A multi-fluid blast furnace model was simply introduced and was used to simulate several innovative ironmaking operations. The simulation results show that injecting hydrogen bearing materials, especially injecting na...A multi-fluid blast furnace model was simply introduced and was used to simulate several innovative ironmaking operations. The simulation results show that injecting hydrogen bearing materials, especially injecting natural gas and plastics, the hydrogen reduction is enhanced, and the furnace performance is improved simultaneously. Total heat input shows obvious decrease due to the decrease of heat consumption in direct reduction, solution loss and silicon transfer reactions. If carbon composite agglomerates are charged into the furnace, the temperature of thermal reserve zone will obviously decrease, and the reduction of iron-bearing burden materials will be retarded. However, the efficiency of blast furnace is improved just due to the decrease in heat requirements for solution loss, sinter reduction, and silicon transfer reactions, and less heat loss through top gas and furnace wall. Finally, the model is used to investigate the performance of blast furnace under the condition of top gas recycling together with plastics injection, cold oxygen blasting and carbon composite agglomerate charging. The lower furnace temperature, extremely accelerated reduction rate, drastically decreased CO2 emission and remarkably enhanced heat efficiency were obtained by using the innovative operations, and the blast furnace operation with superhigh efficiency can be realized.展开更多
AIM: To clarify the usefulness of postsurgical capsule endoscopy(CE) in the diagnosis of recurrent small bowel lesions of Crohn's disease(CD). METHODS: This prospective study included 19 patients who underwent ile...AIM: To clarify the usefulness of postsurgical capsule endoscopy(CE) in the diagnosis of recurrent small bowel lesions of Crohn's disease(CD). METHODS: This prospective study included 19 patients who underwent ileocolectomy or partial ileal resection for CD. CE was performed 2-3 wk after surgery to check for the presence/absence and severity of lesions remaining in the small bowel, and for any recurrence at the anastomosed area. CE was repeated 6-8 mo after surgery and the findings were compared with those obtained shortly after surgery. The Lewis score (LS) was used to evaluate any inflammatory changes of the small bowel. RESULTS: One patient was excluded from analysis because of insufficient endoscopy data at the initial CE. The total LS shortly after surgery was 428.3 on average(median, 174; range, 8-4264), and was ≥ 135(active stage) in 78%(14 of 18) of the patients. When the remaining unresected small bowel was divided into 3 equal portions according to the transition time(proximal, middle, and distal tertiles), the mean LS was 286.6, 83.0, and 146.7, respectively, without any significant difference. Ulcerous lesions in the anastomosed area were observed in 83% of all patients. In 38% of the 13 patients who could undergo CE again after 6-8 mo, the total LS was higher by ≥ 100 than that recorded shortly after surgery, thus indicating a diagnosis of endoscopic progressive recurrence. CONCLUSION: Our pilot study suggests that CE can be used to objectively evaluate the postoperative recurrence of small bowel lesions after surgery for CD.展开更多
Drug-induced liver injury(DILI)is a major cause of acute liver injury,liver failure,and liver transplantation worldwide.In recent years,immune checkpoint inhibitors have become widely used.This has led to an increase ...Drug-induced liver injury(DILI)is a major cause of acute liver injury,liver failure,and liver transplantation worldwide.In recent years,immune checkpoint inhibitors have become widely used.This has led to an increase in DILI,for which pathophysiology and management methods differ significantly from the past.As the number of cases of acute liver injury and liver transplantation due to DILI is expected to increase,information about a DILI is becoming more valuable.DILI is classified into two types according to its etiology:intrinsic DILI,in which the drug or its metabolites cause liver damage that is dose-dependent and predictable;and idiosyncratic DILI,in which liver damage is also dose-independent but unpredictable.In addition,depending on the course of the disease,chronic DILI or drug-induced autoimmune hepatitis may be present.The number of DILI cases caused by antimicrobial agents is decreasing,whereas that caused by drugs for malignant tumors and health foods is increasing.The Roussel Uclaf Causality Assessment Method is widely used to assess causality in DILI.Liver injury is a type of immune-related adverse event.The pattern of hepatic injury in immune-related adverse events is mostly hepatocellular,but mixed type and bile stasis have also been reported.Sclerosing cholangitis caused by immune checkpoint inhibitors has also been reported as a unique type of injury.Treatment mainly comprises withdrawal of immune checkpoint inhibitors and steroid administration;however,mycophenolate mofetil may be considered if the disease is refractory to steroids.展开更多
AIM To assess the clinical significance of prophylactic lateral pelvic lymph node dissection (LPLND) in stage Ⅳ low rectal cancer.METHODS We selected 71 consecutive stage Ⅳ low rectal cancer patients who underwent p...AIM To assess the clinical significance of prophylactic lateral pelvic lymph node dissection (LPLND) in stage Ⅳ low rectal cancer.METHODS We selected 71 consecutive stage Ⅳ low rectal cancer patients who underwent primary tumor resection,and enrolled 50 of these 71 patients without clinical LPLN metastasis.The patients had distant metastasis such as liver,lung,peritoneum,and paraaortic LN.Clinical LPLN metastasis was defined as LN with a maximum diameter of 10 mm or more on preoperative pelvic computed tomography scan.All patients underwent primary tumor resection,27 patients underwent total mesorectal excision(TME) with LPLND(LPLND group),and 23 patients underwent only TME(TME group).Bilateral LPLND was performed simultaneously with primary tumor resection in LPLND group.R0 resection of both primary and metastatic sites was achieved in 20 of 50 patients.We evaluated possible prognostic factors for 5-year overall survival (OS),and compared 5-year cumulative local recurrence between the LPLND and TME groups.RESULTS For OS,univariate analyses revealed no significant benefit in the LPLND compared with the TME group (28.7% vs 17.0%,P = 0.523); multivariate analysis revealed that R0 resection was an independent prognostic factor.Regarding cumulative local recurrence,the LPLND group showed no significant benefit compared with TME group (21.4% vs 14.8%,P = 0.833).CONCLUSION Prophylactic LPLND shows no oncological benefits in patients with Stage Ⅳ low rectal cancer without clinical LPLN metastasis.展开更多
As obesity continues to escalate worldwide,nonalcoholic fatty liver disease(NAFLD)has emerged as the most prevalent form of liver disease,with a reported global prevalence of 30.1%(1).The prevalence of NAFLD,which was...As obesity continues to escalate worldwide,nonalcoholic fatty liver disease(NAFLD)has emerged as the most prevalent form of liver disease,with a reported global prevalence of 30.1%(1).The prevalence of NAFLD,which was around 25%in the 1990s,has been increasing year by year in recent years and has exceeded 35%in the past few years(1).The spectrum of disease includes nonalcoholic fatty liver(NAFL),characterized by macrovesicular hepatic steatosis that may be accompanied by mild inflammation,and nonalcoholic steatohepatitis(NASH),which is additionally characterized by the presence of inflammation and cellular injury(2).展开更多
AIM:To determine the efficacy and safety of rapid induction therapy with oral tacrolimus without a meal in steroid-refractory ulcerative colitis(UC)patients.METHODS:This was a prospective,multicenter,observational stu...AIM:To determine the efficacy and safety of rapid induction therapy with oral tacrolimus without a meal in steroid-refractory ulcerative colitis(UC)patients.METHODS:This was a prospective,multicenter,observational study.Between May 2010 and August 2012,49 steroid-refractory UC patients(55 flare-ups)were consecutively enrolled.All patients were treated with oral tacrolimus without a meal at an initial dose of 0.1mg/kg per day.The dose was adjusted to maintain trough whole-blood levels of 10-15 ng/m L for the first 2 wk.Induction of remission at 2 and 4 wk after tacrolimus treatment initiation was evaluated using Lichtiger’s clinical activity index(CAI).RESULTS:The mean CAI was 12.6±3.6 at onset.Within the first 7 d,93.5%of patients maintained high trough levels(10-15 ng/m L).The CAI significantly decreased beginning 2 d after treatment initiation.At 2wk,73.1%of patients experienced clinical responses.After tacrolimus initiation,31.4%and 75.6%of patients achieved clinical remission at 2 and 4 wk,respectively.Treatment was well tolerated.CONCLUSION:Rapid induction therapy with oral tacrolimus shortened the time to achievement of appropriate trough levels and demonstrated a high remission rate 28 d after treatment initiation.Rapid induction therapy with oral tacrolimus appears to be a useful therapy for the treatment of refractory UC.展开更多
To evaluate the stability of N-alkylated pyrrolidone derivatives （NRPs）, which are supposed to be used as precipitants for U（VI） and Pu（IV, VI） species in HNO3 media, under irradiation environment, some candidat...To evaluate the stability of N-alkylated pyrrolidone derivatives （NRPs）, which are supposed to be used as precipitants for U（VI） and Pu（IV, VI） species in HNO3 media, under irradiation environment, some candidate NRPs were irradiated by γ-ray. Irradia- tion to HNO3 solutions up to 6 mol dm-3 （= M） containing 2 M N-n-butyl-2-pyrrolidone （NBP）, one of NRPs with lower hy- drophobicity, has revealed that the residual ratios of NBP in the samples of HNO3 up to 3 M decreased identically and linearly. Approximately 20% of NBP was found to be degraded after the irradiation at 1 MGy. It was also found that the decrease in the precipitation ratio of UOf＋ （P.R., %） was gentle and that the P.R. values were relatively in accordance with the residual ratios of NBP. On the other hand, the degradation of the samples irradiated in 6 M HNO3 was found more distinguished. It was pro- posed from the analyses of degraded compounds that the degradation of NBP in HNO3 by γ-ray irradiation started from the cleavage of the pyrrolidone ring by the addition of oxygen atom originating from HNO3, followed by the formation of chain compounds by the successive addition of oxygen, leading to the generation of oxalic acid and acetic acid. The stability of other NRPs in 3 M HNO3 was evaluated to be nearly identical with that of NBP except lower P.R. values of the samples containing NRPs with higher hydrophobicity irradiated at more than 0.5 MGy.展开更多
We report the lithium ionic conductivities of closo –type complex hydrides synthesized from various molar ratios of lithium borohydride(LiBH4) and decaborane(B10H14) as starting materials. The prepared closo –type c...We report the lithium ionic conductivities of closo –type complex hydrides synthesized from various molar ratios of lithium borohydride(LiBH4) and decaborane(B10H14) as starting materials. The prepared closo –type complex hydrides comprised [B12H12]^2-, [B11H11]^2-, and [B10H10]^2- complex anions. In addition, increasing the LiBH4 content in the starting materials increased the amounts of [B11H11]^2- and [B10H10]^2-, leading to an improved ion conductivity of the prepared sample. The present study offers useful insights into strategies for controlling the complex anion composition in emerging solid electrolytes of closo-type complex hydrides at the molecular level, and improving their ionic conductivities.展开更多
A 26-year-old woman with ulcerative colitis was transferred to our hospital with left hemiparesis due to cerebral infarction. Cervical ultrasonography and magnetic resonance imaging angiography revealed thrombosis at ...A 26-year-old woman with ulcerative colitis was transferred to our hospital with left hemiparesis due to cerebral infarction. Cervical ultrasonography and magnetic resonance imaging angiography revealed thrombosis at the right common carotid artery and the right internal carotid artery. Antithrombotic and anticoagulant therapies were commenced. After about 2 wk of the treatment, the frequency of her diarrhea increased. She underwent emergency subtotal colectomy, but 10 d later an abundant hemorrhage from the remnant rectum occurred, so the remnant rectum was resected and an ileal pouch anal anastomosis was performed. Antithrombotic and anticoagulant therapies were continued, but neither her neurological status nor magnetic resonance imaging angiography findings showed subsequent changes. She was discharged 3 mon after operation. This is a rare case of common carotid arterial thrombosis occurring as a complication of ulcerative colitis, in which antithrombotic and anticoagulant therapies are considered to provoke a deterioration of the patient’s bowel disease.展开更多
Surgical resection is the only curative treatment modality for colorectal cancer limited locally.Evidence for the kind of resection procedure that is effective for improving prognosis is insufficient.Prognosis improve...Surgical resection is the only curative treatment modality for colorectal cancer limited locally.Evidence for the kind of resection procedure that is effective for improving prognosis is insufficient.Prognosis improvement is expected with the no-touch isolation technique(NTIT),making it the most important resection procedure.We are conducting a multicenter randomized controlled trial(RCT) to confirm the efficacy of NTIT in patients with colorectal cancer.The present review serves as a preface to our trial,as it focuses on basic and clinical studies that support the efficacy of NTIT.The detection ratios of circulating tumor cells(CTCs) of peripheral blood indicate the progress and prognosis of colorectal cancer.In a rabbit liver tumor model,metastases increased after surgical manipulation.Also,CTCs increased during the radical excision of colorectal cancer.However,NTIT decreased the detection of CTCs of intraoperative portal vein blood in patients with colorectal cancer.Although these aforementioned results support the use of NTIT,a previous controlled prospective trial was not able to confirm the clinical benefit of NTIT,as it had an insufficient sample size and many patients were lost to follow-up.Therefore,we initiated a large-scale highquality RCT to confirm the efficacy of NTIT for colorectal cancer.展开更多
There exist certain behaviors that people tend to do in disaster situations before evacuation. Such behaviors include warning confirmation behavior(for example, seeking information) and family-oriented behavior(for ex...There exist certain behaviors that people tend to do in disaster situations before evacuation. Such behaviors include warning confirmation behavior(for example, seeking information) and family-oriented behavior(for example,contacting one’s family). Identifying factors that affect these behaviors is of particular importance in building a better understanding of why people often fail to respond quickly to evacuation orders. For this purpose, the present study employed some of the established factors affecting evacuation behavior as predictor variables along with the timing of an evacuation order. A total of 518 participants took part in a 12-item online questionnaire survey that contained a hypothetical disaster scenario. The results of ordinal logistic regression analyses revealed that only risk area residence and disaster preparedness were associated with warning confirmation behavior, while gender, age, disaster preparedness,and risk perception had some associations with family-oriented behavior. Also, the participants were not more likely to engage in these behaviors in the morning and the afternoon than the evening in the hypothetical scenario. These findings imply the possibility that people engage in warning confirmation behavior and family-oriented behavior before evacuation regardless of individual characteristics and the circumstances surrounding them.展开更多
BACKGROUND Low-molecular-weight dextran(LMWD)is considered a safe alternative to contrast media for blood displacement during optical coherence tomography(OCT)imaging.AIM To investigate whether the use of LMWD for OCT...BACKGROUND Low-molecular-weight dextran(LMWD)is considered a safe alternative to contrast media for blood displacement during optical coherence tomography(OCT)imaging.AIM To investigate whether the use of LMWD for OCT is protective against kidney injury in patients with advanced renal insufficiency.METHODS In this retrospective cohort study,we identified 421 patients with advanced renal insufficiency(estimated glomerular filtration rate<45 mL/min/1.73 m2)who underwent coronary angiography or percutaneous coronary intervention;79 patients who used additional LMWD for OCT imaging(LMWD group)and 342 patients who used contrast medium exclusively(control group).We evaluated the differences between these two groups and performed a propensity score-matched subgroup comparison.RESULTS The median total volume of contrast medium was 133.0 mL in the control group vs 140.0 mL in the LMWD group.Although baseline renal function was not statistically different between these two groups,the LMWD group demonstrated a strong trend toward the progression of renal insufficiency as indicated by the greater change in serum creatinine level during the 1-year follow-up compared with the control group.Patients in the LMWD group experienced worsening renal function more frequently than patients in the control group.Propensity score matching adjusted for total contrast media volume consistently indicated a trend toward worsening renal function in the LMWD group at the 1-year follow-up.Delta serum creatinine at 1-year follow-up was significantly greater in the LMWD group than that in the control group[0.06(-0.06,0.29)vs-0.04(-0.23,0.08)mg/dL,P=0.001],despite using similar contrast volume.CONCLUSION OCT using LMWD may not be protective against worsening renal function in patients with advanced renal insufficiency.展开更多
As obesity incidence increases worldwide,nonalcoholic fatty liver disease(NAFLD)has become the most common form of liver disease,with a reported global prevalence of 25.2%(1).Nonalcoholic steatohepatitis(NASH)is a sev...As obesity incidence increases worldwide,nonalcoholic fatty liver disease(NAFLD)has become the most common form of liver disease,with a reported global prevalence of 25.2%(1).Nonalcoholic steatohepatitis(NASH)is a severe form of NAFLD.However,the precise natural history of NAFLD/NASH remains unclear.NASH is rapidly becoming the leading cause of end-stage liver disorders and liver transplants and is associated with increased cardiovascular disease risk(2).As a result,it poses critical health issues globally from both medical and socioeconomic perspectives.展开更多
The reducibility of iron-bearing burdens was emphasized for improving the operation efficiency of blast furnace. The blast furnace operation of charging the burdens with high reducibility has been numerically evaluate...The reducibility of iron-bearing burdens was emphasized for improving the operation efficiency of blast furnace. The blast furnace operation of charging the burdens with high reducibility has been numerically evaluated using a multi-fluid blast furnace model. The effects of reaction rate constants and diffusion coefficients were investigated separately or simultaneously for clarifying the variations of furnace state. According to the model simulation results, in the upper zone, the indirect reduction of the burdens proceeds at a faster rate and the shaft efficiency is enhanced with the improvement under the conditions of interface reaction and intra-particle diffusion. In the lower zone, direct reduction in molten slag is restrained. As a consequence, CO utilization of top gas is enhanced and the ratio of direct reduction is decreased. It is possible to achieve higher energy efficiency of the blast furnace, and this is represented by the improvement in productivity and the decrease in consumption of reducing agent. The use of high-reducibility burdens contributes to a better performance of blast furnace. More efforts are necessary to develop and apply highreducibility sinter and carbon composite agglomerates for practical application at a blast furnace.展开更多
Ventricular fibrillation （VF） is a malignant arrhythmia, usually initiated by a ventricular premature contraction （VPC） during the vulnerable period of cardiac repolarization. Ablation therapy for VF has been desc...Ventricular fibrillation （VF） is a malignant arrhythmia, usually initiated by a ventricular premature contraction （VPC） during the vulnerable period of cardiac repolarization. Ablation therapy for VF has been described and increasingly reported. Targets for VF triggers are VPCs preceded by Purkinje potentials or from the right ventricular outflow tract （RVOT） in structurally normal hearts, and VPC triggers preceded by Purkinje potentials in ischemic cardiomyopathy. During the session, mapping should be focused on the earliest activation and determining the earliest potential is the key to a successful ablation. However, suppression of VF can be achieved by not only the elimination of triggering VPCs, but also by substrate modification of possible reentry circuits in the Purkinje network, or between the PA and RVOT. The most important issue before the ablation session is the recording of the 12-lead ECG of the triggering event, which can prove invaluable in regionalizing the origin of the triggering VPC for more detailed mapping. In cases where the VPC is not spontaneous or inducible, ablation may be performed by pace mapping. Further studies are needed to evaluate the precise mechanisms of this arrhythmia.展开更多
In our previous studies, we developed the normal periodontal ligament index (nPLI) and the residual periodontal ligament index (rPLI), to estimate residual periodontal ligament support for individual teeth during trea...In our previous studies, we developed the normal periodontal ligament index (nPLI) and the residual periodontal ligament index (rPLI), to estimate residual periodontal ligament support for individual teeth during treatment planning for partially edentulous patients. The purpose of the current in vitro study was to analyze tooth mobility resulting from periodontal attachment loss, and to determine the application range of both nPLI and rPLI. The association of horizontal load-displacement and conditions of attachment loss was measured in triplicate for each anatomical tooth model at 10-minute intervals, using a universal tester at a crosshead speed of 0.05 mm/min, and a load of 0.1 N. The conditions of attachment loss were: (I) 0 mm (cementoenamel junction), (II) 2 mm attachment level, and (III) two-thirds, and (IV) one-half lengths of normal attachment. Except for the upper first molar, lower lateral incisor, lower first premolar, and the lower first molar, the displacement of each tooth type was increased significantly relative to Level I (P P < 0.01). The results indicated that nPLI at two-thirds of normal attachment and greater, and rPLI at less than two-thirds of normal attachment should be applied, respectively.展开更多
Porous and single crystalline platinum （Pt） nanoparticles （NPs） have been successfully synthesized by reduction of H2PtC16.6H20 and then investigated by optical spectroscopy and transmission electron microscopy. H...Porous and single crystalline platinum （Pt） nanoparticles （NPs） have been successfully synthesized by reduction of H2PtC16.6H20 and then investigated by optical spectroscopy and transmission electron microscopy. H2PtCI6-6H20 was reduced using ethylene glycol in the presence of polyvinylpyrrolidone under highly acidic conditions （pH 〈 1） to form single crystalline Pt particles about 5 nm in size. These particles were then stacked via {100} facets, forming 50-nm length porous nanocubes with a mosaic structure. The porous Pt NPs exhibited excellent catalytic properties for methanol oxidation. In particular, the electrochemical surface area was -63 m2/g, five times higher than that for non-porous Pt NPs prepared using a conventional method. We suggest that the high catalytic activity of porous Pt NPs is due to a combination of the crystalline structure having exposed {100} facets and a porous morphology.展开更多
文摘A multi-fluid blast furnace model was simply introduced and was used to simulate several innovative ironmaking operations. The simulation results show that injecting hydrogen bearing materials, especially injecting natural gas and plastics, the hydrogen reduction is enhanced, and the furnace performance is improved simultaneously. Total heat input shows obvious decrease due to the decrease of heat consumption in direct reduction, solution loss and silicon transfer reactions. If carbon composite agglomerates are charged into the furnace, the temperature of thermal reserve zone will obviously decrease, and the reduction of iron-bearing burden materials will be retarded. However, the efficiency of blast furnace is improved just due to the decrease in heat requirements for solution loss, sinter reduction, and silicon transfer reactions, and less heat loss through top gas and furnace wall. Finally, the model is used to investigate the performance of blast furnace under the condition of top gas recycling together with plastics injection, cold oxygen blasting and carbon composite agglomerate charging. The lower furnace temperature, extremely accelerated reduction rate, drastically decreased CO2 emission and remarkably enhanced heat efficiency were obtained by using the innovative operations, and the blast furnace operation with superhigh efficiency can be realized.
文摘AIM: To clarify the usefulness of postsurgical capsule endoscopy(CE) in the diagnosis of recurrent small bowel lesions of Crohn's disease(CD). METHODS: This prospective study included 19 patients who underwent ileocolectomy or partial ileal resection for CD. CE was performed 2-3 wk after surgery to check for the presence/absence and severity of lesions remaining in the small bowel, and for any recurrence at the anastomosed area. CE was repeated 6-8 mo after surgery and the findings were compared with those obtained shortly after surgery. The Lewis score (LS) was used to evaluate any inflammatory changes of the small bowel. RESULTS: One patient was excluded from analysis because of insufficient endoscopy data at the initial CE. The total LS shortly after surgery was 428.3 on average(median, 174; range, 8-4264), and was ≥ 135(active stage) in 78%(14 of 18) of the patients. When the remaining unresected small bowel was divided into 3 equal portions according to the transition time(proximal, middle, and distal tertiles), the mean LS was 286.6, 83.0, and 146.7, respectively, without any significant difference. Ulcerous lesions in the anastomosed area were observed in 83% of all patients. In 38% of the 13 patients who could undergo CE again after 6-8 mo, the total LS was higher by ≥ 100 than that recorded shortly after surgery, thus indicating a diagnosis of endoscopic progressive recurrence. CONCLUSION: Our pilot study suggests that CE can be used to objectively evaluate the postoperative recurrence of small bowel lesions after surgery for CD.
基金supported by Yokohama City University Personal Research Grant.
文摘Drug-induced liver injury(DILI)is a major cause of acute liver injury,liver failure,and liver transplantation worldwide.In recent years,immune checkpoint inhibitors have become widely used.This has led to an increase in DILI,for which pathophysiology and management methods differ significantly from the past.As the number of cases of acute liver injury and liver transplantation due to DILI is expected to increase,information about a DILI is becoming more valuable.DILI is classified into two types according to its etiology:intrinsic DILI,in which the drug or its metabolites cause liver damage that is dose-dependent and predictable;and idiosyncratic DILI,in which liver damage is also dose-independent but unpredictable.In addition,depending on the course of the disease,chronic DILI or drug-induced autoimmune hepatitis may be present.The number of DILI cases caused by antimicrobial agents is decreasing,whereas that caused by drugs for malignant tumors and health foods is increasing.The Roussel Uclaf Causality Assessment Method is widely used to assess causality in DILI.Liver injury is a type of immune-related adverse event.The pattern of hepatic injury in immune-related adverse events is mostly hepatocellular,but mixed type and bile stasis have also been reported.Sclerosing cholangitis caused by immune checkpoint inhibitors has also been reported as a unique type of injury.Treatment mainly comprises withdrawal of immune checkpoint inhibitors and steroid administration;however,mycophenolate mofetil may be considered if the disease is refractory to steroids.
文摘AIM To assess the clinical significance of prophylactic lateral pelvic lymph node dissection (LPLND) in stage Ⅳ low rectal cancer.METHODS We selected 71 consecutive stage Ⅳ low rectal cancer patients who underwent primary tumor resection,and enrolled 50 of these 71 patients without clinical LPLN metastasis.The patients had distant metastasis such as liver,lung,peritoneum,and paraaortic LN.Clinical LPLN metastasis was defined as LN with a maximum diameter of 10 mm or more on preoperative pelvic computed tomography scan.All patients underwent primary tumor resection,27 patients underwent total mesorectal excision(TME) with LPLND(LPLND group),and 23 patients underwent only TME(TME group).Bilateral LPLND was performed simultaneously with primary tumor resection in LPLND group.R0 resection of both primary and metastatic sites was achieved in 20 of 50 patients.We evaluated possible prognostic factors for 5-year overall survival (OS),and compared 5-year cumulative local recurrence between the LPLND and TME groups.RESULTS For OS,univariate analyses revealed no significant benefit in the LPLND compared with the TME group (28.7% vs 17.0%,P = 0.523); multivariate analysis revealed that R0 resection was an independent prognostic factor.Regarding cumulative local recurrence,the LPLND group showed no significant benefit compared with TME group (21.4% vs 14.8%,P = 0.833).CONCLUSION Prophylactic LPLND shows no oncological benefits in patients with Stage Ⅳ low rectal cancer without clinical LPLN metastasis.
文摘As obesity continues to escalate worldwide,nonalcoholic fatty liver disease(NAFLD)has emerged as the most prevalent form of liver disease,with a reported global prevalence of 30.1%(1).The prevalence of NAFLD,which was around 25%in the 1990s,has been increasing year by year in recent years and has exceeded 35%in the past few years(1).The spectrum of disease includes nonalcoholic fatty liver(NAFL),characterized by macrovesicular hepatic steatosis that may be accompanied by mild inflammation,and nonalcoholic steatohepatitis(NASH),which is additionally characterized by the presence of inflammation and cellular injury(2).
文摘AIM:To determine the efficacy and safety of rapid induction therapy with oral tacrolimus without a meal in steroid-refractory ulcerative colitis(UC)patients.METHODS:This was a prospective,multicenter,observational study.Between May 2010 and August 2012,49 steroid-refractory UC patients(55 flare-ups)were consecutively enrolled.All patients were treated with oral tacrolimus without a meal at an initial dose of 0.1mg/kg per day.The dose was adjusted to maintain trough whole-blood levels of 10-15 ng/m L for the first 2 wk.Induction of remission at 2 and 4 wk after tacrolimus treatment initiation was evaluated using Lichtiger’s clinical activity index(CAI).RESULTS:The mean CAI was 12.6±3.6 at onset.Within the first 7 d,93.5%of patients maintained high trough levels(10-15 ng/m L).The CAI significantly decreased beginning 2 d after treatment initiation.At 2wk,73.1%of patients experienced clinical responses.After tacrolimus initiation,31.4%and 75.6%of patients achieved clinical remission at 2 and 4 wk,respectively.Treatment was well tolerated.CONCLUSION:Rapid induction therapy with oral tacrolimus shortened the time to achievement of appropriate trough levels and demonstrated a high remission rate 28 d after treatment initiation.Rapid induction therapy with oral tacrolimus appears to be a useful therapy for the treatment of refractory UC.
文摘To evaluate the stability of N-alkylated pyrrolidone derivatives （NRPs）, which are supposed to be used as precipitants for U（VI） and Pu（IV, VI） species in HNO3 media, under irradiation environment, some candidate NRPs were irradiated by γ-ray. Irradia- tion to HNO3 solutions up to 6 mol dm-3 （= M） containing 2 M N-n-butyl-2-pyrrolidone （NBP）, one of NRPs with lower hy- drophobicity, has revealed that the residual ratios of NBP in the samples of HNO3 up to 3 M decreased identically and linearly. Approximately 20% of NBP was found to be degraded after the irradiation at 1 MGy. It was also found that the decrease in the precipitation ratio of UOf＋ （P.R., %） was gentle and that the P.R. values were relatively in accordance with the residual ratios of NBP. On the other hand, the degradation of the samples irradiated in 6 M HNO3 was found more distinguished. It was pro- posed from the analyses of degraded compounds that the degradation of NBP in HNO3 by γ-ray irradiation started from the cleavage of the pyrrolidone ring by the addition of oxygen atom originating from HNO3, followed by the formation of chain compounds by the successive addition of oxygen, leading to the generation of oxalic acid and acetic acid. The stability of other NRPs in 3 M HNO3 was evaluated to be nearly identical with that of NBP except lower P.R. values of the samples containing NRPs with higher hydrophobicity irradiated at more than 0.5 MGy.
基金supported by METX,JSPS KAKENHI (Grant numbers, 16K0 676 6, 17H0 6519, 17K18972, 18H01727, and JP18H05513)Collaborative Research Center on Energy Materials in IMR (E-IMR)Target Project 4 of WPI-AIMR, Tohoku University
文摘We report the lithium ionic conductivities of closo –type complex hydrides synthesized from various molar ratios of lithium borohydride(LiBH4) and decaborane(B10H14) as starting materials. The prepared closo –type complex hydrides comprised [B12H12]^2-, [B11H11]^2-, and [B10H10]^2- complex anions. In addition, increasing the LiBH4 content in the starting materials increased the amounts of [B11H11]^2- and [B10H10]^2-, leading to an improved ion conductivity of the prepared sample. The present study offers useful insights into strategies for controlling the complex anion composition in emerging solid electrolytes of closo-type complex hydrides at the molecular level, and improving their ionic conductivities.
文摘A 26-year-old woman with ulcerative colitis was transferred to our hospital with left hemiparesis due to cerebral infarction. Cervical ultrasonography and magnetic resonance imaging angiography revealed thrombosis at the right common carotid artery and the right internal carotid artery. Antithrombotic and anticoagulant therapies were commenced. After about 2 wk of the treatment, the frequency of her diarrhea increased. She underwent emergency subtotal colectomy, but 10 d later an abundant hemorrhage from the remnant rectum occurred, so the remnant rectum was resected and an ileal pouch anal anastomosis was performed. Antithrombotic and anticoagulant therapies were continued, but neither her neurological status nor magnetic resonance imaging angiography findings showed subsequent changes. She was discharged 3 mon after operation. This is a rare case of common carotid arterial thrombosis occurring as a complication of ulcerative colitis, in which antithrombotic and anticoagulant therapies are considered to provoke a deterioration of the patient’s bowel disease.
基金Supported by National Cancer Research and Development Fund,No.26-A-4
文摘Surgical resection is the only curative treatment modality for colorectal cancer limited locally.Evidence for the kind of resection procedure that is effective for improving prognosis is insufficient.Prognosis improvement is expected with the no-touch isolation technique(NTIT),making it the most important resection procedure.We are conducting a multicenter randomized controlled trial(RCT) to confirm the efficacy of NTIT in patients with colorectal cancer.The present review serves as a preface to our trial,as it focuses on basic and clinical studies that support the efficacy of NTIT.The detection ratios of circulating tumor cells(CTCs) of peripheral blood indicate the progress and prognosis of colorectal cancer.In a rabbit liver tumor model,metastases increased after surgical manipulation.Also,CTCs increased during the radical excision of colorectal cancer.However,NTIT decreased the detection of CTCs of intraoperative portal vein blood in patients with colorectal cancer.Although these aforementioned results support the use of NTIT,a previous controlled prospective trial was not able to confirm the clinical benefit of NTIT,as it had an insufficient sample size and many patients were lost to follow-up.Therefore,we initiated a large-scale highquality RCT to confirm the efficacy of NTIT for colorectal cancer.
文摘There exist certain behaviors that people tend to do in disaster situations before evacuation. Such behaviors include warning confirmation behavior(for example, seeking information) and family-oriented behavior(for example,contacting one’s family). Identifying factors that affect these behaviors is of particular importance in building a better understanding of why people often fail to respond quickly to evacuation orders. For this purpose, the present study employed some of the established factors affecting evacuation behavior as predictor variables along with the timing of an evacuation order. A total of 518 participants took part in a 12-item online questionnaire survey that contained a hypothetical disaster scenario. The results of ordinal logistic regression analyses revealed that only risk area residence and disaster preparedness were associated with warning confirmation behavior, while gender, age, disaster preparedness,and risk perception had some associations with family-oriented behavior. Also, the participants were not more likely to engage in these behaviors in the morning and the afternoon than the evening in the hypothetical scenario. These findings imply the possibility that people engage in warning confirmation behavior and family-oriented behavior before evacuation regardless of individual characteristics and the circumstances surrounding them.
文摘BACKGROUND Low-molecular-weight dextran(LMWD)is considered a safe alternative to contrast media for blood displacement during optical coherence tomography(OCT)imaging.AIM To investigate whether the use of LMWD for OCT is protective against kidney injury in patients with advanced renal insufficiency.METHODS In this retrospective cohort study,we identified 421 patients with advanced renal insufficiency(estimated glomerular filtration rate<45 mL/min/1.73 m2)who underwent coronary angiography or percutaneous coronary intervention;79 patients who used additional LMWD for OCT imaging(LMWD group)and 342 patients who used contrast medium exclusively(control group).We evaluated the differences between these two groups and performed a propensity score-matched subgroup comparison.RESULTS The median total volume of contrast medium was 133.0 mL in the control group vs 140.0 mL in the LMWD group.Although baseline renal function was not statistically different between these two groups,the LMWD group demonstrated a strong trend toward the progression of renal insufficiency as indicated by the greater change in serum creatinine level during the 1-year follow-up compared with the control group.Patients in the LMWD group experienced worsening renal function more frequently than patients in the control group.Propensity score matching adjusted for total contrast media volume consistently indicated a trend toward worsening renal function in the LMWD group at the 1-year follow-up.Delta serum creatinine at 1-year follow-up was significantly greater in the LMWD group than that in the control group[0.06(-0.06,0.29)vs-0.04(-0.23,0.08)mg/dL,P=0.001],despite using similar contrast volume.CONCLUSION OCT using LMWD may not be protective against worsening renal function in patients with advanced renal insufficiency.
文摘As obesity incidence increases worldwide,nonalcoholic fatty liver disease(NAFLD)has become the most common form of liver disease,with a reported global prevalence of 25.2%(1).Nonalcoholic steatohepatitis(NASH)is a severe form of NAFLD.However,the precise natural history of NAFLD/NASH remains unclear.NASH is rapidly becoming the leading cause of end-stage liver disorders and liver transplants and is associated with increased cardiovascular disease risk(2).As a result,it poses critical health issues globally from both medical and socioeconomic perspectives.
文摘The reducibility of iron-bearing burdens was emphasized for improving the operation efficiency of blast furnace. The blast furnace operation of charging the burdens with high reducibility has been numerically evaluated using a multi-fluid blast furnace model. The effects of reaction rate constants and diffusion coefficients were investigated separately or simultaneously for clarifying the variations of furnace state. According to the model simulation results, in the upper zone, the indirect reduction of the burdens proceeds at a faster rate and the shaft efficiency is enhanced with the improvement under the conditions of interface reaction and intra-particle diffusion. In the lower zone, direct reduction in molten slag is restrained. As a consequence, CO utilization of top gas is enhanced and the ratio of direct reduction is decreased. It is possible to achieve higher energy efficiency of the blast furnace, and this is represented by the improvement in productivity and the decrease in consumption of reducing agent. The use of high-reducibility burdens contributes to a better performance of blast furnace. More efforts are necessary to develop and apply highreducibility sinter and carbon composite agglomerates for practical application at a blast furnace.
文摘Ventricular fibrillation （VF） is a malignant arrhythmia, usually initiated by a ventricular premature contraction （VPC） during the vulnerable period of cardiac repolarization. Ablation therapy for VF has been described and increasingly reported. Targets for VF triggers are VPCs preceded by Purkinje potentials or from the right ventricular outflow tract （RVOT） in structurally normal hearts, and VPC triggers preceded by Purkinje potentials in ischemic cardiomyopathy. During the session, mapping should be focused on the earliest activation and determining the earliest potential is the key to a successful ablation. However, suppression of VF can be achieved by not only the elimination of triggering VPCs, but also by substrate modification of possible reentry circuits in the Purkinje network, or between the PA and RVOT. The most important issue before the ablation session is the recording of the 12-lead ECG of the triggering event, which can prove invaluable in regionalizing the origin of the triggering VPC for more detailed mapping. In cases where the VPC is not spontaneous or inducible, ablation may be performed by pace mapping. Further studies are needed to evaluate the precise mechanisms of this arrhythmia.
文摘In our previous studies, we developed the normal periodontal ligament index (nPLI) and the residual periodontal ligament index (rPLI), to estimate residual periodontal ligament support for individual teeth during treatment planning for partially edentulous patients. The purpose of the current in vitro study was to analyze tooth mobility resulting from periodontal attachment loss, and to determine the application range of both nPLI and rPLI. The association of horizontal load-displacement and conditions of attachment loss was measured in triplicate for each anatomical tooth model at 10-minute intervals, using a universal tester at a crosshead speed of 0.05 mm/min, and a load of 0.1 N. The conditions of attachment loss were: (I) 0 mm (cementoenamel junction), (II) 2 mm attachment level, and (III) two-thirds, and (IV) one-half lengths of normal attachment. Except for the upper first molar, lower lateral incisor, lower first premolar, and the lower first molar, the displacement of each tooth type was increased significantly relative to Level I (P P < 0.01). The results indicated that nPLI at two-thirds of normal attachment and greater, and rPLI at less than two-thirds of normal attachment should be applied, respectively.
文摘Porous and single crystalline platinum （Pt） nanoparticles （NPs） have been successfully synthesized by reduction of H2PtC16.6H20 and then investigated by optical spectroscopy and transmission electron microscopy. H2PtCI6-6H20 was reduced using ethylene glycol in the presence of polyvinylpyrrolidone under highly acidic conditions （pH 〈 1） to form single crystalline Pt particles about 5 nm in size. These particles were then stacked via {100} facets, forming 50-nm length porous nanocubes with a mosaic structure. The porous Pt NPs exhibited excellent catalytic properties for methanol oxidation. In particular, the electrochemical surface area was -63 m2/g, five times higher than that for non-porous Pt NPs prepared using a conventional method. We suggest that the high catalytic activity of porous Pt NPs is due to a combination of the crystalline structure having exposed {100} facets and a porous morphology.
