Kinetic Study on Alpha-Form Crystallization of Mixed-Acid Triacylglycerols POP, PPO, and Their Mixture.

The crystallization behavior of the metastable α form of triacylglycerols (TAGs) plays a critical role as a precursor for the crystallization of more stable ß' and ß forms for various applications in food and pharmaceutical products. However, precise analysis of the crystallization kinetics of α has not been performed, likely due to its rapid and complex behavior. This paper presents the observation results of the initial stages of the isothermal crystallization kinetics of α forms of 1,3-dipalmitoyl-2-oleoyl-glycerol (POP), 1,2-dipalmitoyl-3-oleoyl-rac-glycerol (rac-PPO), and molecular compound (MC) crystals of a POP/rac-PPO (1/1) mixture (MCPOP/PPO) using synchrotron radiation time-resolved X-ray diffraction and polarized optical microscopy. In all the TAGs, α crystals with a worm-like morphology started to grow rapidly in the first stage. Then, the α crystals slowly transformed into more stable forms in different manners for different TAG samples. In POP, the conversion was simple, as the α-2 form transformed into γ-3, whereas in rac-PPO, the lamellar distance values of the α-2 form continuously decreased with time and changed into the α-3 form. In the MCPOP/PPO crystals, in contrast, separate crystallization of α-2 of a rac-PPO fraction initially occurred, followed by the crystallization of α-2 of POP, and the two α forms merged into α-2 of MCPOP/PPO. This separate crystallization was caused by large differences in the crystallization kinetics of the α forms of POP and rac-PPO.

Investigating age and regional effects on the relation between the incidence of heat-related ambulance transport and daily maximum temperature or WBGT.

BACKGROUND: Although age and regional climate are considered to have effects on the incidence ratio of heat-related illness, quantitative estimation of age or region on the effect of occurring temperature for heat stroke is limited. METHODS: By utilizing data on the number of daily heat-related ambulance transport (HAT) in each of three age groups (7-17, 18-64, 65 years old, or older) and 47 prefectures in Japan, and daily maximum temperature (DMT) or Wet Bulb Globe Temperature (DMW) of each prefecture for the summer season, the effects of age and region on heat-related illness were studied. Two-way ANOVA was used to analyze the significance of the effect of age and 10 regions in Japan on HAT. The population-weighted average of DMT or DMW measured at weather stations in each prefecture was used as DMT or DMW for each prefecture. DMT or DMW when HAT is one in 100,000 people (T1 and W1, respectively) was calculated for each age category and prefecture as an indicator of heat acclimatization. The relation between T1 or W1 and average DMT or DMW of each age category and prefecture were also analyzed. RESULTS: HAT of each age category and prefecture was plotted nearly on the exponential function of corresponding DMT or DMW. Average R2 of the regression function in 47 prefectures in terms of DMW was 0.86, 0.93, and 0.94 for juveniles, adults, and elderly, respectively. The largest regional difference of W1 in 47 prefectures was 4.5 and 4.8 °C for juveniles and adults, respectively between Hokkaido and Tokyo, 3.9 °C for elderly between Hokkaido and Okinawa. Estimated W1 and average DMT or DMW during the summer season for 47 prefectures was linearly related. Regarding age difference, the regression line showed that W1 of the prefecture for DMW at 30 °C of WBGT was 31.1 °C, 32.4 °C, and 29.8 °C for juveniles, adults, and elderly, respectively. CONCLUSIONS: Age and regional differences affected the incidence of HAT. Thus, it is recommended that public prevention measures for heat-related disorders take into consideration age and regional variability.

Mixing Ratio and Cooling Rate Dependence of Molecular Compound Formation in OPO/POP Binary Mixture.

Owing to the increasing reports of the harmful effects of trans and saturated fatty acids, the demand for trans- and saturated-fatty-acid-free oil and fat products is increasing among consumers. However, it is difficult to maintain the product stability and shape retention of such oil and fat products. As a result, there is a high demand in the processed oil and fat industry to develop solutions to such problems. Herein, we used molecular compound (MC) crystals in an attempt to find alternatives to trans and saturated fatty acids. The MCs used were 1,3-dioleoyl-2-palmitoyl-sn-glycerol (OPO) and 1,3-dipalmitoyl-2-oleoyl-sn-glycerol (POP)-the main components of lard and palm oil, respectively. We believe that OPO and POP can be used to obtain no-trans, low-saturation, and high-oleic-acid oil and fat products. Optimal conditions for efficient MC crystallization were examined by changing the oil and fat composition under rapid cooling conditions assuming industrial cooling process by using differential scanning calorimetry and synchrotron radiation time-resolved X-ray diffraction methods. It was concluded that the increase in OPO concentration destabilized MC formation, while the increase in POP concentration stabilized it under rapid cooling conditions. As a result, it was shown that MC crystals can be efficiently obtained by reducing the degree of POP supercooling.

Multiple ß Forms of Saturated Monoacid Triacylglycerol Crystals.

We have investigated the polymorphism of triacylglycerol (TAG) crystals as they affect the qualities such as shelf life, mouth feel, and texture of chocolate and other products. Saturated monoacid TAGs, like trilaurin, are considered as models for TAG crystallization; however, there is still debate about the number of their polymorphs that exist. In this study, we characterized a set of novel polymorphs, ß forms of saturated monoacid TAGs, which were obtained via different pathways depending on the crystallization history, by polarized light microscopy, X-ray diffraction, and differential scanning calorimetry. Saturated monoacid TAGs were crystallized as the unstable polymorphs, the α or ß' forms first, and then they were transformed into ß forms by solid-solid transformations. The ß form that had transformed from ß' changed its morphology by a polymorphic transformation, while the ß form made from the α form kept its spherulite morphology. The ß forms obtained showed different melting points. Additional heat treatment promoted further polymorphic transformation. Four novel ß forms were found for each of the saturated monoacid TAGs, trilaurin, trimyristin, tripalmitin, and tristearin. They showed similar polymorphism with the same subcell packing.

Microsporidial keratitis retrospectively diagnosed by ultrastructural study of formalin-fixed paraffin-embedded corneal tissue: a case report.

BACKGROUND: The utility of formalin-fixed paraffin-embedded (FFPE) corneal tissue specimens for retrospective diagnosis of microsporidial keratitis was evaluated by transmission electron microscopy (TEM) analysis and the possible second case of microsporidial keratitis after Descemet stripping automated endothelial keratoplasty (DSAEK) was described. CASE PRESENTATION: A 68-year-old man presented with multiple crystalline opacities in the corneal stroma that progressed extremely slowly after DSAEK. Fungiflora Y staining of corneal scrapings from the affected regions revealed an oval microorganism. Topical voriconazole administration was ineffective and penetrating keratoplasty was performed. Histological and molecular analyses were carried out on the excised cornea. Ziehl-Neelsen staining revealed an acid-fast, oval organism that was visible by ultraviolet illumination after Fungiflora Y and Uvitex 2B staining, whereas periodic acid-Schiff and Grocott's staining did not yield any significant findings. Microsporidium was detected by TEM of FFPE tissue. Nosema or Vittaforma sp. was suspected as the causative microorganism by PCR of FFPE tissue and by the fact that those species are known to cause eye infection. The corneal graft has maintained transparency at 1 year and half postoperatively. CONCLUSIONS: This is the first known case of microsporidial keratitis diagnosed retrospectively by molecular and ultrastructural study of FFPE tissue, and the possible second case of microsporidial keratitis after DSAEK. Microsporidial keratitis should be considered when corneal opacity refractory to conventionally known therapy would occur after DSAEK. Our findings suggest that more microsporidial keratitis cases than have been reported to date can be identified by TEM or PCR examination of FFPE corneal specimens.

Clinical outcomes and nadir prostate-specific antigen (PSA) according to initial PSA levels in primary androgen deprivation therapy for metastatic prostate cancer.

PURPOSE: To investigate the clinical outcomes of metastatic prostate cancer patients and the relationship between nadir prostate-specific antigen (PSA) levels and different types of primary androgen deprivation therapy (PADT). This study utilized data from the Japan Study Group of Prostate Cancer registry, which is a large, multicenter, population-based database. METHODS: A total of 2982 patients treated with PADT were enrolled. Kaplan-Meier analysis was used to compare progression-free survival (PFS) and overall survival (OS) in patients treated using combined androgen blockade (CAB) and non-CAB therapies. The relationships between nadir PSA levels and PADT type according to initial serum PSA levels were also investigated. RESULTS: Among the 2982 enrolled patients, 2101 (70.5 %) were treated with CAB. Although CAB-treated patients had worse clinical characteristics, their probability of PFS and OS was higher compared with those treated with a non-CAB therapy. These results were due to a survival benefit with CAB in patients with an initial PSA level of 500-1000 ng/mL. Nadir PSA levels were significantly lower in CAB patients than in non-CAB patients with comparable initial serum PSA levels. CONCLUSIONS: A small survival benefit for CAB in metastatic prostate cancer was demonstrated in a Japanese large-scale prospective cohort study. The clinical significance of nadir PSA levels following PADT was evident, but the predictive impact of PSA nadir on OS was different between CAB and non-CAB therapy.

Validation of TNM classification for metastatic prostatic cancer treated using primary androgen deprivation therapy.

PURPOSE: The current tumor-node-metastasis (TNM) classification system has been used for many years. The prognosis of patients with metastatic prostate cancer (mPC) treated using primary androgen deprivation therapy (PADT) was analyzed according to the TNM classification. METHODS: A total of 5618 cases with lymph node metastases only (N1M0), non-regional lymph node metastasis (M1a), bone metastasis (M1b), and distant metastasis (M1c) were selected from the Japanese Study Group of Prostate Cancer database. Overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) rates were calculated using Kaplan-Meier analysis. The influence of clinical variables on patient prognosis was evaluated using the Cox proportional hazard regression model. RESULTS: The 5-year OS, CSS, and PFS were 76.0, 83.2, and 38.8% in N1M0, 57.5, 69.0, and 23.0% in M1a, 54.0, 63.1, and 23.0% in M1b, and 40.0, 51.5, and 16.6% in M1c, respectively. OS, CSS, and PFS worsened as the stages progressed. OS, CSS, and PFS were all significantly worse in N1M1b compared with N0M1b. Multivariate analysis revealed that OS and CSS were worse in patients with a Gleason score ≥8 and that combined androgen blockade (CAB) treatment provided better OS than non-CAB treatments at any tumor stage. However, OS and CSS were worse in individuals with a prostate-specific antigen >100 ng/ml only in M1b. CONCLUSIONS: Patient prognosis worsened with stage progression; therefore, current TNM classification system of mPC for PADT was shown to be trustworthy. Each PC cell that develops bone or lymphoid metastasis may exhibit different characteristics.

Use of preoperative factors including urodynamic evaluations and nerve-sparing status for predicting urinary continence recovery after robot-assisted radical prostatectomy: Nerve-sparing technique contributes to the reduction of postprostatectomy incontinence.

AIMS: To examine which preoperative factors, including urodynamic evaluations, and operative procedures could predict continence status after robot-assisted radical prostatectomy (RARP) in this study. MATERIALS AND METHODS: Univariate and multivariate logistic regression analyses of preoperative factors such as age, body mass index, prostate-specific antigen level before biopsy, prostate size before surgery, membranous urethral length measured using magnetic resonance imaging (MRI), bladder compliance and maximum urethral closure pressure (MUCP) measured by urodynamic study (UDS), and nerve-sparing (NS) status predicting 24-hr pad test >2 g/day at 1 year after RARP were examined in 111 patients enrolled in this study. RESULTS: The number of patients with incontinence at 1 year after RARP was 39 (35.1%). The only predictive factor for urinary continence was NS grades. To investigate the contribution of NS to urinary continence, 84 patients underwent UDS three times; before, immediately after, and 1 year after RARP. Chronological UDS revealed that recovery patterns of storage and voiding functions were the same among non-NS, unilateral-NS, and bilateral-NS groups, and that higher degrees of NS contributed to lesser decreases in MUCP and longer functional urethral length (FUL) after RARP. CONCLUSION: Preoperative factors, including the results of UDS, could not predict continence 1 year after RARP. The NS procedure contributed to continence status. NS favorably affected MUCP and FUL; however, it did not affect bladder function after RARP. Neurourol. Urodynam. 35:1034-1039, 2016. © 2015 Wiley Periodicals, Inc.

Deconvolution of partially compensated solar images from additional wavefront sensing.

A technique for restoring solar images partially compensated with adaptive optics is developed. An additional wavefront sensor is installed in an adaptive optics system to acquire residual wavefront information simultaneously to a solar image. A point spread function is derived from the wavefront information and used to deconvolve the solar image. Successful image restorations are demonstrated when the estimated point spread functions have relatively high Strehl ratios.

The relationship between prostate-specific antigen and TNM classification or Gleason score in prostate cancer patients with low prostate-specific antigen levels.

BACKGROUND: Prostate-specific antigen (PSA) is a useful biomarker for risk classification in patients with prostate cancer. However, it is unclear whether a correlation exists between low PSA levels (<10 ng/ml) at diagnosis and prognosis. METHODS: Of the 642 Japanese patients who underwent prostate biopsy and were diagnosed with prostate cancer at Kanazawa University Hospital from 2000 to 2010, 406 patients with a PSA level <20 ng/ml were retrospectively reviewed. RESULTS: PSA levels in 275 (68%) patients were <10 ng/ml. Although the percentage of Gleason score 8-10 in patients with a PSA level of <3.5 ng/ml was higher than that in patients with a PSA level between 3.5 and 10 ng/ml, it was not statistically significant. On the other hand, the percentage of higher stage (T3 and T4) patients with a PSA level <3.5 ng/ml was significantly greater than that in patients with a PSA level between 3.5 and 10 ng/ml (P < 0.0001). The percentage of metastases (N1 and M1) in patients with a PSA level <3.5 ng/ml was also significantly higher than that in patients with a PSA level between 3.5 and 10 ng/ml (P = 0.0112). CONCLUSIONS: Patients with prostate cancer with a PSA level <3.5 ng/ml at diagnosis had a more advanced stage of cancer compared with those with a PSA level between 3.5 and 10 ng/ml. Therefore, risk classification using PSA levels at diagnosis may need to take into consideration this specific PSA range in order to better predict survival.

Effects of dutasteride on lower urinary tract symptoms and general health in men with benign prostatic hypertroplasia and hypogonadism: a prospective study.

INTRODUCTION: We investigated the effects of the relative increase in testosterone by dutasteride administration in patients with benign prostatic hyperplasia and hypogonadism on urinary symptoms or androgen-responsive general health. METHODS: Seventy-six patients were enrolled, and were taking 0.5 mg dutasteride daily for 52 weeks. Before and after treatment, all participants underwent blood test, and body mass index, prostate volume (PV), bone mineral density (BMD), post-voiding residual (PVR) volume, and muscle volume were measured. All patients responded to the questionnaires: International prostatic symptom score (IPSS), Overactive Bladder Symptom score (OABSS). Patients were divided into two groups according to the increase rate of total testosterone (TT): group A, ≥20% increase in TT level; group B, <20% increase or decrease. RESULTS: Baseline TT and free testosterone (FT) levels were significantly lower in group A than group B. Both groups showed marked improvement in PV and PVR. Group A showed significant improvement in IPSS and OABSS with a significant increase of FT level, whereas group B showed no significant change. Dutasteride treatment contributed to a significant increase in BMD in group A. CONCLUSIONS: Dutasteride treatment significantly improved urinary symptoms and BMD in patients with low baseline serum TT and FT levels.

Fabrication and Characterization of Oleofoams Composed of Tribehenoyl-glycerol: Toward a Stable and Higher Air-content Colloidal System.

Oleofoams have garnered significant attention in many personal care applications because of their favorable physicochemical properties, including texture and detergency. To explore the potential use of mixtures of high-melting-point fat crystals (tribehenoyl-glycerol [BBB]) and edible oils as low-cost and stable aeration systems, we created oleofoams composed of olive oil and BBB. By whipping the BBB/olive oil oleogels after rapid cooling and subsequent heating, we successfully prepared oleofoams without emulsifier additives. Mixtures of the BBB/olive oil formed oleofoams at BBB concentrations of 4.0-20.0 wt.%. The resultant oleofoams maintained their overrun rates and did not coalesce, even with additional whipping after the overrun rate was maximized. More closely packed bubbles, concentrated bubble size distributions, and stronger interfacial elasticity were attributed to the increasing BBB concentrations, and the thermal results revealed that further heating was required to damage the foam structure. The characteristics of these new oleofoams are closely related to their BBB concentrations, and the observed effects are attributed to the network structure of the thickened crystal layer and enhanced gelling in the oil phase.

Heat stroke management during the COVID-19 pandemic: Recommendations from the experts in Japan (2nd edition).

Both coronavirus disease 2019 (COVID-19) and heat stroke have symptoms of fever or hyperthermia and the difficulty in distinguishing them could lead to a strain on emergency medical care. To mitigate the potential confusion that could arise from actions for preventing both COVID-19 spread and heat stroke, particularly in the context of record-breaking summer season temperatures, this work offers new knowledge and evidence that address concerns regarding indoor ventilation and indoor temperatures, mask wearing and heat stroke risk, and the isolation of older adults. Specifically, the current work is the second edition to the previously published guidance for handling heat stroke during the COVID-19 pandemic, prepared by the "Working group on heat stroke medical care during the COVID-19 epidemic," composed of members from four organizations in different medical and related fields. The group was established by the Japanese Association for Acute Medicine Heatstroke and Hypothermia Surveillance Committee. This second edition includes new knowledge, and conventional evidence gleaned from a primary selection of 60 articles from MEDLINE, one article from Cochrane, 13 articles from Ichushi, and a secondary/final selection of 56 articles. This work summarizes the contents that have been clarified in the prevention and treatment of infectious diseases and heat stroke to provide guidance for the prevention, diagnosis, and treatment of heat stroke during the COVID-19 pandemic.

Synchrotron radiation macrobeam and microbeam X-ray diffraction studies of interfacial crystallization of fats in water-in-oil emulsions.

Using macrobeam and microbeam techniques, we performed synchrotron radiation X-ray diffraction (SR-XRD) analyses of fat crystallization in water-in-oil (W/O) emulsion, in combination with DSC and polarized optical microscopic observation. Particular focus was on the crystallization of the fats around water droplets in the W/O emulsion systems using food emulsifiers of polyglycerol polyricinoleate (PGPR) alone (PGPR emulsion), and PGPR and monobehenoylglycerol (MB) (PGPR+MB emulsion). We obtained the following results: (1) macrobeam SR-XRD confirmed that adding MB promoted fat crystallization during cooling, (2) microbeam SR-XRD indicated that the lamellar planes of fat crystals near the water and oil interfaces are arranged almost parallel to the interface planes in both PGPR emulsion and PGPR+MB emulsion, and (3) adding MB resulted in the formation of tiny fat crystals because it promoted crystallization, which occurred both in the bulk oil phase and at the W/O interfaces. The present study is the first to apply microbeam SR-XRD to observe the microscopic features of fat crystallization in W/O emulsion, following fat crystallization in the oil droplets in the oil-in-water (O/W) emulsion (Arima, S.; Ueno, S.; Ogawa, A.; Sato, K. Langmuir 2009, 25, 9777-9784).

SR-PSOX/CXCL16 plays a critical role in the progression of colonic inflammation.

BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) is initiated and perpetuated by a dysregulated immune response to unknown environmental antigens such as luminal bacteria in genetically susceptible hosts. SR-PSOX/CXCL16, a scavenger receptor that binds phosphatidylserine and oxidised lipoprotein, has both phagocytic activity and chemotactic properties. The aim of this study was to investigate the role of SR-PSOX/CXCL16 in patients with IBD and experimental murine colitis. METHODS: The serum levels of SR-PSOX/CXCL16 were measured in patients with IBD. The roles of SR-PSOX/CXCL16 in phagocytosis of bacterial components and cytokine production by macrophages from wild-type (WT) and SR-PSOX/CXCL16 knockout (KO) mice were assessed. Colitis was induced by administering dextran sulfate sodium (DSS) to WT and SR-PSOX/CXCL16 KO mice. Colonic inflammation was analysed by clinical, histological and immunological parameters. Finally, the effect of a monoclonal antibody (mAb) to SR-PSOX/CXCL16 on DSS-induced colitis and trinitrobenzene sulfonic acid-induced colitis models was evaluated. RESULTS: Serum levels of SR-PSOX/CXCL16 correlated significantly with the disease activity of patients with IBD. Ex vivo experiments showed that SR-PSOX/CXCL16 was involved in both phagocytosis of bacterial antigens and the T helper 1 immune response through the production of interleukin 12 and interferon γ. In vivo murine experiments demonstrated the upregulated gene expression of SR-PSOX/CXCL16 in inflamed colonic tissues and the predominant expression of SR-PSOX/CXCL16 on macrophages. SR-PSOX/CXCL16 KO mice were less susceptible to colonic inflammation than were their WT littermates. Administration of SR-PSOX/CXCL16 mAb ameliorated the condition in the two different experimental colitis models. CONCLUSIONS: SR-PSOX/CXCL16 plays a critical role in colonic inflammation and could be a potential therapeutic target for patients with IBD.

Formation of crystal nuclei near critical supersaturation in small volumes.

This work deals with the nucleation of crystals in confined systems in response to the recent high interest in research on crystallization in emulsion and microemulsion droplets. In these confined systems, crystallization often occurs at high supercooling; thus, nucleation determines the overall crystallization process. A decrease in the volume of the confined mother phase leads to the higher supercooling needed for the phase transition. We have numerically solved kinetic equations in order to determine the conditions under which the first crystal nuclei are formed by homogeneous and heterogeneous nucleation from supercooled melt and supersaturated solution, depending on the volume of the mother phase. Supersaturation (or supercooling) increases with decreasing volume of the mother phase. The nucleation barrier depends linearly on the logarithm of volume of the mother phase in all cases under consideration, as follows from the numerical solution of kinetic equations.

Formation and Physical Analysis of Oleogels Composed of Edible Oils and High-Melting Fat Crystals.

This paper reports the preparation of oleogels composed of edible oils (olive oil, squalene, and caprylic/capric triglyceride) and high-melting fat crystals (tribehenoyl-glycerol (BBB)) to explore the potential use of BBB/edible oil mixtures as low-cost and stable gelators. These mixtures exhibited gel-like behaviors upon rapid cooling and subsequent heating. The mixtures of BBB in the liquid oils formed oleogels at BBB concentrations > 4.0 wt%. The thermal behaviors, crystal structures, and crystal morphologies of mixtures of BBB produced from 6.0 wt% BBB crystals in 94.0 wt% liquid oils were examined following the treatment of these systems according to different temperature regimes. In addition, rheological analysis was conducted to evaluate the physical properties and storage stabilities of the prepared oleogels. It was found that rapid cooling to the crystallization temperature (Tc) from 70°C and subsequent heating to the final temperature (Tf) were necessary to reveal the gel-like behavior. In addition, the crystals treated with rapid cooling were smaller and more uniform in size than those treated with a simple cooling procedure. The differential scanning calorimetry melting peaks were broad or split, and exhibited the eutectic mixing behavior of multi-component triacylglycerols. The X-ray diffraction spectra showed that the melt-mediated α to ß transformation of the mixtures was a prerequisite for revealing the gel-like behavior. Moreover, the tempering procedure was found to influence the physical properties of the oleogels, wherein no visible changes were observed for any of the oleogels after rapid cooling and storage for 6 months at 25°C.

Elevated Hydrostatic Pressure Causes Retinal Degeneration Through Upregulating Lipocalin-2.

Elevation of intraocular pressure is a major risk factor for glaucoma development, which causes the loss of retinal ganglion cells (RGCs). Lipocalin 2 (Lcn2) is upregulated in glaucomatous retinae; however, whether Lcn2 is directly involved in glaucoma is debated. In this study, retinal explant cultures were subjected to increased water pressure using a two-chamber culture device, and Lcn2 protein levels were examined by immunoblotting. In situ TdT-mediated dUTP nick and labeling (TUNEL) and glial fibrillary acidic protein (GFAP) immunohistochemical assays were performed to assess apoptosis and gliosis, respectively. The neurotoxicity of Lcn2 in the retinal explant culture was determined with exogenous administration of recombinant Lcn2. The Lcn2 protein levels, percentage of TUNEL-positive cells, and GFAP-positive area were significantly higher in retinae cultured under 50 cm H2O pressure loads compared to those cultured under 20 cm H2O. We found that Lcn2 exhibited neurotoxicity in retinae at dose of 1 µg/ml. The negative effects of increased hydrostatic pressure were attenuated by the iron chelator deferoxamine. This is the first report demonstrating the direct upregulation of Lcn2 by elevating hydrostatic pressure. Modulating Lcn2 and iron levels may be a promising therapeutic approach for retinal degeneration.

Comparison of correction factor for both dynamic total thermal insulation and evaporative resistance between ISO 7933 and ISO 9920.

BACKGROUND: Thermal insulation and evaporative resistance of clothing are the physical parameters to quantify heat transfer and evaporative dissipation from the human body to the environment, respectively. Wind and body movement decrease thermal insulation and evaporative resistance of clothing, which is represented as correction factors for dynamic total thermal insulation (CFi) and evaporative resistance (CFe), respectively. Then, CFi and CFe are parts of the key parameters to predict heat strain of workers by computer simulation. The objective of this study was to elucidate the difference of CFi and CFe between ISO 7933 and ISO 9920 and compare the difference of predicted rectal temperature, water loss, and exposure time limit calculated by using each correction factor. METHODS: CFi of ISO 7933 (CFi7933) and ISO 9920 (CFi9920), and CFe of ISO 7933 (CFe7933) and two kinds of CFe of ISO 9920 (CFe9920a, CFe9920b) were compared in terms of relative air velocity, walking speed for three kinds of thermal insulation of clothing. Next, two modified predicted heat strain (PHS) models were developed: modified PHS integrated with CFi9920 and CFe9920a (PHSmA) and modified PHS integrated with CFi9920 and CFe9920b (PHSmB). We calculated the rectal temperature, water loss, and exposure time limit by PHS, PHSmA, and PHSmB and compared the results. RESULTS: CFi7933 and CFi9920 were almost similar in terms of Var and walking speed, while CFe9920a and CFe9920b were larger than CFe7933 when Var was more than 1.0 m·s-1. Intrinsic clothing insulation (Icl) diminished the effects of Var on CFi7933, CFi9920, CFe7933, and CFe9920b. However, CFe9920a was not influenced by Icl. The predicted rectal temperature and water loss difference were larger between PHS and PHSmA as CFe difference got larger. The duration time when limit of rectal temperature of 38 °C was reached (DlimTre38) calculated by PHS was significantly longer than PHSmA, PHSmB at higher Var. CONCLUSIONS: Precise correction factors for evaporative resistance are required to predict rectal temperature, water loss, and work-time limits.

Involvement of lupus enteritis in a patient with lupus cystitis and nephritis.

We present the case of a patient with lupus enteritis accompanied by both lupus cystitis and lupus nephritis without a history of systemic lupus erythematosus. The patient had a 2-month history of diarrhea and pollakiuria and was admitted to our hospital. Physical examination showed abdominal tenderness. Laboratory data revealed reductions in both total protein and albumin, elevated serum creatinine levels, and elevated antinuclear and anti-Smith antibodies. Urinalysis revealed proteinuria. Stool and urine cultures were negative. Abdominal computed tomography revealed diffuse edematous wall thickening, dilatation of the small intestine suggesting paralytic ileus, and irregular wall thickening of the urinary bladder. Histological results of the cystic and renal biopsies revealed interstitial cystitis and membranous nephropathy which were suggestive of lupus cystitis and lupus nephritis, respectively. The patient's gastrointestinal symptoms were finally diagnosed as resulting from lupus enteritis. After initiating 30 mg oral prednisolone daily, the diarrhea and pollakiuria subsided, and renal function became normal. Lupus enteritis should always be considered in the differential diagnosis when patients complaining of chronic diarrhea of unknown etiology are encountered.