Desquamative Interstitial Pneumonia with Progressive Pulmonary Fibrosis.

A 70-year-old man who smoked was referred to our hospital because of progressive cough and dyspnea. Radiologic images showed ground-glass attenuation predominantly in the lower lung lobes. A surgical lung biopsy was performed, and a diagnosis of desquamative interstitial pneumonia (DIP) was made. The patient's symptoms improved with smoking cessation and steroid treatment, but the ground-glass attenuation did not completely resolve. At 10 years after the diagnosis, the fibrotic lesions deteriorated and treatment with nintedanib was subsequently initiated. Careful observation is needed in patients with DIP whose lung involvement does not completely improve with initial treatment.

22q11.2 Deletion Syndrome Diagnosed 47 Years After Surgery for Tetralogy of Fallot.

A 51-year-old man presented with severe hydrocele testis, dyspnea on exertion, and systemic edema. He had a history of surgery for tetralogy of Fallot (TOF). On the second day of admission, he presented with severe nose bleeding followed by CO2 narcosis. Blood gas analysis revealed an extremely low level of Ca2+. An echocardiogram revealed an excessively enlarged right ventricle and severe pulmonary valve regurgitation (PR). Hypocalcemia, history of TOF, and characteristic facial features suggested 22q11.2 deletion syndrome, which was confirmed by fluorescence in-situ hybridization (FISH) chromosome test. Open heart redo-surgery was performed for severe PR. The surgery revealed a severely hypoplastic pulmonary valve, which is characteristic of 22q11.2 deletion syndrome. 22q11.2 syndrome thus could be overlooked until age over 50 and therefore become critical.

3D image scanning of gravel soil using in-situ X-ray computed tomography.

A typical ground investigation for characterizing geotechnical properties of soil requires sampling soils to test in a laboratory. Laboratory X-ray computed tomography (CT) has been used to non-destructively observe soils and characterize their properties using image processing, numerical analysis, or three-dimensional (3D) printing techniques based on scanned images; however, if it becomes possible to scan the soils in the ground, it may enable the characterization without sampling them. In this study, an in-situ X-ray CT scanning system comprising a drilling machine with an integrated CT scanner was developed. A model test was conducted on gravel soil to verify if the equipment can drill and scan the soil underground. Moreover, image processing was performed on acquired 3D CT images to verify the image quality; the particle morphology (particle size and shape characteristics) was compared with the results obtained for projected particles captured in a two-dimensional (2D) manner by a digital camera. The equipment successfully drilled to a target depth of 800 mm, and the soil was scanned at depths of 700, 750, and 800 mm. Image processing results showed a reasonable agreement between the 3D and 2D particle morphology images, and confirmed the feasibility of the in-situ X-ray CT scanning system.

Plasmonic Metamaterial Ag Nanostructures on a Mirror for Colorimetric Sensing.

In this study, we demonstrate the localized surface plasmon resonance (LSPR) in the visible range by using nanostructures on mirrors. The nanohemisphere-on-mirror (NHoM) structure is based on random nanoparticles that were obtained by heat-treating silver thin films and does not require any top-down nanofabrication processes. We were able to successfully tune over a wide wavelength range and obtain full colors using the NHoM structures, which realized full coverage of the Commission Internationale de l'Eclairage (CIE) standard RGB (sRGB) color space. Additionally, we fabricated the periodic nanodisk-on-glass (NDoG) structure using electron beam lithography and compared it with the NHoM structure. Our analysis of dark-field microscopic images observed by a hyperspectral camera showed that the NHoM structure had less variation in the resonant wavelength by observation points compared with the periodic NDoG structure. In other words, the NHoM structure achieved a high color quality that is comparable to the periodic structure. Finally, we proposed colorimetric sensing as an application of the NHoM structure. We confirmed the significant improvement in performance of colorimetric sensing using the NHoM structure and succeeded in colorimetric sensing using protein drops. The ability to fabricate large areas in full color easily and inexpensively with our proposed structures makes them suitable for industrial applications, such as displays, holograms, biosensing, and security applications.

Partial pressure of carbon dioxide levels reflect disease severity in idiopathic pleuroparenchymal fibroelastosis.

BACKGROUND: Hypercapnia can cause a disturbance of consciousness and adversely affect a patient's general condition. Patients with interstitial lung disease seldom experience hypercapnia. Hypercapnia is a typical phenomenon in patients with pleuroparenchymal fibroelastosis (PPFE), especially in advanced stages. However, the clinical significance of hypercapnia in patients with idiopathic PPFE (iPPFE) has not been studied in detail. METHODS: We retrospectively selected patients with iPPFE who had undergone blood gas analysis. The first blood gas data obtained after iPPFE diagnosis were examined. The partial pressure of carbon dioxide (PCO2) levels and their association with characteristic iPPFE parameters, including the flat chest index (the ratio of the anteroposterior diameter of the thoracic cage to the transverse diameter of the thoracic cage), were investigated. RESULTS: A total of 47 patients with iPPFE were included in this study. The PCO2 level was moderately and inversely correlated with the forced vital capacity. (r = -0.431, P = 0.014), flat chest index (r = -0.497, P < 0.001), and body mass index (r = -0.313, P = 0.038) and was positively correlated with residual volume/total lung capacity. (r = 0.514, P < 0.01). A higher PCO2 level was also significantly associated with poorer prognosis in patients with iPPFE. CONCLUSIONS: PCO2 levels could be used as an indicator of disease severity in patients with iPPFE.

Glucose emission spectra through mid-infrared passive spectroscopic imaging of the wrist for non-invasive glucose sensing.

Non-invasive blood glucose sensing can be achieved using mid-infrared spectroscopy, although no practical device based on this method has yet been developed. Here, we propose mid-infrared passive spectroscopic imaging for glucose measurements from a distance. Spectroscopic imaging of thermal radiation from the human body enabled, for the first time in the world, the detection of glucose-induced luminescence from a distance. In addition, glucose emission spectra of the wrist acquired at regular intervals up to 60 min showed that there was a strong correlation between the glucose emission intensity and blood glucose level measured using an invasive sensor. Thus, the new technology proposed here is expected to be applied to real-time monitoring of diabetic patients to detect hypoglycemic attacks during sleep and to detect hyperglycemia in a population. Moreover, this technology could lead to innovations that would make it possible to remotely measure a variety of substances.

A case of welder's pneumoconiosis treated with corticosteroid followed by nintedanib.

A 32-year-old man who had worked as a welder for 13 years was hospitalized for a fever and hemosputum with dyspnea. He was diagnosed with welding fume-associated lung disease with alveolar hemorrhaging and acute respiratory failure. Despite surviving the acute phase with corticosteroid therapy, hypoxemia persisted after a month and a half, requiring home oxygen therapy. As a result of the introduction of nintedanib, his clinical findings gradually improved, and the patient was weaned from oxygen therapy after six months. Inhalation of a large amount of welding fumes in a short period can cause alveolar hemorrhaging and prolonged pulmonary dysfunction.

Study of factors related to recurrence within 30 days after pneumonia treatment for community-onset pneumonia.

INTRODUCTION: It is not uncommon for patients hospitalized with pneumonia to experience an early relapse. Here, we investigated the factors related to pneumonia recurrence in Japan. PURPOSE: We aimed to elucidate the factors related to early recurrence after completion of pneumonia treatment. METHODS: We examined 696 patients with community-acquired pneumonia (CAP) and nursing and healthcare-associated pneumonia (NHCAP) who were admitted to our hospital between October 2010 and February 2018, excluding those who died during hospitalization. Logistic regression analysis was used to assess the endpoint of recurrence within 30 days after the end of antibiotic treatment. RESULTS: NHCAP, chronic lung disease and duration of antibiotic treatment were significant risk factors for recurrence of pneumonia within 30 days after antibiotic discontinuation. Aspiration pneumonia was not be a significant factor in the early recurrence of pneumonia. CONCLUSIONS: Long-term use of antimicrobials may be a risk factor in early recurrence of pneumonia.

Localized surface plasmon resonance in deep ultraviolet region below 200 nm using a nanohemisphere on mirror structure.

Localized surface plasmon resonance (LSPR) was performed in the deep ultraviolet (UVC) region with Al nanohemisphere structures fabricated by means of a simple method using a combination of vapor deposition, sputtering, and thermal annealing without top-down nanofabrication technology such as electron beam lithography. The LSPR in the UV region was obtained and tuned by the initial metal film thickness, annealing temperature, and dielectric spacer layer thickness. Moreover, we achieved a flexible tuning of the LSPR in a much deeper UVC region below 200 nm using a nanohemisphere on a mirror (NHoM) structure. NHoM is a structure in which a metal nanohemisphere is formed on a metal substrate that is interposed with an Al2O3 thin film layer. In the experimental validation, Al and Ga were used for the metal hemispheres. The LSPR spectrum of the NHoM structures was split into two peaks, and the peak intensities were enhanced and sharpened. The shorter branch of the LSPR peak appeared in the UVC region below 200 nm. Both the peak intensities and linewidth were flexibly tuned by the spacer thickness. This structure can contribute to new developments in the field of deep UV plasmonics.

Identification of black microplastics using long-wavelength infrared hyperspectral imaging with imaging-type two-dimensional Fourier spectroscopy.

Despite recent progress in focal plane array Fourier transform infrared spectroscopy (FPA-FT-IR) for automatic microplastic (MP) discrimination, the analysis time is still too long (e.g., 9 h for a sample with a diameter of 47 mm) and the equipment is expensive. As a solution, a hyperspectral camera restricted to the near-infrared or short-wavelength infrared band could be applied. However, with these bands, the minimum discriminable size is only about 100 µm, and discrimination among darkly colored plastics is difficult. The long-wavelength infrared (LWIR) band is reportedly effective for discrimination among darkly colored plastics. In this study, we constructed a palm-sized LWIR hyperspectral camera (105 mm × 90 mm × 50 mm, 1.25 kg) for imaging-type two-dimensional Fourier spectroscopy. Our system used a general-purpose, inexpensive, and compact microbolometer for the LWIR band. This system could record the absorbance of black MPs (polystyrene, polyethylene, and polypropylene) in a 3.8 mm × 3.0 mm area in 36 s, which was less than 1/6th of the time required for FPA-FT-IR. Additionally, our system could obtain spectra for a 12 µm × 12 µm area. Because our device is cheaper and more compact than a FPA-FT-IR, it will be easier to take out in the field or on a research vessel.

Evaluation of high-stability optical beats in laser chaos by plasmonic photomixing.

The stability of optical beats in a chaotically oscillating laser is compared to that of a free-running continuous-wave laser using a highly efficient plasmonic photomixer. Using a chaotically oscillating laser diode, stable optical beats are observed over an operation current range of 60-90 mA. The optical spectra are stable even with frequent mode hopping. In contrast, optical beats in a free-running continuous-wave laser are not stable compared to those of a chaotically oscillating laser, because of intermittent hopping of the laser modes. The high stability of chaotically oscillating lasers makes these lasers promising candidates for optical pump sources in terahertz time-domain spectroscopy systems.

Radiosynthesis of 18F-labeled d-allose.

Rare sugars are defined as monosaccharides that exist in nature but are only present in limited quantities. d-Allose is a rare sugar that has been reported to have some unique physiological effects. The present study describes suitable synthetic procedures for novel rare sugars of d-allose that are 18F-labeled at the C-3 and C-6 positions and the preparation of the appropriate labeling precursors. The goal is to facilitate in vivo, noninvasive positron emission tomography (PET) investigation of the behavior of rare sugar analogs of d-allose in organs. We found five precursors that were practical for labeling, three for 3-deoxy-3-[18F]fluoro-d-allose ([18F]3FDA) and two for 6-deoxy-6-[18F]fluoro-d-allose ([18F]6FDA). With manual operation synthesis, the highest radiochemical conversion rates were 75% for [18F]3FDA with a precursor of 1,2,4,6-tetra-O-acetyl-3-O-trifluoromethanesulfonyl-ß-d-glucopyranose and 69% for [18F]6FDA with a precursor of 1,2,3,4-tetra-O-acetyl-6-O-trifluoromethanesulfonyl-ß-d-allopyranose. Furthermore, the practical yields of [18F]3FDA and [18F]6FDA using an automated synthesizer were also investigated. Radiochemical yields of 67% and 49% were obtained for [18F]3FDA and [18F]6FDA, respectively, in an automated synthesizer. As basic assessment of stability for use in PET scanning, high performance liquid chromatography analysis showed no decomposition of [18F]3FDA and [18F]6FDA after up to 6 h in rabbit blood plasma.

Procalcitonin-Guided Antibiotic Discontinuation Might Shorten the Duration of Antibiotic Treatment Without Increasing Pneumonia Recurrence.

BACKGROUND: The optimal duration of antibiotic treatment has not been established for pneumonia patients. Some investigators reported procalcitonin (PCT)-guided antimicrobial stewardship reduces the duration of antibiotic use without increasing mortality in pneumonia patients. MATERIAL AND METHODS: We prospectively enrolled hospitalized community-acquired pneumonia or healthcare-associated pneumonia patients with PCT levels >0.20 ng/mL on admission, who were admitted between 2014 and 2017. PCT levels were measured on days 5, 8 and 11 and every 3 days thereafter if needed. Physicians were encouraged and strongly encouraged to discontinue antibiotics when PCT levels decreased below 0.20 ng/mL and 0.10 ng/mL, respectively. Those admitted between 2010 and 2014 were included in the study as historical controls. Primary endpoints were duration of antibiotic treatment and recurrence of pneumonia within 30 days after antibiotic discontinuation. RESULTS: The PCT-guided and control groups consisted of 116 patients each. Background factors including pneumonia severity and PCT levels did not differ between the 2 groups. Median duration of antibiotic treatment was 8.0 and 11 days in the PCT-guided and control groups, respectively (P < 0.001). Multivariable regression analysis revealed that PCT-guided antibiotic discontinuation (partial regression coefficient [PRC] -1.9319, P < 0.001), PCT (PRC 0.1501, P = 0.0059) and albumin (PRC -1.4398, P = 0.0096) were significantly related to duration of antibiotic treatment. Pneumonia recurrence within 30 days after antibiotic discontinuation was not statistically different between the 2 groups (4.3% vs. 6.0%, P = 0.5541). CONCLUSIONS: PCT-guided antibiotic discontinuation might be useful for shortening the duration of antibiotic treatment without increasing pneumonia recurrence.

Parametric standing wave generation of a shallow reflection plane in a nonrigid sample for use in a noninvasive blood glucose monitor.

When monitoring a moist sample using mid-infrared spectroscopy, its thickness must be <100 µm to avoid light absorption from the water. Therefore, we propose an ultrasonic-assisted mid-infrared spectroscopic imaging method that can generate a reflection plane at a depth of 100 µm from the surface of the sample by creating an ultrasonic standing wave. A frequency of 10 MHz is required to obtain an optical path length of 100 µm in biological samples. However, because biological samples generally have high compressibility, attenuation of ultrasonic waves at this frequency is significant. We use agar as a biological phantom and observe that a reflection plane is generated inside by ultrasonic standing waves using optical coherence tomography. It is found that when the sample is vibrated with an 800-kHz ultrasonic wave, a reflection plane is generated at a depth shallower than the theoretically predicted value. We believe that the reflection plane is generated by parametric standing waves, which are based on parametric effect. We detect the waveform distortion using an acoustic emission sensor and confirm the higher harmonics that generate the observed reflection plane using a fast Fourier transform.

Procalcitonin is not an independent predictor of 30-day mortality, albeit predicts pneumonia severity in patients with pneumonia acquired outside the hospital.

BACKGROUND: Procalcitonin (PCT) is a useful marker for pneumonia. However, its clinical usefulness in elderly patients has not been studied extensively. This study aimed to assess the relationship between PCT and prognosis and pneumonia severity in elderly patients with pneumonia acquired outside the hospital. METHODS: Data considered relevant to pneumonia severity and prognosis were retrospectively obtained from clinical charts of all patients with pneumonia who were admitted to our hospital from 2010 to 2017. The primary outcome was 30-day mortality in elderly patients (aged ≥75 years), and the relationship between PCT levels and pneumonia severity, as determined by the pneumonia severity index (PSI) was also examined. RESULTS: Data were collected from 667 patients, of which 436 were elderly patients. Multivariate and receiver operating characteristic curve analysis revealed that albumin, body mass index, and PSI class rather than PCT are important factors related to 30-day mortality in elderly patients. PCT was also not an independent prognostic factor in younger patients. PCT levels significantly differed by pneumonia severity (mild, moderate, and severe) in both younger (p < 0.001) and elderly (p < 0.0001) patients, with levels increasing as severity increased. In contrast, C-reactive protein (CRP) levels and white blood cell counts did not significantly differ by pneumonia severity in younger and elderly patients. A subgroup analysis focused on Streptococcus pneumoniae pneumonia revealed that PCT levels differed by severity in elderly patients (p = 0.03), with levels increasing as severity increased. CONCLUSION: PCT was not an independent predictor of 30-day mortality in both of elderly and younger patients. PCT levels, but not CRP levels, significantly increased with increasing pneumonia severity in younger and elderly patients, although the degree of increase tended to be lower in elderly patients compared to younger patients for the same severity. PCT levels also significantly increased with increasing pneumonia severity in elderly patients with Streptococcus pneumoniae pneumonia.

[Aorta-left Main Trunk Interposition for Adult Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery Using a Prosthetic Graft;Report of a Case].

A 70-year-old woman with back pain was diagnosed with adult anomalous origin of the left coronary artery from the pulmonary artery [Bland-White-Garland (BWG) syndrome]. Preoperative transthoracic echocardiography showed diffuse hypokinesia of the left ventricle and mild mitral valve regurgitation. Coronary angiography revealed dilatation of both coronary arteries, but no aneurysms. The left coronary ostium was removed as buttons of the pulmonary arterial wall, and a prosthetic graft (8 mm ePTFE graft) was interposed between the ascending aorta and coronary button. The pulmonary arterial wall was repaired with a bovine pericardium. Postoperative angiography showed good flow of the graft. The antegrade flow provided by this simple technique will allow feasible percutaneous coronary intervention in the future.