307 subjects (89.8%) were 0 - 9 points and 35 subjects (10.2%) were over 10 points (10 points or over). For women [OR = 7.009, 95% CI 2.387 - 20.584;p < 0.001], religion [OR = 1.813, 95% CI 1.175 - 2.798;p = 0.007], self-blame [OR = 1.808, 95% CI 1.280 - 2.556;p = 0.001], substance use [OR = 1.453, 95% CI 1.103 - 1.913;p = 0.008] were risk factors of depression status. On the other hand, high job satisfaction level [OR = 0.945, 95% CI 0.921 - 0.969;p < 0.001], higher age [OR = 0.927, 95% CI 0.873 - 0.984;p =0.014], use of instrumental support [OR = 0.622, 95% CI 0.399 - 0.969;p = 0.036], and use of social support [OR = 0.588, 95% CI 0.376 - 0.921;p = 0.020] were factors that reduced the risk of depression. These findings suggested that in order to improve the depression status of university teachers, and to develop mental health measures for university faculty members based on such risk factors are necessary in the future.展开更多
A building integrated energy system (photovoltaic (PV) and fuel cell (FC)) is proposed for assessment of the energy self-sufficiency rate in five cities of Mie prefecture in Japan. In this work, it is considered that ...A building integrated energy system (photovoltaic (PV) and fuel cell (FC)) is proposed for assessment of the energy self-sufficiency rate in five cities of Mie prefecture in Japan. In this work, it is considered that the electricity requirement of the building is provided by the building integrated photovoltaic (BIPV) system and the gap between the energy demand and BIPV supply is fulfilled by the FC. The FC is powered by the electrolytic H2 produced from the surplus power of PV. A design study of using the proposed system in five cities in Mie prefecture, which are in center part of Japan, has been performed. It has been observed that the monthly power production from BIPV is higher in spring and summer, while it is lower in autumn and winter at all considered locations. The self-sufficiency rate of the FC system is higher with decreasing households’ number and it has been observed that the 12 households are more suitable for full cover of the electricity demand by the combined system of PV and FC. The relationship between the households’ number and self-sufficiency rate of the FC system per solar PV installation area can be expressed by exponential curve. The coefficient of the exponential curve can predict the suitable city for the BIPV system with FC system utilizing electrolytic H2 generated by using excess energy from the PV system.展开更多
This study is to understand the impact of operating conditions, especially initial operation temperature (T<sub>ini</sub>) which is set in a high temperature range, on the temperature profile of the interf...This study is to understand the impact of operating conditions, especially initial operation temperature (T<sub>ini</sub>) which is set in a high temperature range, on the temperature profile of the interface between the polymer electrolyte membrane (PEM) and the catalyst layer at the cathode (i.e., the reaction surface) in a single cell of polymer electrolyte fuel cell (PEFC). A 1D multi-plate heat transfer model based on the temperature data of the separator measured using the thermograph in a power generation experiment was developed to evaluate the reaction surface temperature (T<sub>react</sub>). In addition, to validate the proposed heat transfer model, T<sub>react</sub> obtained from the model was compared with that from the 3D numerical simulation using CFD software COMSOL Multiphysics which solves the continuity equation, Brinkman equation, Maxwell-Stefan equation, Butler-Volmer equation as well as heat transfer equation. As a result, the temperature gap between the results obtained by 1D heat transfer model and those obtained by 3D numerical simulation is below approximately 0.5 K. The simulation results show the change in the molar concentration of O<sub>2</sub> and H<sub>2</sub>O from the inlet to the outlet is more even with the increase in T<sub>ini</sub> due to the lower performance of O<sub>2</sub> reduction reaction. The change in the current density from the inlet to the outlet is more even with the increase in T<sub>ini</sub> and the value of current density is smaller with the increase in T<sub>ini </sub>due to the increase in ohmic over-potential and concentration over-potential. It is revealed that the change in T<sub>react</sub> from the inlet to the outlet is more even with the increase in T<sub>ini</sub> irrespective of heat transfer model. This is because the generated heat from the power generation is lower with the increase in T<sub>ini </sub>due to the lower performance of O<sub>2</sub> reduction reaction.展开更多
In this paper, an energy system consisting of solar collector, biogas dry reforming reactor and solid oxide fuel cell (SOFC) has been proposed. The heat produced from the concentrating solar collector is used to drive...In this paper, an energy system consisting of solar collector, biogas dry reforming reactor and solid oxide fuel cell (SOFC) has been proposed. The heat produced from the concentrating solar collector is used to drive a biogas dry reforming reactor in order to produce H<sub>2</sub> as a fuel for SOFC, in such as system. The aim of this study is to clarify the impact of climate data on the performance of solar collector with various sizes/designs. The temperature of heat transfer fluid produced by the solar collector is calculated by adopting the climate data for Nagoya city in Japan in 2021. The amount of H<sub>2</sub> produced from the biogas dry reforming reactor and the power generated by SOFC were simulated. The results show the temperature of heat transfer fluid (T<sub>fb</sub>) and T<sub>fb</sub> ratio (a) based on the length of absorber (dx) = 1 m have a peak near the noon following the trend of solar intensity (I). Results also revealed that a increases with increase in dx. It is found that the differences of T<sub>fb</sub> and a between dx = 2 m and dx = 3 m are larger than those between dx = 1 m and dx = 2 m. It is revealed that T<sub>fb</sub> and a are higher in spring and summer. dx = 4 m is the optimum length of solar absorber. The amount of H<sub>2</sub> produced from the biogas dry reforming reactor as well as the power generated by SOFC is the highest in August, resulting that it is prefer to produce H<sub>2</sub> and to generate SOFC in summer.展开更多
Invasive fungal infections are a major challenging problem in the management of febrile neutropenia (FN) in patients with hematologic malignancies. Liposomal amphotericin B (L-AmB) or micafungin (MCFG) has been widely...Invasive fungal infections are a major challenging problem in the management of febrile neutropenia (FN) in patients with hematologic malignancies. Liposomal amphotericin B (L-AmB) or micafungin (MCFG) has been widely used as a first-line empirical antifungal therapy for suspected fungal infection in such patients. However, there are several issues in patients receiving these agents: drug related toxicities for L-AmB and breakthrough fungal infections for MCFG. In order to make the best use of these 2 agents, we conducted a prospective study of sequential therapy from MCFG to L-AmB, and evaluated the efficacy and safety of this strategy in FN patients with hematologic malignancies. A total of 18 patients were enrolled, and 11 patients who fulfilled the protocol defined criteria were evaluated. Underlying diseases consisted of acute leukemia (n = 9), non-Hodgkin lymphoma (n = 1), and myelodysplastic syndrome (n = 1). Treatment success was achieved in 8 patients (72.7%). Drug-related adverse events occurred in 8 patients (72.7%). All of those adverse events except one case were below grade 2. Three patients required discontinuation of L-AmB. Although our empirical antifungal sequential therapy seems to be encouraging for antibiotics-refractory FN in patients with hematologic malignancies, further investigation in large-scale studies is warranted.展开更多
Aneurysmal subarachnoid hemorrhage remains serious hemorrhagic stroke with high morbidities and mortalities.Aneurysm rupture causes arterial bleeding-induced mechanical brain tissue injuries and elevated intracranial ...Aneurysmal subarachnoid hemorrhage remains serious hemorrhagic stroke with high morbidities and mortalities.Aneurysm rupture causes arterial bleeding-induced mechanical brain tissue injuries and elevated intracranial pressure,followed by global cerebral ischemia.Post-subarachnoid hemorrhage ischemia,tissue injuries as well as extravasated blood components and the breakdown products activate microglia,astrocytes and Toll-like receptor 4,and disrupt blood-brain barrier associated with the induction of many inflammatory and other cascades.Once blood-brain barrier is disrupted,brain tissues are directly exposed to harmful blood contents and immune cells,which aggravate brain injuries furthermore.Blood-brain barrier disruption after subarachnoid hemorrhage may be developed by a variety of mechanisms including endothelial cell apoptosis and disruption of tight junction proteins.Many molecules and pathways have been reported to disrupt the blood-brain barrier after subarachnoid hemorrhage,but the exact mechanisms remain unclear.Multiple independent and/or interconnected signaling pathways may be involved in blood-brain barrier disruption after subarachnoid hemorrhage.This review provides recent understandings of the mechanisms and the potential therapeutic targets of blood-brain barrier disruption after subarachnoid hemorrhage.展开更多
AIM: To evaluate the clinical utility of serum fibrosis markers, including YKL-40, in patients with HCV-associated liver disease. METHODS: A total of 109 patients with HCV-associated liver disease were enrolled. We me...AIM: To evaluate the clinical utility of serum fibrosis markers, including YKL-40, in patients with HCV-associated liver disease. METHODS: A total of 109 patients with HCV-associated liver disease were enrolled. We measured serum type IV collagen, amino-terminal peptide of type III procollagen (PIIIP), hyaluronic acid (HA), YKL-40 levels and biochemical. Parameters by RIA or ELISA. Eighty-eight patients underwent liver biopsy, and 67 of 109 patients received interferon (IFN) therapy. We also investigated the relationship between the concentrations of serum fibrosis markers and histological fibrosis scores (METAVIR), and evaluated the changes of the levels of fibrosis markers before and after the IFN therapy. RESULTS: The increase in serum levels of all markers, particularly HA, was correlated with the progression of liver fibrosis (for type IV collagen, F= 9.076, P<0.0001; for PIIIP, F= 9.636, P<0.0001; for HA, F=13.128, P<0.0001; and for YKL-40, F= 8.016, P<0.0001). YKL-40 had strong correlation with HA (r= 0.536, P<0.0001). Based on the receiver operating curve (ROC), the ability of serum HA exceeded the abilities of other serum markers to determine fibrosis score 4 from fibrosis score 0-3 (AUC = 0.854). While YKL-40 was superior to other fibrosis markers for predicting severe fibrosis (F2-F4) from mild fibrosis (FO-F1) (YKL-40, AUC = 0.809; HA, AUC = 0.805). After IFN therapy, only YKL-40 values significantly decreased not only in the responder group, but also in the nonresponder group (P = 0.03). CONCLUSION: YKL-40 may be a useful non-invasive serum marker to estimate the degree of liver fibrosis and to evaluate the efficacy of IFN therapies in patients with HCV-associated liver disease.展开更多
Rotavirus is an acute enteric pathogen in infants and children. We reported a rare case of a 6-mo-old infant with protein-loosing enteropathy (PLE) caused by rotavirus gastroenteritis, and evaluated the immunological ...Rotavirus is an acute enteric pathogen in infants and children. We reported a rare case of a 6-mo-old infant with protein-loosing enteropathy (PLE) caused by rotavirus gastroenteritis, and evaluated the immunological profile in peripheral blood lymphocytes. Laboratory examinations showed lymphopenia, hypoproteinemia, hypoalbuminemia, hypogammaglobulinemia, and elevation of alpha-1-antitrypsin (α1-AT) clearance. Lymphocytes subpopulation study revealed the reversal of CD4+/CD8+ ratio with the selective decrease of CD4- positive lymphocytes. Moreover, the excessive increase of T cells producing IFN-gamma (IFN-γ) was found, which plays an important role in the protection against viral infection. The primary or secondary activation of immune system by rotavirus may influence structural integrity and vascular permeability, which may play a triggering role in protein-loosing enteropathy.展开更多
Subarachnoid hemorrhage by a ruptured cerebral aneurysmremains the most devastating cerebrovascular disorderswith high morbidity and mortality (Suzuki et al.,2017), which are mainly caused by early brain injury anddel...Subarachnoid hemorrhage by a ruptured cerebral aneurysmremains the most devastating cerebrovascular disorderswith high morbidity and mortality (Suzuki et al.,2017), which are mainly caused by early brain injury anddelayed cerebral ischemia. Despite many experimentaland clinical research efforts, the mechanisms of earlybrain injury as well as delayed cerebral ischemia remainunclarified. However, recent works have suggested thattenascin-C, which is a special type of secreted extracellularmatrix proteins, is promising as a novel therapeutictarget against post-subarachnoid hemorrhage early braininjury and delayed cerebral ischemia.展开更多
Aneurysmal subarachnoid hemorrhage remains devastating,and the most important determinant of poor outcome is early brain injury（EBI）.In clinical settings,as a surrogate marker of EBI,loss of consciousness at ictus,p...Aneurysmal subarachnoid hemorrhage remains devastating,and the most important determinant of poor outcome is early brain injury（EBI）.In clinical settings,as a surrogate marker of EBI,loss of consciousness at ictus,poor initial clinical grades,and some radiographic findings are used,but these markers are somewhat subjective.Thus,it is imperative to find biomarkers of EBI that have beneficial prognostic and therapeutic implications.In our opinion,an ideal biomarker is a molecule that is implicated in the pathogenesis of both EBI and subsequently developing delayed cerebral ischemia（DCI）,being a therapeutic target,and can be measured easily in the peripheral blood in an acute stage.A good candidate of such a biomarker is a matricellular protein,which is a secreted,inducible and multifunctional extracellular matrix protein.There are many kinds of matricellular proteins reported,but only tenascin-C,osteopontin,galectin-3 and periostin are reported relevant to EBI and DCI.Reliable biomarkers of EBI may stratify aneurysmal subarachnoid hemorrhage patients into categories of risk to develop DCI,and allow objective monitoring of the response to treatment for EBI and earlier diagnosis of DCI.This review emphasizes that further investigation of matricellular proteins as an avenue for biomarker discovery is warranted.展开更多
AIM- To immunohistochemicaUy examine micrometastasis and VEGF-C expression in hilar bile duct carcinoma （HBDC） and to evaluate the clinical significance of the results. METHODS： A total of 361 regional lymph nodes ...AIM- To immunohistochemicaUy examine micrometastasis and VEGF-C expression in hilar bile duct carcinoma （HBDC） and to evaluate the clinical significance of the results. METHODS： A total of 361 regional lymph nodes from 25 patients with node-negative HBDC were immunostained with an antibody against cytokeratins 8 and 18 （CAM 5.2）, and immunohistochemical staining of VEGF-C was performed in 34 primary resected tumors. RESULTS： Lymph node micrometastasis was detected in 6 （24%） of the 25 patients and 10 （2.8%） of the 361 lymph nodes. Patients with micrometastasis showed significantly poorer survival rates than those without （P= 0.025）. VEGF-C expression was positive in 17 （50%） of 34 HBDC, and significantly correlated with lymph node metastasis （P=0.042） and microscopic venous invasion （P=0.035）. CONCLUSIONS： It is suggested that immunohistochemically detected lymph node micrometastasis has an impact on the outcome of HBDC. VEGF-C expression is highly correlated with lymph node metastasis in HBDC and might therefore be a useful predictor.展开更多
Target of research in subarachnoid hemorrhage（SAH）：The outcome of aneurysmal SAH remains poor despite advances in the diagnosis and treatment.Although many factors related to patients,aneurysms,and institutions,as ...Target of research in subarachnoid hemorrhage（SAH）：The outcome of aneurysmal SAH remains poor despite advances in the diagnosis and treatment.Although many factors related to patients,aneurysms,and institutions,as well as physiological parameters and medical complications were reported as prognostic factors,展开更多
To test the influence of binder strength, porous concretes with 4 binder strengths between 30.0-135.0 MPa and 5 void ratios between 15%-35% were tested. The results indicated that for the same aggregate, the rates of ...To test the influence of binder strength, porous concretes with 4 binder strengths between 30.0-135.0 MPa and 5 void ratios between 15%-35% were tested. The results indicated that for the same aggregate, the rates of strength reduction due to the increases in void ratio were the same for binders with different strengths. To study the influence of aggregate size, 3 single size aggregates with nominal sizes of 5.0, 13.0 and 20.0 mm （Nos. 7, 6 and 5 according to JIS A 5001） were used to make porous concrete. The strengths of porous concrete are found to be dependent on aggregate size. The rate of strength reduction of porous concrete with small aggregate size is found to be higher than that with larger aggregate size. At the same void ratio, the strength of porous concrete with large aggregate is larger than that with small aggregate. The general equations for porous concrete are related to compressive strength and void ratio for different binder strengths and aggregate sizes.展开更多
AIM: In patients with liver cirrhosis and portal hypertension, portal hypertensive colopathy is thought to be an important cause of lower gastrointestinal hemorrhage. In this study, we evaluated the prevalence of colo...AIM: In patients with liver cirrhosis and portal hypertension, portal hypertensive colopathy is thought to be an important cause of lower gastrointestinal hemorrhage. In this study, we evaluated the prevalence of colonic mucosal changes in patients with liver cirrhosis and its clinical significance. METHODS: We evaluated the colonoscopic findings and liver function of 47 patients with liver cirrhosis over a 6-year period. The main cause of liver cirrhosis was post-viral hepatitis (68%) related to hepatitis B (6%) or C (62%) infection. All patients underwent upper gastrointestinal endoscopy to examine the presence of esophageal varices, cardiac varices, and congestive gastropathy, as well as a full colonoscopy to observe changes in colonic mucosa. Portal hypertensive colopathy was defined endoscopically in patients with vascular ectasia, redness, and blue vein. Vascular ectasia was classified into two types: type 1, solitary vascular ectasia; and type 2, diffuse vascular ectasia. RESULTS: Overall portal hypertensive colopathy was present in 31 patients (66%), including solitary vascular ectasia in 17 patients (36%), diffuse vascular ectasia in 20 patients (42%), redness in 10 patients (21%) and blue vein in 6 patients (12%). As the Child-Pugh class increased in severity, the prevalence of portal hypertensive colopathy rose. Child-Pugh class B and C were significantly associated with portal hypertensive colopathy. Portal hypertensive gastropathy, esophageal varices, ascites and hepatocellular carcinoma were not related to occurrence of portal hypertensive colopathy. Platelet count was significantly associated with portal hypertensive colopathy, but prothrombin time, serum albumin level, total bilirubin level and serum ALT level were not related to occurrence of portal hypertensive colopathy. CONCLUSION: As the Child-Pugh class worsens and platelet count decreases, the prevalence of portal hypertensive colopathy increases in patients with liver cirrhosis. A colonoscopic examination in patients with liver cirrhosis is indicated, especially those with worsening Child-Pugh class and/or decreasing platelet count, to prevent complications such as lower gastrointestinal bleeding.展开更多
In the case of fault diagnosis for roller bearings, the conventional diagnosis approaches by using the time interval of energy impacts in time-frequency distribution or the pass-frequencies are based on the assumption...In the case of fault diagnosis for roller bearings, the conventional diagnosis approaches by using the time interval of energy impacts in time-frequency distribution or the pass-frequencies are based on the assumption that machinery operates under a constant rotational speed. However, when the rotational speed varies in the broader range, the pass-frequencies vary with the change of rotational speed and bearing faults cannot be identified by the interval of impacts. Researches related to automatic diagnosis for rotational machinery in variable operating conditions were quite few. A novel automatic feature extraction method is proposed based on a pseudo-Wigner-Ville distribution （PWVD） and an extraction of symptom parameter （SP）. An extraction method for instantaneous feature spectrum is presented using the relative crossing information （RCI） and sequential inference approach, by which the feature spectrum from time-frequency distribution can be automatically, sequentially extracted. The SPs are considered in the frequency domain using the extracted feature spectrum to identify among the conditions of a machine. A method to obtain the synthetic symptom parameter is also proposed by the least squares mapping （LSM） technique for increasing the diagnosis sensitivity of SP. Practical examples of diagnosis for bearings are given in order to verify the effectiveness of the proposed method. The verification results show that the features of bearing faults, such as the outer-race, inner-race and roller element defects have been effectively extracted, and the proposed method can be used for condition diagnosis of a machine under the variable rotational speed.展开更多
Although interferon (IFN) based therapy for recurrent hepatitis C virus (HCV) infection after liver transplantation has been widely accepted, it induces various adverse effects such as thrombocytopenia, resulting in i...Although interferon (IFN) based therapy for recurrent hepatitis C virus (HCV) infection after liver transplantation has been widely accepted, it induces various adverse effects such as thrombocytopenia, resulting in its interruption. Recently, concomitant splenectomy at the time of living donor liver transplantation (LDLT) has been tried to overcome this problem, but this procedure leads to several complications such as excessive intraoperative bleeding and serious infection. A 60-year-old female received LDLT using a left lobe graft from her second son for liver failure caused by hepatitis C-related cirrhosis. Six months after LDLT, she was diagnosed as recurrent HCV infection by liver biopsy. IFN monotherapy was started from 7 mo after LDLT and her platelet count decreased to less than 50 000/μL, which thus made it necessary to discontinue the treatment. We decided to attempt laparoscopic splenectomy (LS) under general anesthesia. Since intra-abdominal findings did not show any adhesion formations around the spleen, LS could be successfully performed. After LS, since her platelet count immediately increased to 225 000/μL 14 d after operation, IFN therapy was restarted and we could convert the combination therapy of IFN and ribavirin, resulting in no detectable viral marker. Inconclusion, LS can be performed safely even after LDLT, and LS after LDLT is a feasible and less invasive modality for thrombocytopenia caused by antiviral therapy.展开更多
基金funded by Taiju Life Social Welfare Foundation(to HS).
文摘Aneurysm rupture can result in subarachnoid hemorrhage,a condition with potentially severe consequences,such as disability and death.In the acute stage,early brain injury manifests as intracranial pressure elevation,global cerebral ischemia,acute hydrocephalus,and direct blood–brain contact due to aneurysm rupture.This may subsequently cause delayed cerebral infarction,often with cerebral vasospasm,significantly affecting patient outcomes.Chronic complications such as brain volume loss and chronic hydrocephalus can further impact outcomes.Investigating the mechanisms of subarachnoid hemorrhage-induced brain injury is paramount for identifying effective treatments.Stem cell therapy,with its multipotent differentiation capacity and anti-inflammatory effects,has emerged as a promising approach for treating previously deemed incurable conditions.This review focuses on the potential application of stem cells in subarachnoid hemorrhage pathology and explores their role in neurogenesis and as a therapeutic intervention in preclinical and clinical subarachnoid hemorrhage studies.
基金partially supported by the Science and Technology Research Partnership for Sustainable Development(SATREPS)in collaboration with the Japan Science and Technology Agency(JPMJSA2001)the state assignment of Ministry of Science and Higher Education of the Russian Federation(122042700044-6).
文摘Rising atmospheric CO_(2)(carbon dioxide)concentrations and salinization are manifestations of climate change that affect plant growth and productivity.Species with an intermediate C_(3)-C_(4)type of photosynthesis live in a wide range of precipitation,temperature,and soil quality,but are more often found in warm and dry habitats.One of the intermediate C_(3)-C_(4)photosynthetic type is C_(2)photosynthesis with a carbon concentration mechanism(CCM)that reassimilates CO_(2)released via photorespiration.However,the ecological significance under which C_(2)photosynthesis has advantages over C_(3)and C_(4)plants remains largely unexplored.Salt tolerance and functioning of CCM were studied in plants from two populations(P1 and P2)of Sedobassia sedoides(Pall.)Freitag&G.Kadereit Asch.species with C_(2)photosynthesis exposed to 4 d and 10 d salinity(200 mM NaCl)at ambient(785.7 mg/m^(3),aCO_(2)and elevated(1571.4 mg/m^(3),eCO_(2))CO_(2).On the fourth day of salinity,an increase in Na+content,activity catalase,and superoxide dismutase was observed in both populations.P2 plants showed an increase in proline content and a decrease in photosynthetic enzyme content:rubisco,phosphoenolpyruvate carboxylase(PEPC),and glycine decarboxylase(GDC),which indicated a weakening of C_(2)and C_(4)characteristics under salinity.Treatment under 10 d salinity led to an increased Na^(+)content and activity of cyclic electron flow around photosystem I(PSI CEF),a decreased content of K^(+)and GDC in both populations.P1 plants showed greater salt tolerance,which was assessed by the degree of reduction in photosynthetic enzyme content,PSI CEF activity,and changes in relative growth rate(RGR).Differences between populations were evident under the combination of eCO_(2)and salinity.Under long-term salinity and eCO_(2),more salt-tolerant P1 plants had a higher dry biomass(DW),which was positively correlated with PSI CEF activity.In less salt-tolerant P2 plants,DW correlated with transpiration and dark respiration.Thus,S.sedoides showed a high degree of photosynthetic plasticity under the influence of salinity and eCO_(2)through strengthening(P1 plants)and weakening C_(4)characteristics(P2 plants).
文摘An energy production system consisting of a solar collector, biogas dry reforming reactor and solid oxide fuel cell (SOFC) was assumed to be installed in Kolkata, India. This study aims to understand the impact of climate conditions on the performance of solar collectors with different lengths of parabolic trough solar collector (dx) and mass flow rate of heat transfer fluid (m). In addition, this study has evaluated the amount of H2 produced by biogas dry reforming (GH2), the amount of power generated by SOFC (PSOFC) and the maximum number of possible households (N) whose electricity demand could be met by the energy system proposed, considering the performance of solar collector with the different dx and m. As a result, the optimum dx was found to be 4 m. This study revealed that the temperature of heat transfer fluid (Tfb) decreased with the increase in m. Tfb in March, April and May was higher than that in other months, while Tfb from June to December was the lowest. GH2, PSOFC and N in March, April and May were higher than those in other months, irrespective of m. The optimum m was 0.030 kg/s.
文摘Risk factors of the depression are the occupational stress. The mental health condition of university teachers who participate in the socialization of diverse students is an important issue;however, there are few studies on depression among university teachers. The purpose of this study is to clarify Japanese university teachers’ depression status assessed by the Patient Health Questionnaire-9 and its influence factors: Japanese university teachers’ depression status depression status, personal background, job situation, social support, and stress coping behavior. The self-administered questionnaire survey was mailed to 924 university teachers in Japan, with a survey return rate of 43.8% (N = 405). A total of 342 surveys were completed and valid. The Patient Health Questionnaire 9 (PHQ-9), Multidimensional Scale of Perceived Social Support (MSPSS), the Japanese version of the Brief Coping Orientation to Problems Experienced (COPE) and the Work Situation Questionnaire (WSQ) were analyzed to clarify the depression status and its influence factors. Multivariate logistic regression analysis was used to examine factors related to the major depression. The subjects included 274 men (80.1%) and 68 women (19.9%), 105 professors (30.7%), 52 associate professors (15.2%), 53 lecturers (15.5%) and 132 assistants (38.6%). The subjects’ mean of age and teaching experiences were 44.1 ± 9.7 years, 15.6 ± 10.1 years. The mean PHQ score was 3.9 ± 4.1, and 307 subjects (89.8%) were 0 - 9 points and 35 subjects (10.2%) were over 10 points (10 points or over). For women [OR = 7.009, 95% CI 2.387 - 20.584;p < 0.001], religion [OR = 1.813, 95% CI 1.175 - 2.798;p = 0.007], self-blame [OR = 1.808, 95% CI 1.280 - 2.556;p = 0.001], substance use [OR = 1.453, 95% CI 1.103 - 1.913;p = 0.008] were risk factors of depression status. On the other hand, high job satisfaction level [OR = 0.945, 95% CI 0.921 - 0.969;p < 0.001], higher age [OR = 0.927, 95% CI 0.873 - 0.984;p =0.014], use of instrumental support [OR = 0.622, 95% CI 0.399 - 0.969;p = 0.036], and use of social support [OR = 0.588, 95% CI 0.376 - 0.921;p = 0.020] were factors that reduced the risk of depression. These findings suggested that in order to improve the depression status of university teachers, and to develop mental health measures for university faculty members based on such risk factors are necessary in the future.
文摘A building integrated energy system (photovoltaic (PV) and fuel cell (FC)) is proposed for assessment of the energy self-sufficiency rate in five cities of Mie prefecture in Japan. In this work, it is considered that the electricity requirement of the building is provided by the building integrated photovoltaic (BIPV) system and the gap between the energy demand and BIPV supply is fulfilled by the FC. The FC is powered by the electrolytic H2 produced from the surplus power of PV. A design study of using the proposed system in five cities in Mie prefecture, which are in center part of Japan, has been performed. It has been observed that the monthly power production from BIPV is higher in spring and summer, while it is lower in autumn and winter at all considered locations. The self-sufficiency rate of the FC system is higher with decreasing households’ number and it has been observed that the 12 households are more suitable for full cover of the electricity demand by the combined system of PV and FC. The relationship between the households’ number and self-sufficiency rate of the FC system per solar PV installation area can be expressed by exponential curve. The coefficient of the exponential curve can predict the suitable city for the BIPV system with FC system utilizing electrolytic H2 generated by using excess energy from the PV system.
文摘This study is to understand the impact of operating conditions, especially initial operation temperature (T<sub>ini</sub>) which is set in a high temperature range, on the temperature profile of the interface between the polymer electrolyte membrane (PEM) and the catalyst layer at the cathode (i.e., the reaction surface) in a single cell of polymer electrolyte fuel cell (PEFC). A 1D multi-plate heat transfer model based on the temperature data of the separator measured using the thermograph in a power generation experiment was developed to evaluate the reaction surface temperature (T<sub>react</sub>). In addition, to validate the proposed heat transfer model, T<sub>react</sub> obtained from the model was compared with that from the 3D numerical simulation using CFD software COMSOL Multiphysics which solves the continuity equation, Brinkman equation, Maxwell-Stefan equation, Butler-Volmer equation as well as heat transfer equation. As a result, the temperature gap between the results obtained by 1D heat transfer model and those obtained by 3D numerical simulation is below approximately 0.5 K. The simulation results show the change in the molar concentration of O<sub>2</sub> and H<sub>2</sub>O from the inlet to the outlet is more even with the increase in T<sub>ini</sub> due to the lower performance of O<sub>2</sub> reduction reaction. The change in the current density from the inlet to the outlet is more even with the increase in T<sub>ini</sub> and the value of current density is smaller with the increase in T<sub>ini </sub>due to the increase in ohmic over-potential and concentration over-potential. It is revealed that the change in T<sub>react</sub> from the inlet to the outlet is more even with the increase in T<sub>ini</sub> irrespective of heat transfer model. This is because the generated heat from the power generation is lower with the increase in T<sub>ini </sub>due to the lower performance of O<sub>2</sub> reduction reaction.
文摘In this paper, an energy system consisting of solar collector, biogas dry reforming reactor and solid oxide fuel cell (SOFC) has been proposed. The heat produced from the concentrating solar collector is used to drive a biogas dry reforming reactor in order to produce H<sub>2</sub> as a fuel for SOFC, in such as system. The aim of this study is to clarify the impact of climate data on the performance of solar collector with various sizes/designs. The temperature of heat transfer fluid produced by the solar collector is calculated by adopting the climate data for Nagoya city in Japan in 2021. The amount of H<sub>2</sub> produced from the biogas dry reforming reactor and the power generated by SOFC were simulated. The results show the temperature of heat transfer fluid (T<sub>fb</sub>) and T<sub>fb</sub> ratio (a) based on the length of absorber (dx) = 1 m have a peak near the noon following the trend of solar intensity (I). Results also revealed that a increases with increase in dx. It is found that the differences of T<sub>fb</sub> and a between dx = 2 m and dx = 3 m are larger than those between dx = 1 m and dx = 2 m. It is revealed that T<sub>fb</sub> and a are higher in spring and summer. dx = 4 m is the optimum length of solar absorber. The amount of H<sub>2</sub> produced from the biogas dry reforming reactor as well as the power generated by SOFC is the highest in August, resulting that it is prefer to produce H<sub>2</sub> and to generate SOFC in summer.
文摘Invasive fungal infections are a major challenging problem in the management of febrile neutropenia (FN) in patients with hematologic malignancies. Liposomal amphotericin B (L-AmB) or micafungin (MCFG) has been widely used as a first-line empirical antifungal therapy for suspected fungal infection in such patients. However, there are several issues in patients receiving these agents: drug related toxicities for L-AmB and breakthrough fungal infections for MCFG. In order to make the best use of these 2 agents, we conducted a prospective study of sequential therapy from MCFG to L-AmB, and evaluated the efficacy and safety of this strategy in FN patients with hematologic malignancies. A total of 18 patients were enrolled, and 11 patients who fulfilled the protocol defined criteria were evaluated. Underlying diseases consisted of acute leukemia (n = 9), non-Hodgkin lymphoma (n = 1), and myelodysplastic syndrome (n = 1). Treatment success was achieved in 8 patients (72.7%). Drug-related adverse events occurred in 8 patients (72.7%). All of those adverse events except one case were below grade 2. Three patients required discontinuation of L-AmB. Although our empirical antifungal sequential therapy seems to be encouraging for antibiotics-refractory FN in patients with hematologic malignancies, further investigation in large-scale studies is warranted.
基金supported by a grant-in-aid for Scientific Research from Japan Society for the Promotion of Science(grant number:17K10825)to HS
文摘Aneurysmal subarachnoid hemorrhage remains serious hemorrhagic stroke with high morbidities and mortalities.Aneurysm rupture causes arterial bleeding-induced mechanical brain tissue injuries and elevated intracranial pressure,followed by global cerebral ischemia.Post-subarachnoid hemorrhage ischemia,tissue injuries as well as extravasated blood components and the breakdown products activate microglia,astrocytes and Toll-like receptor 4,and disrupt blood-brain barrier associated with the induction of many inflammatory and other cascades.Once blood-brain barrier is disrupted,brain tissues are directly exposed to harmful blood contents and immune cells,which aggravate brain injuries furthermore.Blood-brain barrier disruption after subarachnoid hemorrhage may be developed by a variety of mechanisms including endothelial cell apoptosis and disruption of tight junction proteins.Many molecules and pathways have been reported to disrupt the blood-brain barrier after subarachnoid hemorrhage,but the exact mechanisms remain unclear.Multiple independent and/or interconnected signaling pathways may be involved in blood-brain barrier disruption after subarachnoid hemorrhage.This review provides recent understandings of the mechanisms and the potential therapeutic targets of blood-brain barrier disruption after subarachnoid hemorrhage.
文摘AIM: To evaluate the clinical utility of serum fibrosis markers, including YKL-40, in patients with HCV-associated liver disease. METHODS: A total of 109 patients with HCV-associated liver disease were enrolled. We measured serum type IV collagen, amino-terminal peptide of type III procollagen (PIIIP), hyaluronic acid (HA), YKL-40 levels and biochemical. Parameters by RIA or ELISA. Eighty-eight patients underwent liver biopsy, and 67 of 109 patients received interferon (IFN) therapy. We also investigated the relationship between the concentrations of serum fibrosis markers and histological fibrosis scores (METAVIR), and evaluated the changes of the levels of fibrosis markers before and after the IFN therapy. RESULTS: The increase in serum levels of all markers, particularly HA, was correlated with the progression of liver fibrosis (for type IV collagen, F= 9.076, P<0.0001; for PIIIP, F= 9.636, P<0.0001; for HA, F=13.128, P<0.0001; and for YKL-40, F= 8.016, P<0.0001). YKL-40 had strong correlation with HA (r= 0.536, P<0.0001). Based on the receiver operating curve (ROC), the ability of serum HA exceeded the abilities of other serum markers to determine fibrosis score 4 from fibrosis score 0-3 (AUC = 0.854). While YKL-40 was superior to other fibrosis markers for predicting severe fibrosis (F2-F4) from mild fibrosis (FO-F1) (YKL-40, AUC = 0.809; HA, AUC = 0.805). After IFN therapy, only YKL-40 values significantly decreased not only in the responder group, but also in the nonresponder group (P = 0.03). CONCLUSION: YKL-40 may be a useful non-invasive serum marker to estimate the degree of liver fibrosis and to evaluate the efficacy of IFN therapies in patients with HCV-associated liver disease.
文摘Rotavirus is an acute enteric pathogen in infants and children. We reported a rare case of a 6-mo-old infant with protein-loosing enteropathy (PLE) caused by rotavirus gastroenteritis, and evaluated the immunological profile in peripheral blood lymphocytes. Laboratory examinations showed lymphopenia, hypoproteinemia, hypoalbuminemia, hypogammaglobulinemia, and elevation of alpha-1-antitrypsin (α1-AT) clearance. Lymphocytes subpopulation study revealed the reversal of CD4+/CD8+ ratio with the selective decrease of CD4- positive lymphocytes. Moreover, the excessive increase of T cells producing IFN-gamma (IFN-γ) was found, which plays an important role in the protection against viral infection. The primary or secondary activation of immune system by rotavirus may influence structural integrity and vascular permeability, which may play a triggering role in protein-loosing enteropathy.
基金funded by a grant-in-aid for Scientific Research from Japan Society for the Promotion of Science,No.17K10825(to HS)and 17K16640(to MS)
文摘Subarachnoid hemorrhage by a ruptured cerebral aneurysmremains the most devastating cerebrovascular disorderswith high morbidity and mortality (Suzuki et al.,2017), which are mainly caused by early brain injury anddelayed cerebral ischemia. Despite many experimentaland clinical research efforts, the mechanisms of earlybrain injury as well as delayed cerebral ischemia remainunclarified. However, recent works have suggested thattenascin-C, which is a special type of secreted extracellularmatrix proteins, is promising as a novel therapeutictarget against post-subarachnoid hemorrhage early braininjury and delayed cerebral ischemia.
基金supported by a Grant-in-Aid for Scientific Research from Novartis Pharmaceuticals to HS
文摘Aneurysmal subarachnoid hemorrhage remains devastating,and the most important determinant of poor outcome is early brain injury（EBI）.In clinical settings,as a surrogate marker of EBI,loss of consciousness at ictus,poor initial clinical grades,and some radiographic findings are used,but these markers are somewhat subjective.Thus,it is imperative to find biomarkers of EBI that have beneficial prognostic and therapeutic implications.In our opinion,an ideal biomarker is a molecule that is implicated in the pathogenesis of both EBI and subsequently developing delayed cerebral ischemia（DCI）,being a therapeutic target,and can be measured easily in the peripheral blood in an acute stage.A good candidate of such a biomarker is a matricellular protein,which is a secreted,inducible and multifunctional extracellular matrix protein.There are many kinds of matricellular proteins reported,but only tenascin-C,osteopontin,galectin-3 and periostin are reported relevant to EBI and DCI.Reliable biomarkers of EBI may stratify aneurysmal subarachnoid hemorrhage patients into categories of risk to develop DCI,and allow objective monitoring of the response to treatment for EBI and earlier diagnosis of DCI.This review emphasizes that further investigation of matricellular proteins as an avenue for biomarker discovery is warranted.
文摘AIM- To immunohistochemicaUy examine micrometastasis and VEGF-C expression in hilar bile duct carcinoma （HBDC） and to evaluate the clinical significance of the results. METHODS： A total of 361 regional lymph nodes from 25 patients with node-negative HBDC were immunostained with an antibody against cytokeratins 8 and 18 （CAM 5.2）, and immunohistochemical staining of VEGF-C was performed in 34 primary resected tumors. RESULTS： Lymph node micrometastasis was detected in 6 （24%） of the 25 patients and 10 （2.8%） of the 361 lymph nodes. Patients with micrometastasis showed significantly poorer survival rates than those without （P= 0.025）. VEGF-C expression was positive in 17 （50%） of 34 HBDC, and significantly correlated with lymph node metastasis （P=0.042） and microscopic venous invasion （P=0.035）. CONCLUSIONS： It is suggested that immunohistochemically detected lymph node micrometastasis has an impact on the outcome of HBDC. VEGF-C expression is highly correlated with lymph node metastasis in HBDC and might therefore be a useful predictor.
基金supported by a Grant-in-Aid for Scientific Research from Mie Medical Research Foundation to HS
文摘Target of research in subarachnoid hemorrhage（SAH）：The outcome of aneurysmal SAH remains poor despite advances in the diagnosis and treatment.Although many factors related to patients,aneurysms,and institutions,as well as physiological parameters and medical complications were reported as prognostic factors,
文摘To test the influence of binder strength, porous concretes with 4 binder strengths between 30.0-135.0 MPa and 5 void ratios between 15%-35% were tested. The results indicated that for the same aggregate, the rates of strength reduction due to the increases in void ratio were the same for binders with different strengths. To study the influence of aggregate size, 3 single size aggregates with nominal sizes of 5.0, 13.0 and 20.0 mm （Nos. 7, 6 and 5 according to JIS A 5001） were used to make porous concrete. The strengths of porous concrete are found to be dependent on aggregate size. The rate of strength reduction of porous concrete with small aggregate size is found to be higher than that with larger aggregate size. At the same void ratio, the strength of porous concrete with large aggregate is larger than that with small aggregate. The general equations for porous concrete are related to compressive strength and void ratio for different binder strengths and aggregate sizes.
文摘AIM: In patients with liver cirrhosis and portal hypertension, portal hypertensive colopathy is thought to be an important cause of lower gastrointestinal hemorrhage. In this study, we evaluated the prevalence of colonic mucosal changes in patients with liver cirrhosis and its clinical significance. METHODS: We evaluated the colonoscopic findings and liver function of 47 patients with liver cirrhosis over a 6-year period. The main cause of liver cirrhosis was post-viral hepatitis (68%) related to hepatitis B (6%) or C (62%) infection. All patients underwent upper gastrointestinal endoscopy to examine the presence of esophageal varices, cardiac varices, and congestive gastropathy, as well as a full colonoscopy to observe changes in colonic mucosa. Portal hypertensive colopathy was defined endoscopically in patients with vascular ectasia, redness, and blue vein. Vascular ectasia was classified into two types: type 1, solitary vascular ectasia; and type 2, diffuse vascular ectasia. RESULTS: Overall portal hypertensive colopathy was present in 31 patients (66%), including solitary vascular ectasia in 17 patients (36%), diffuse vascular ectasia in 20 patients (42%), redness in 10 patients (21%) and blue vein in 6 patients (12%). As the Child-Pugh class increased in severity, the prevalence of portal hypertensive colopathy rose. Child-Pugh class B and C were significantly associated with portal hypertensive colopathy. Portal hypertensive gastropathy, esophageal varices, ascites and hepatocellular carcinoma were not related to occurrence of portal hypertensive colopathy. Platelet count was significantly associated with portal hypertensive colopathy, but prothrombin time, serum albumin level, total bilirubin level and serum ALT level were not related to occurrence of portal hypertensive colopathy. CONCLUSION: As the Child-Pugh class worsens and platelet count decreases, the prevalence of portal hypertensive colopathy increases in patients with liver cirrhosis. A colonoscopic examination in patients with liver cirrhosis is indicated, especially those with worsening Child-Pugh class and/or decreasing platelet count, to prevent complications such as lower gastrointestinal bleeding.
基金supported by National Natural Science Foundation of China (Grant No. 50875016, 51075023)Fundamental Research Funds for the Central Universities of China (Grant No. JD0903, JD0904)
文摘In the case of fault diagnosis for roller bearings, the conventional diagnosis approaches by using the time interval of energy impacts in time-frequency distribution or the pass-frequencies are based on the assumption that machinery operates under a constant rotational speed. However, when the rotational speed varies in the broader range, the pass-frequencies vary with the change of rotational speed and bearing faults cannot be identified by the interval of impacts. Researches related to automatic diagnosis for rotational machinery in variable operating conditions were quite few. A novel automatic feature extraction method is proposed based on a pseudo-Wigner-Ville distribution （PWVD） and an extraction of symptom parameter （SP）. An extraction method for instantaneous feature spectrum is presented using the relative crossing information （RCI） and sequential inference approach, by which the feature spectrum from time-frequency distribution can be automatically, sequentially extracted. The SPs are considered in the frequency domain using the extracted feature spectrum to identify among the conditions of a machine. A method to obtain the synthetic symptom parameter is also proposed by the least squares mapping （LSM） technique for increasing the diagnosis sensitivity of SP. Practical examples of diagnosis for bearings are given in order to verify the effectiveness of the proposed method. The verification results show that the features of bearing faults, such as the outer-race, inner-race and roller element defects have been effectively extracted, and the proposed method can be used for condition diagnosis of a machine under the variable rotational speed.
文摘Although interferon (IFN) based therapy for recurrent hepatitis C virus (HCV) infection after liver transplantation has been widely accepted, it induces various adverse effects such as thrombocytopenia, resulting in its interruption. Recently, concomitant splenectomy at the time of living donor liver transplantation (LDLT) has been tried to overcome this problem, but this procedure leads to several complications such as excessive intraoperative bleeding and serious infection. A 60-year-old female received LDLT using a left lobe graft from her second son for liver failure caused by hepatitis C-related cirrhosis. Six months after LDLT, she was diagnosed as recurrent HCV infection by liver biopsy. IFN monotherapy was started from 7 mo after LDLT and her platelet count decreased to less than 50 000/μL, which thus made it necessary to discontinue the treatment. We decided to attempt laparoscopic splenectomy (LS) under general anesthesia. Since intra-abdominal findings did not show any adhesion formations around the spleen, LS could be successfully performed. After LS, since her platelet count immediately increased to 225 000/μL 14 d after operation, IFN therapy was restarted and we could convert the combination therapy of IFN and ribavirin, resulting in no detectable viral marker. Inconclusion, LS can be performed safely even after LDLT, and LS after LDLT is a feasible and less invasive modality for thrombocytopenia caused by antiviral therapy.
