RESUMO
BACKGROUND: Hepatectomy with vascular resection (VR) for perihilar cholangiocarcinoma (PHCC) is a challenging procedure. However, only a few reports on this procedure have been published and its clinical significance has not been fully evaluated. METHODS: Patients undergoing surgical resection for PHCC from 2002-2017 were studied. The surgical outcomes of VR and non-VR groups were compared. RESULTS: Some 238 patients were included. VR was performed in 85 patients. The resected vessels were hepatic artery alone (31 patients), portal vein alone (37 patients) or both (17 patients). The morbidity rates were almost the same in the VR (49.4 per cent) and non-VR (43.8 per cent) groups (P = 0.404). The mortality rates of VR (3.5 per cent) and non-VR (3.3 per cent) were also comparable (P > 0.999). The median survival time (MST) was 45 months in the non-VR group and 36 months in VR group (P = 0.124). Among patients in whom tumour involvement was suspected on preoperative imaging and whose carbohydrate antigen 19-9 (CA19-9) value was 37 U/ml or less, MST in the VR group was significantly longer than that in the non-VR group (50 versus 34 months, P = 0.017). In contrast, when the CA19-9 value was greater than 37 U/ml, MST of the VR and non-VR groups was comparable (28 versus 29 months, P = 0.520). CONCLUSION: Hepatectomy with VR for PHCC can be performed in a highly specialized hepatobiliary centre with equivalent short- and long-term outcomes to hepatectomy without VR.
Assuntos
Neoplasias dos Ductos Biliares , Colangiocarcinoma , Tumor de Klatskin , Neoplasias dos Ductos Biliares/cirurgia , Ductos Biliares Intra-Hepáticos , Colangiocarcinoma/cirurgia , Hepatectomia , Humanos , Tumor de Klatskin/cirurgiaRESUMO
BACKGROUND AND PURPOSE: With the increasing use of the Pipeline Embolization Device for the treatment of aneurysms, predictors of clinical and angiographic outcomes are needed. This study aimed to identify predictors of incomplete occlusion at last angiographic follow-up. MATERIALS AND METHODS: In our retrospective, single-center cohort study, 105 ICA aneurysms in 89 subjects were treated with Pipeline Embolization Devices. Patients were followed per standardized protocol. Clinical and angiographic outcomes were analyzed. We introduced a new morphologic classification based on the included angle of the parent artery against the neck location: outer convexity type (included angle, <160°), inner convexity type (included angle, >200°), and lateral wall type (160° ≤ included angle ≤200°). This classification reflects the metal coverage rate and flow dynamics. RESULTS: Imaging data were acquired in 95.3% of aneurysms persistent at 6 months. Complete occlusion was achieved in 70.5%, and incomplete occlusion, in 29.5% at last follow-up. Multivariable regression analysis revealed that 60 years of age or older (OR, 5.70; P = .001), aneurysms with the branching artery from the dome (OR, 10.56; P = .002), fusiform aneurysms (OR, 10.2; P = .009), and outer convexity-type saccular aneurysms (versus inner convexity type: OR, 30.3; P < .001; versus lateral wall type: OR, 9.71; P = .001) were independently associated with a higher rate of incomplete occlusion at the last follow-up. No permanent neurologic deficits or rupture were observed in the follow-up period. CONCLUSIONS: The aneurysm neck located on the outer convexity is a new, incomplete occlusion predictor, joining older age, fusiform aneurysms, and aneurysms with the branching artery from the dome. No permanent neurologic deficits or rupture was observed in the follow-up, even with incomplete occlusion.
Assuntos
Embolização Terapêutica/instrumentação , Aneurisma Intracraniano/patologia , Aneurisma Intracraniano/terapia , Resultado do Tratamento , Adulto , Idoso , Estudos de Coortes , Procedimentos Endovasculares/instrumentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço , Estudos RetrospectivosRESUMO
AIM: We developed and psychometrically tested the Japanese version of the Professional Attitude Scale for Nurses (PASN-J). BACKGROUND: Nurses must recognize the importance of their professionalism; therefore, it is critical to quantitatively measure nurses' professional attitudes. INTRODUCTION: This instrument validation study was designed to generate an itemized scale and examine its content validity/psychometric testing using a sample of Japanese nurses. METHODS: Based on a trait approach focusing on the characteristic traits of the nursing profession, a 59-item draft scale was generated. During November 2017, 2657 nurses from 29 facilities in Japan were surveyed. The questionnaire included demographics, the 59-item draft scale, and a self-report scale of nurses' professional behaviour and nursing practice ability. Using exploratory and confirmatory factor analyses, we evaluated the construct, criterion-related, concurrent, and known-groups validity, and reliability of the PASN-J. RESULTS: Data from 1716 participants were analysed. The analyses yielded a 38-item, 3-factor scale that adequately fit the data. PASN-J scores were positively correlated with nurses' professional behaviour and nursing practice ability. CONCLUSION: The 38-item PASN-J has good reliability and validity, making it useful for measuring the current condition of nursing professionalism and evaluating nursing education. Implications for Nursing and Health Policy: This scale can evaluate nursing education and promote nurses' professionalism. The PASN-J will help identifying the elements of undergraduate nursing education that require further emphasis. Additionally, the PASN-J could facilitate the development of nursing policies to promote professional development in nurses. Ultimately, evaluating nursing education with the PASN-J enhances nurses' professional attitudes and subsequently improves their quality of nursing, nursing efficiency and patient outcomes.
Assuntos
Bacharelado em Enfermagem , Enfermeiras e Enfermeiros , Estudantes de Enfermagem , Atitude , Humanos , Japão , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
AIM: To test the hypothesis that the addition of a glucagon-like peptide-1 receptor agonist that can decrease glucose levels without increasing the hypoglycaemia risk will achieve appropriate glycaemic control during the peri-operative period. METHODS: We studied 70 people with Type 2 diabetes who underwent elective cardiac surgery. Participants were randomized to either an insulin-alone or an insulin plus liraglutide 0.6 mg/day group. We evaluated average M values, which indicated the proximity index of the target glucose level from day 1 to day 10. RESULTS: The average M value in the liraglutide plus insulin group was significantly lower than that in the insulin-alone group (liraglutide plus insulin 5.8 vs insulin-alone 12.3; P < 0.001). The frequency of insulin dose modification in the liraglutide plus insulin group was significantly lower than that in the insulin-alone group (odds ratio 0.19, 95% CI 0.08-0.49; P < 0.001). The frequency of hypoglycaemia in the liraglutide plus insulin group tended to be lower than that in the insulin-alone group (odds ratio 0.57, 95% CI 0.15-2.23; P = 0.21). CONCLUSIONS: The results of this study showed that the addition of low-dose liraglutide to insulin achieved lower M values than insulin alone, suggesting that the addition of low-dose liraglutide may achieve better glycaemic control during the peri-operative period. (Clinical trials registry no.: UMIN 000008003).
Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Receptor do Peptídeo Semelhante ao Glucagon 1/agonistas , Insulina/administração & dosagem , Liraglutida/administração & dosagem , Período Perioperatório/métodos , Idoso , Idoso de 80 Anos ou mais , Glicemia/análise , Procedimentos Cirúrgicos Cardíacos/mortalidade , Diabetes Mellitus Tipo 2/sangue , Quimioterapia Combinada , Feminino , Hemoglobinas Glicadas/análise , Humanos , Hiperglicemia/complicações , Hipoglicemia/complicações , Hipoglicemia/epidemiologia , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/efeitos adversos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Fatores de RiscoRESUMO
Given the growing use of electric bidet toilets in Japan and other countries, we assessed the relationship between bidet toilet use and haemorrhoids or urogenital infections. Data were collected using a web-based longitudinal survey. In total, 10 305 subjects randomly selected from panels of a Japanese website research company for the baseline survey in 2013 were asked about their frequency of bidet toilet use and receipt of a doctor's diagnosis or subjective symptom of haemorrhoids and urogenital infections. One- and three-year follow-up surveys were performed in 2014 and 2016, respectively, and information on newly diagnosed/experienced outcomes occurring during the follow-up period were collected. Cumulative incidence of haemorrhoids and urogenital infections was not significantly increased by habitual use of a bidet toilet. In men, more habitual users reported subjective symptoms of irritated skin around the anus, which were newly experienced during follow-up than non-habitual users (adjusted risk ratio 1.36 (95% confidence interval 1.06-1.75)). Further studies are needed to confirm this relationship. Several of the outcomes were significantly more prevalent in habitual users, but these results were probably explained by reverse causation.
Assuntos
Aparelho Sanitário/efeitos adversos , Hemorroidas/epidemiologia , Infecções do Sistema Genital/epidemiologia , Infecções Urinárias/epidemiologia , Adulto , Idoso , Dermatite/epidemiologia , Feminino , Humanos , Incidência , Japão/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Períneo/patologia , Adulto JovemRESUMO
The exact structure of the rutile-TiO2(110)-(1 × 2) surface, which had been under debate over the past 30 years, was investigated using the newly developed technique of total-reflection high-energy positron diffraction (TRHEPD), which is a positron counterpart of reflection high-energy electron diffraction (RHEED). The rocking-curves for the 00-spot obtained from the experimental diffraction patterns were compared to the curves for various models calculated with a full-dynamical theory. It was found that the rocking-curves matched those for a surface consisting of a Ti2O3 configuration, originally suggested by Onishi and Iwasawa [H. Onishi and Y. Iwasawa, Surf. Sci., 1994, 313, L783], but with a further modification of atomic positions close to the ones proposed by Wang et al. [Q. Wang, A. R. Oganov, Q. Zhu and X. F. Zhou, Phys. Rev. Lett., 2014, 113, 266101]. This result demonstrates that TRHEPD can distinguish between the existence and absence of the oxygen atoms on the topmost surface, and between the Ti atoms residing in positions at the interstitial-vertical sites and those at interstitial-horizontal sites.
RESUMO
Topological defects in liquid crystals not only affect the optical and rheological properties of the host, but can also act as scaffolds in which to trap nano or micro-sized colloidal objects. The creation of complex defect shapes, however, often involves confining the liquid crystals in curved geometries or adds complex-shaped colloidal objects, which are unsuitable for device applications. Using topologically patterned substrates, here we demonstrate the controlled generation of three-dimensional defect lines with non-trivial shapes and even chirality, in a flat slab of nematic liquid crystal. By using the defect lines as templates and the electric response of the liquid crystals, colloidal superstructures are constructed, which can be reversibly reconfigured at a voltage as low as 1.3 V. Three-dimensional engineering of the defect shapes in liquid crystals is potentially useful in the fabrication of self-healing composites and in stabilizing artificial frustrated phases.
RESUMO
BACKGROUND/OBJECTIVES: To examine the influence of season and climate (air temperature and humidity) on water intake by the food group in a sample of free-living Japanese adults. SUBJECTS/METHODS: Four-nonconsecutive-day, semi-weighed dietary records were collected from each of the four seasons in a single 12-month period (16 days in total). The influence of season and climate on individual water intake by the food group was analyzed using a mixed linear model. Participants were 242 healthy adults (121 women aged 30-69 years and 121 men aged 30-76 years) from four areas in Japan. RESULTS: For women and men together, the mean total water intake was 2230 g/day (highest in summer: 2331 g/day; lowest in winter: 2134 g/day). Fifty-one percent of water was derived from foods and the rest from beverages. In a mixed linear model adjusted for sex, age and body mass index, intake of water from foods decreased by 3.1 g/day and that from beverages increased by 8.4 g/day, with an increase in the mean outdoor air temperature on the survey day of 1 °C (both P < 0.0001). The influence of humidity was nonsignificant. CONCLUSIONS: In contrast to previous findings in Western countries, half of water intake in Japanese adults was derived from foods. Water intake from beverages was positively associated with air temperature, whereas that from foods was inversely associated with air temperature.
Assuntos
Bebidas/análise , Comportamento de Ingestão de Líquido , Ingestão de Líquidos , Análise de Alimentos , Estações do Ano , Temperatura , Adulto , Idoso , Registros de Dieta , Inquéritos sobre Dietas/métodos , Feminino , Voluntários Saudáveis , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Características de ResidênciaRESUMO
OBJECTIVE: To examine the association of dietary habits with high total antioxidant capacity (TAC) with frailty among elderly Japanese women. DESIGN: Cross-sectional multicenter study. SETTING: Thirty-five of 47 prefectures in Japan. PARTICIPANTS: 2121 grandmothers or acquaintances of dietetic students aged 65 and older. MEASUREMENTS: Dietary TAC and food intakes were calculated using a validated brief-type self-administered diet history questionnaire. The TAC value of each food was assigned using four different assays, ferric reducing ability of plasma (FRAP), oxygen radical absorbance capacity (ORAC), Trolox equivalent antioxidant capacity (TEAC), and total radical-trapping antioxidant parameter (TRAP). Frailty was defined as the presence three or more of the following four components: slowness and weakness (two points), exhaustion, low physical activity, and unintentional weight loss. RESULTS: The number of subjects with frailty was 486 (23%). Multivariate adjusted ORs (95% CI) for frailty in the highest compared to the lowest quintile were 0.35 (0.24, 0.53) for FRAP, 0.35 (0.23, 0.52) for ORAC, 0.40 (0.27, 0.60) for TEAC, and 0.41 (0.28, 0.62) for TRAP. The intakes of green tea, coffee, vegetables, and fruits which contribute to dietary TAC were also associated with lower odds of frailty (the range of multivariate adjusted OR: 0.47 for vegetables to 0.77 for green tea), although the odds ratios were less marked than those of dietary TAC. CONCLUSIONS: Dietary habits with high TAC showed a stronger inverse association with frailty in elderly Japanese women than the individual foods examined.
Assuntos
Antioxidantes/administração & dosagem , Antioxidantes/farmacologia , Dieta , Idoso Fragilizado/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Antioxidantes/análise , Café/química , Estudos Transversais , Dietética , Fadiga/diagnóstico , Comportamento Alimentar , Feminino , Análise de Alimentos , Frutas/química , Humanos , Japão , Prevalência , Inquéritos e Questionários , Chá/química , Verduras/química , Redução de Peso/efeitos dos fármacosRESUMO
It has long been suggested that the Ca(2+)-mechanisms are largely involved in generating the early afterdepolarization (EAD) as well as the delayed afterdepolarization (DAD). This view was examined in a quantitative manner by applying the lead potential analysis to a new human ventricular cell model. In this ventricular cell model, the tight coupled LCC-RyR model (CaRU) based on local control theory (Hinch et al. 2004) and ion channel models mostly based on human electrophysiological data were included to reproduce realistic Ca(2+) dynamics as well as the membrane excitation. Simultaneously, the Ca(2+) accumulation near the Ca(2+) releasing site was incorporated as observed in real cardiac myocytes. The maximum rate of ventricular repolarization (-1.02 mV/ms) is due to IK1 (-0.55 mV/ms) and the rest is provided nearly equally by INCX (-0.20 mV/ms), INaL (-0.16 mV/ms) and INaT (-0.13 mV/ms). These INaL and INaT components are due to closure of the voltage gate, which remains partially open during the plateau potential. DADs could be evoked by applying high-frequency stimulations supplemented by a partial Na(+)/K(+) pump inhibition, or by a microinjection of Ca(2+). EADs was evoked by retarding the inactivation of INaL. The lead potential (VL) analysis revealed that IK1 and IKr played the primary role to reverse the AP repolarization to depolarizing limb of EAD. ICaL and INCX amplified EAD, while the remaining currents partially antagonized dVL/dt. The maximum rate of rise of EAD was attributable to the rapid activation of both ICaL (45.5%) and INCX (54.5%).
Assuntos
Potenciais de Ação/fisiologia , Sinalização do Cálcio/fisiologia , Potenciais da Membrana/fisiologia , Modelos Cardiovasculares , Miócitos Cardíacos/fisiologia , Função Ventricular/fisiologia , Cálcio/metabolismo , Canais de Cálcio/metabolismo , Simulação por Computador , Ventrículos do Coração/citologia , Humanos , Ativação do Canal Iônico/fisiologia , Miócitos Cardíacos/citologiaRESUMO
OBJECTIVE: Sunscreens containing UVA absorbers in high concentrations are expected to be developed, since recent studies have suggested the possibility of involvement of UVA ray in skin cancer and early skin aging. Solubility and stability of supersaturation of UVA absorbers in UVB absorber were determined in the absence and the presence of cosmetic oil. Coexistence effect of UVA absorbers was analyzed to dissolve them in high concentrations. METHODS: Two UVA absorbers, diethylamino hydroxybenzoyl hexyl benzoate (DHHB) and butyl methoxydibenzoylmethane (BMDM), a UVB absorber, 2-ethylhexyl methoxycinnamate (EHMC), and a cosmetic oil, 2-ethylhexyl ester of oligomer of hydroxystearic acid (EH-O-HSA), were used. Their solutions were prepared at 80°C and cooled to 5°C. The solid DHHB and/or BMDM were added to it, and the time evolution of concentrations of the UVA absorbers in the solution phase was monitored. RESULTS: At the saturation in the absence of EH-O-HSA at 5°C, weight ratio of DHHB and BMDM to EHMC was 0.39/1.00 and 0.22/1.00, respectively. Addition of EH-O-HSA slightly changed the solubility of DHHB and BMDM. When the weight ratio of EH-O-HSA to EHMC was 0.20/1.00, weight ratio of DHHB and BMDM to EHMC was 0.35/1.00 and 0.25/1.00, respectively at the saturation at 5°C. In the presence of EH-O-HSA, a strong coexistence effect of DHHB and BMDM was found on their solubility. A thermodynamically stable saturated solution at 5°C having the composition that DHHB: BMDM: EHMC: EH-O-HSA = 0.47: 0.46: 1.00: 0.20 was obtained by the simultaneous addition of solid DHHB and BMDM into the initial solution. CONCLUSION: The solution type composite having the highest concentrations of DHHB and BMDM prepared in this study exhibited critical wavelength at 368 nm that was just below the border for sunscreens being qualified as 'Broad Spectrum' protection under the new rule launched by US FDA.
Assuntos
Alcanos/química , Chalconas/química , Cinamatos/química , Protetores Solares/química , Humanos , Propiofenonas , Solubilidade , Raios Ultravioleta/efeitos adversosRESUMO
Up to date, no worldwide standard in vitro method has been established for the determination of the sun protection factor (SPF), since there are many problems in terms of its repeatability and reliability. Here, we have studied the problems on the in vitro SPF measurements brought about by the phenomenon called viscous fingering. A spatially periodic stripe pattern is usually formed spontaneously when a viscous fluid is applied onto a solid substrate. For the in vitro SPF measurements, the recommended amount of sunscreen is applied onto a substrate, and the intensity of the transmitted UV light through the sunscreen layer is evaluated. Our theoretical analysis indicated that the nonuniformity of the thickness of the sunscreen layer varied the net UV absorbance. Pseudo-sunscreen composites having no phase separation structures were prepared and applied on a quartz plate for the measurements of the UV absorbance. Two types of applicators, a block applicator and a 4-sided applicator were used. The flat surface was always obtained when the 4-sided applicator was used, while the spatially periodic stripe pattern was always generated spontaneously when the block applicator was used. The net UV absorbance of the layer on which the stripe pattern was formed was found to be lower than that of the flat layer having the same average thickness. Theoretical simulations quantitatively reproduced the variation of the net UV absorbance led by the change of the geometry of the layer. The results of this study propose the definite necessity of strict regulations on the coating method of sunscreens for the establishment of the in vitro SPF test method.
Assuntos
Cinamatos/química , Protetores Solares/química , Raios Ultravioleta , Modelos Teóricos , Reprodutibilidade dos Testes , Análise Espectral/métodos , ViscosidadeRESUMO
BACKGROUND: Multiple early gastric cancers (EGCs) may develop in 6-14% of patients even after achieving curative endoscopic submucosal dissection (ESD); however, a useful biomarker for predicting recurrence is not available. The present study investigated whether the expression of CD44 variant 9 (CD44v9), a functional cancer stem cell marker, in the primary gastric cancer tissue represents an indicator of recurrence. METHODS: Eighty-eight patients who underwent ESD for EGC from 2008 to 2010 were enrolled and monitored for recurrence for 3 years. The expression levels of CD44v9 in the tissue of initial EGCs were evaluated by immunohistochemistry, and the recurrence rate was compared between CD44v9-positive and CD44v9-negative groups. The mucin phenotype and expression of microRNA-21 (miR-21) and programmed cell death protein 4 (PDCD4) were also analysed. RESULTS: The recurrence rate of EGC was significantly higher in the CD44v9-positive group than in the CD44v9-negative group (hazard ratio (HR), 21.8; 95% confidence interval (CI), 5.71-83.1). However, mucin phenotypes and the expression of miR-21 and PDCD4 did not predict recurrence after ESD. Meanwhile, grade of gastric atrophy was also identified as a significant marker of multiple recurrence (HR, 4.95; 95% CI, 1.30-18.8). CONCLUSION: CD44 variant 9 expression represents a potential predictive marker for recurrence in EGC.
Assuntos
Adenocarcinoma/diagnóstico , Biomarcadores Tumorais , Receptores de Hialuronatos/fisiologia , Recidiva Local de Neoplasia/diagnóstico , Neoplasias Gástricas/diagnóstico , Adenocarcinoma/metabolismo , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/metabolismo , Progressão da Doença , Endoscopia , Feminino , Gastrectomia/métodos , Humanos , Receptores de Hialuronatos/metabolismo , Masculino , Pessoa de Meia-Idade , Prognóstico , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: Functional dyspepsia (FD) is a heterogeneous disease, and categorized into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). However, many FD patients have overlap of both PDS and EPS. The present study was designed to examine whether FD could be categorized based on the presence of concomitant gastrointestinal symptoms. METHODS: A web survey comprised of the Gastrointestinal Symptom Rating Scale (GSRS), Rome III criteria of FD, and demographic information was sent to public participants who have no history of severe illness. Factor and cluster analyses were conducted to identify sub-categories of FD based on GSRS. KEY RESULTS: A total of 8038 participants completed the survey. A total of 563 participants met the criteria for FD, whereas 6635 participants did not have dyspepsia symptoms. The remainder had either organic disease (377) or uninvestigated dyspepsia (463). The cluster analysis categorized participants as constipation predominant (cluster C), diarrhea predominant (cluster D), or having neither diarrhea nor constipation (cluster nCnD). Cluster C and D were significantly associated with the presence of FD [odds ratio (OR) 2.57, 95% confidence interval (CI) 2.06-3.21; OR 2.80; 95% CI 2.27-3.45, respectively]. In FD, especially in PDS cases, the scores of upper gastrointestinal symptoms were higher in cluster C or D than in cluster nCnD. CONCLUSIONS & INFERENCES: The severity of dyspepsia symptoms is associated with the presence of bowel symptoms especially in PDS. This novel categorization of FD based on concomitant constipation or diarrhea may improve classification of patients.
Assuntos
Constipação Intestinal/etiologia , Diarreia/etiologia , Dispepsia/classificação , Dispepsia/complicações , Adulto , Idoso , Análise por Conglomerados , Constipação Intestinal/epidemiologia , Coleta de Dados , Diarreia/epidemiologia , Dispepsia/diagnóstico , Feminino , Humanos , Masculino , Prevalência , Adulto JovemRESUMO
A 48-year-old man without underlying disease developed mediastinitis and was treated by mediastinal drainage. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in a culture of the abscess material. He was treated with anti-MRSA antibiotics and the MRSA infection improved. Four weeks after the onset of MRSA infection, he developed rapidly progressive glomerulonephritis (RPGN) with nephrotic syndrome (NS). A renal biopsy showed endocapillary proliferative glomerulonephritis with IgA-predominant glomerular deposition. These clinicopathological findings were consistent with those in glomerulonephritis following MRSA infection (post-MRSA infection glomerulonephritis). The level of serum creatinine increased to 6.3 mg/dl, 7 weeks after the onset of RPGN. At that time, the eradication of MRSA infection was considered. He was given middle-dose steroid therapy. Thereafter, his RPGN with NS improved. MRSA infection did not recur. If the disease activity of post-MRSA infection glomerulonephritis persists after the disappearance of MRSA infection, the application of immunosuppressive therapy with steroids may be useful.
Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Antibacterianos/uso terapêutico , Glomerulonefrite/tratamento farmacológico , Imidazóis/uso terapêutico , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Prednisolona/uso terapêutico , Infecções Estafilocócicas/tratamento farmacológico , Tetrazóis/uso terapêutico , Biópsia , Quimioterapia Combinada , Glomerulonefrite/microbiologia , Humanos , Masculino , Infecções Estafilocócicas/microbiologiaRESUMO
Ce(1-x-y)Ti(x)Pt(y)O(2-delta) (x=0.15; y=0.01) and Ce(1-x-y)Ti(x)Pd(y)O(2-delta) (x=0.25; y=0.02 and 0.05) are found to be good CO oxidation catalysts [T. Baidya et al., J. Phys. Chem. B 110, 5262 (2006); T. Baidya et al., J. Phys. Chem. C 111, 830 (2007)]. A detailed structural study of these compounds has been carried out by extended x-ray absorption fine structure along with x-ray diffraction and x-ray photoelectron spectroscopy. The gross cubic fluorite structure of CeO(2) is retained in the mixed oxides. Oxide ion sublattice around Ti as well as Pt and Pd ions is destabilized in the solid solution. Instead of ideal eight coordinations, Ti, Pd, and Pt ions have 4+3, 4+3, and 3+4 coordinations creating long and short bonds. The long Ti-O, Pd-O, and Pt-O bonds are approximately 2.47 A (2.63 A for Pt-O) which are much higher than average Ce-O bonds of 2.34 A.
RESUMO
OBJECTIVES: To evaluate the in-vivo plaque composition and characteristics in patients with type 2 diabetes mellitus (DM) using Virtual Histology intravascular ultrasound (VH IVUS). METHODS: In 90 patients with stable angina pectoris, de novo target vessels were studied and plaque components were analysed. Patients were divided into two groups: a diabetic group (36 vessels) and a non-diabetic group (54 vessels). RESULTS: The percentage area of necrotic core and dense calcium were significantly larger in the DM group than the non-DM group (necrotic core: 11.0% (interquartile range (IQR): 7.2-15.2%) vs 7.6% (IQR 5.6-13.2%), p = 0.03; dense calcium: 5.6% (IQR: 2.3-7.3%) vs 2.9% (IQR: 1.7-4.9%), p = 0.01). The DM group presented with a significantly higher presence of at least one VH IVUS-derived thin-cap fibroatheroma (VHD-TCFA) (75% vs 41%, p = 0.001) and VH IVUS-derived fibrocalcific atheroma (VHD-FCA) (75% vs 40%, p = 0.001). In the DM group, 53% of the vessels had both VHD-TCFA and VHD-FCA, which was significantly higher than non-DM group (17%, p = 0.0004). CONCLUSIONS: Coronary plaque characteristics in DM patients showed an increased amount of dense calcium and necrotic core, as well as a higher frequency of VHD-TCFA and VHD-FCA. Atherosclerosis of the target vessel was more advanced in diabetic patients.
Assuntos
Doença da Artéria Coronariana/patologia , Diabetes Mellitus Tipo 2/patologia , Angiopatias Diabéticas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Calcinose/diagnóstico por imagem , Calcinose/patologia , Doença da Artéria Coronariana/diagnóstico por imagem , Vasos Coronários/patologia , Diabetes Mellitus Tipo 2/diagnóstico por imagem , Angiopatias Diabéticas/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Necrose , Ultrassonografia de Intervenção/métodosRESUMO
Direct observation of the unstable intermediate in the radical addition reaction of the oxime ether 1 mediated by triethylborane (Et(3)B) is described using (1)H and (11)B micro channeled cell for synthesis monitoring (MICCS), which was recently developed as an interfacing microchip for NMR. It was possible that the signal of the intermediate was observed as a result of using MICCS technique with a standard NMR instrument. This result supports the structure of the intermediate analyzed by diffusion-ordered spectroscopy (DOSY) NMR method in a previous paper. The procedure of micro channeled cell for synthesis monitoring-nuclear magnetic resonance (MICCS-NMR) was much easier than that of DOSY method. It was proven that it could be applied to the reaction in an anhydrous condition.
Assuntos
Boranos/química , Espectroscopia de Ressonância Magnética/métodos , Oximas/química , Boro/análise , Espectroscopia de Ressonância Magnética/instrumentação , PrótonsRESUMO
We performed an improved search for nu(mu) --> nu(e) oscillation with the KEK to Kamioka (K2K) long-baseline neutrino oscillation experiment, using the full data sample of 9.2 x 10(19) protons on target. No evidence for a nu(e) appearance signal was found, and we set bounds on the nu(mu) --> nu(e) oscillation parameters. At Deltam(2)=2.8 x 10(-3) eV(2), the best-fit value of the K2Knu(mu) disappearance analysis, we set an upper limit of sin(2)2theta(mue) < 0.13 at a 90% confidence level.
RESUMO
We report the result from a search for charged-current coherent pion production induced by muon neutrinos with a mean energy of 1.3 GeV. The data are collected with a fully active scintillator detector in the K2K long-baseline neutrino oscillation experiment. No evidence for coherent pion production is observed, and an upper limit of is set on the cross section ratio of coherent pion production to the total charged-current interaction at 90% confidence level. This is the first experimental limit for coherent charged pion production in the energy region of a few GeV.