Diagnosis and treatment of nail melanoma: a review of the clinicopathologic, dermoscopic, and genetic characteristics.

Nail melanoma (NM) is an important differential diagnosis in patients with longitudinal melanonychia. However, diagnosis is often challenging as it is difficult to differentiate from other pigmented nail disorders. The main challenge for diagnosis is obtaining adequate nail matrix biopsy specimens for histopathological assessment. Furthermore, the histopathological changes in the early stages of NM are subtle and contribute to a delay in diagnosis and care. Therefore, the integration of clinical and histopathological analyses is essential. Clinical and dermoscopic features, such as a broadened width of asymmetric bands in an irregular pattern, with multicolour pigmentation, periungual pigmentation, and continuous growth, are features that support the diagnosis of NM. The essential histological features that must be assessed are cellular morphology, architectural features, melanocyte density, and inflammatory changes. The reported mutations in NMs were BRAF (0-43%), NRAS (0-31%), KIT (0-50%), NF1 (0-50%), and GNAQ (0-25%). Surgery is the primary treatment for NM. The recommended treatment for in situ or minimally invasive NM is functional surgery, but cases with suspected bone invasion should be treated with amputation. Targeted therapy and immunotherapy are indicated for advanced stages of NM. This review summarizes the updated guidelines for the diagnosis and treatment of NM.

Recovery of renal function in patients with lupus nephritis and reduced renal function: the beneficial effect of hydroxychloroquine.

BACKGROUND: Reduced renal function is associated with worse renal outcome in patients with lupus nephritis (LN). However, there is insufficient knowledge regarding renal function recovery in patients with LN with reduced baseline renal function. Therefore, the present study aimed to investigate renal function recovery and related factors in patients with reduced baseline renal function. METHODS: The present retrospective longitudinal cohort study included patients with LN and reduced renal function. Reduced renal function was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. Recovery of renal function was determined by an eGFR of >60 mL/min/1.73 m2 at six months after baseline, and factors associated with it were evaluated using logistic regression analysis. RESULTS: We included 90 patients with LN, with a mean eGFR value of 37.2 ± 13.9 mL/min/1.73 m2. Forty-six (51.1%) patients recovered their renal function after six months. On multivariate analysis, hydroxychloroquine use (odds ratio (OR) = 3.891, 95% confidence interval (CI) 1.196-12.653, p = 0.024), prolonged LN (OR = 0.926, 95% CI 0.874-0.981, p = 0.009) and high-grade tubular atrophy (OR = 0.451, 95% CI 0.208-0.829, p = 0.013) were associated with renal function recovery. During follow up, 25 patients were on end-stage renal disease (ESRD). Kaplan-Meier analysis revealed that renal function recovery after six months and lower probability of ESRD are associated. CONCLUSIONS: In patients with LN and reduced renal function, renal function recovery at six months was associated with use of hydroxychloroquine and inversely related to longer duration of LN and higher grade of tubular atrophy.

Impact of stringent response in proteinuria on long-term renal outcomes in proliferative lupus nephritis.

OBJECTIVES: Favourable long-term prognosis in proliferative lupus nephritis (LN) is associated with the achievement of complete renal response (CR), which is defined as a urine protein/creatinine ratio (UPCR) of < 0.5. However, it is unclear whether a more stringent cut-off for proteinuria (normal value of proteinuria; UPCR < 0.15) is better than CR. We aimed to evaluate the effect of stringent CR, defined as a UPCR of <0.15, on long-term renal outcomes in proliferative LN. METHODS: We included 87 patients with class III or IV LN who achieved CR at one year after induction therapy. Clinical and laboratory data were compared between the stringent and non-stringent CR groups. Logistic regression analysis was performed to identify factors associated with achievement of stringent CR. Cox analysis was performed to analyse the risk factors for renal flare and development of chronic kidney disease (CKD). RESULTS: The stringent and non-stringent CR groups included 58 and 29 patients, respectively. The two groups showed no significant baseline differences in terms of the clinical, laboratory and pathological classification. The sustained CR rates during five years were 91.3% and 50.0% (p = 0.014) in the stringent and non-stringent CR groups, respectively. In Cox analyses, the achievement of stringent CR was associated with a lower risk of five-year renal flare rate (hazard ratio (HR) = 0.161, 95% confidence interval (CI) 0.063-0.411, p < 0.01) and development of CKD (HR = 0.189, 95% CI 0.047-0.752, p = 0.018). Mycophenolate mofetil induction therapy was associated with achievement of stringent CR at a borderline level of significance (HR = 7.268, 95% CI 0.894-59.089, p = 0.064). CONCLUSION: Achievement of stringent CR predicted lower risk of renal flare and development of CKD in proliferative LN. These findings suggest that stringent CR is a valuable treatment target in proliferative LN.

Clinical Impact of a Protocolized Kidney Donor Follow-up System.

BACKGROUND: Adequate kidney donor management after donation is increasingly emphasized due to concerns of renal function impairment after nephrectomy with increasing life expectancy. In this study, the clinical impact of a protocolized kidney donor follow-up system by nephrologists was evaluated. METHODS: A total of 427 living kidney donors underwent nephrectomy from January 2010 to December 2014 and were followed for at least 2 years at the Samsung Medical Center. Donors were followed-up by nephrologists after the establishment of a donor clinic with systemized protocols in January 2013. The primary outcomes were incidence of post-donation low estimated glomerular filtration rate (eGFR) and renal function adaptability. Secondary outcomes were changes in compliance and incidence of hyperuricemia and microalbuminuria. RESULTS: The patients were divided into 2 groups according to the time of nephrectomy: the pre-donor clinic period (n = 182) and the donor clinic period (n = 172). Preoperative eGFR in patients in the pre-donor clinic period was higher than that in patients in the donor clinic period. After donation, poor renal adaptation was less frequent in the donor clinic period compared to the pre-donor clinic period. Low eGFR tended to be less common during the donor clinic period. Shorter mean outpatient clinic visit intervals with more visits within 6 months after donation and earlier detection of de novo hyperuricemia were found during the donor clinic period. CONCLUSION: A protocolized donor clinic run by nephrologists may improve post-nephrectomy renal outcomes and compliance and facilitate better management of potential risk factors of chronic kidney disease in donors.

Investigation of multifilament MgB2 superconducting joint technique for development of MRI magnets.

This study presents the investigation of superconducting joints fabricated using multifilament magnesium diboride (MgB2) wires for the development of persistent-current mode magnetic resonance imaging (MRI) magnets. The critical current of the jointed samples decreased with increasing cutting angle because the smaller cutting angle allowed greater exposure of the MgB2 filament, thereby increasing the contact area for the wire-bulk-wire connection. In addition, an appropriate pressing pressure (300 MPa) was necessary to establish the multifilament MgB2 joint without significant degradation of superconducting properties. The resistance of the optimal MgB2 joint, measured using the field-decay technique, was <1.5 × 10-14 Ω. Therefore, the proposed joint technique can be employed for developing multifilament MgB2 MRI magnets operating in the persistent-current mode.

Depth extraction with offset pixels.

Numerous depth extraction techniques have been proposed in the past. However, the utility of these techniques is limited as they typically require multiple imaging units, bulky platforms for computation, cannot achieve high speed and are computationally expensive. To counter the above challenges, a sensor with Offset Pixel Apertures (OPA) has been recently proposed. However, a working system for depth extraction with the OPA sensor has not been discussed. In this paper, we propose the first such system for depth extraction using the OPA sensor. We also propose a dedicated hardware implementation for the proposed system, named as the Depth Map Processor (DMP). The DMP can provide depth at 30 frames per second at 1920 × 1080 resolution with 31 disparity levels. Furthermore, the proposed DMP has low power consumption as for the aforementioned speed and resolution it only requires 290.76 mW. The proposed system makes it an ideal choice for depth extraction systems in constrained environments.

Inhibition of Candida albicans biofilm and hyphae formation by biocompatible oligomers.

Candida albicans is a yeast pathogen known for its virulence and high morbidity rate, and it easily colonizes host tissues and implant devices and forms mature biofilms, which play an important role in pathogenesis and drug resistance. In this study, we investigated the abilities of thermoresponsive oligomers of N-vinylcaprolactam (OVCLs) to inhibit biofilm formation by C. albicans. One synthetic and four commercial OVCLs (≤MW 240 000) at a concentration of 5 µg ml-1 were found to decrease C. albicans biofilm formation by more than 90% at 37°C, but to be less effective at 25°C. Microscopic observations showed that OVCLs clearly inhibited hyphal formation and cell aggregation by C. albicans, and this appeared to be responsible for their antibiofilm effects. In addition, effective antibiofouling coatings of OVCL/poly(lactic-co-glycolic acid) polymer blends were prepared on glass surfaces. SIGNIFICANCE AND IMPACT OF THE STUDY: The emergence of multidrug-resistant Candida strains has prompted searches for new antifungals. The antibiofilm and antihyphae properties of OVCLs and OVCL coating against a fluconazole-resistant Candida albicans strain are present in this study. These findings suggest that OVCL and OVCL-coated biomaterials are potentially useful for controlling fungal biofilm formation by and the virulence of antifungal-resistant C. albicans.

Predictive Factors of Renal Adaptation After Nephrectomy in Kidney Donors.

BACKGROUND: Despite compensatory hyperfiltration in remaining nephrons following donor nephrectomy, some donors show impaired renal adaptation and low estimated glomerular filtration rate (eGFR). We investigated the factors predicting early renal adaptation after nephrectomy and identified kidney donors at risk of inadequate renal adaptation. METHODS: A total of 265 living kidney donors from 2010 to 2013 were retrospectively analyzed. Renal function was serially followed for 6 months after the operation. Regression analyses were performed to identify the independent predictors of low eGFR (eGFR <60 mL/min/1.73 m2) and impaired renal adaptation (%Modification of Diet in Renal Disease [MDRD] <66% of baseline eGFR). RESULTS: A total of 148 donors belonged to the low eGFR group, and changes in eGFR (ΔeGFR) at postoperative (PO) 1 day and 1 month were identified as independent predictors of low eGFR. Impaired renal adaptation was related to age, ΔeGFR PO 2-3 days, and ΔeGFR PO 1 month. Early renal adaptation was associated with age, male gender, and residual kidney computerized tomography angiography (CTA) volume. The best sensitivity and specificity were obtained with a cutoff value of ΔeGFR 31 at PO 1 day and 1 month for predicting low eGFR and with a value of ΔeGFR 27 at PO 2-3 days and 1 month for predicting impaired renal adaptation. CONCLUSIONS: Our study showed that the degree of early renal adaptation determines subsequent renal function in kidney donors. Closer monitoring and management may be required in old or male donors with small residual CTA kidney volume as well as donors with persistent ΔeGFR >27 within 1 month of nephrectomy.

Carvacrol-rich oregano oil and thymol-rich thyme red oil inhibit biofilm formation and the virulence of uropathogenic Escherichia coli.

AIMS: Urinary tract infections are caused primarily by uropathogenic Escherichia coli (UPEC), and indwelling catheters are usually colonized by UPEC biofilms tolerant to common antibiotics. Hence, UPEC biofilms pose a substantial challenge, and there is an urgent need for effective control strategies. METHODS AND RESULTS: In this study, 79 essential oils were screened for antibiofilm ability against UPEC. Components of active oils were identified, and their antibiofilm activities were also investigated using 96-well plates with crystal violet assay, scanning electron microscopy, and confocal laser scanning microscopy. Oregano oil and thyme red oil and their major common constituents, carvacrol and thymol, significantly inhibited UPEC biofilm formation at subinhibitory concentrations (<0·01%). These findings were supported by observations that carvacrol and thymol reduced fimbriae production and the swarming motility of UPEC. Furthermore, carvacrol and thymol markedly decreased the hemagglutinating ability of UPEC, and UPEC was more easily killed by human whole blood in the presence of carvacrol and thymol. CONCLUSIONS: Carvacrol-rich oregano oil and thymol-rich thyme red oil have high antibiofilm and antivirulence activities against UPEC. SIGNIFICANCE AND IMPACT OF STUDY: In the wake of rising antimicrobial resistance, we envisage that carvacrol and thymol could be used to prevent biofilm formation by UPEC and to reduce its virulence.

Note: Progress on the use of MgB2 superconducting joint technique for the development of MgB2 magnets for magnetic resonance imaging (MRI).

This note presents a superconducting joint technique for the development of MgB2 magnetic resonance imaging (MRI) magnets. The MgB2 superconducting joint was fabricated by a powder processing method using Mg and B powders to establish a wire-bulk-wire connection. The joint resistance measured using a field-decay method was <10-14 Ω, demonstrating that the proposed joint technique could be employed for developing "next-generation" MgB2 MRI magnets operating in the persistent current mode.

Association Studies of Bone Morphogenetic Protein 2 Gene Polymorphisms With Acute Rejection in Kidney Transplantation Recipients.

OBJECTIVE: Bone morphogenetic proteins (BMP) belong to the transforming growth factor beta superfamily of proteins. This study was performed to evaluate the association of BMP gene polymorphisms with acute renal allograft rejection (AR) and graft dysfunction (GD) in Koreans. METHODS: Three hundred thirty-one patients who had kidney transplantation procedures were recruited. Transplantation outcomes were determined in terms of AR and GD criteria. We selected six single nucleotide polymorphisms (SNPs): rs1979855 (5' near gene), rs1049007 (Ser87Ser), rs235767 (intron), rs1005464 (intron), rs235768 (Arg190Ser), and rs3178250 (3; untranslated region). RESULTS: Among the six SNPs tested, the rs235767, rs1005464, and rs3178250 SNPs were significantly associated with AR (P < .05). The rs1049007 and rs235768 SNPs also showed an association with GD (P < .05). CONCLUSIONS: In conclusion, these results suggest that the BMP2 gene polymorphism may be related to the development of AR and GD in kidney transplant recipients.

Everolimus-Induced Systemic Serositis After Simultaneous Liver and Kidney Transplantation: A Case Report.

Although everolimus, a mammalian target of rapamycin inhibitor, has been used as a potent immunosuppressive agent in organ transplantation, data regarding its adverse effect profile compared with that of sirolimus in clinical circumstances are limited. A 50-year-old man who underwent simultaneous liver and kidney transplantation 14 months previously was admitted with large pleural effusion, pericardial effusion, and ascites. Laboratory findings and cultures for possible infectious causes were all negative. Pericardial window surgery with drainage of the pericardial fluid was performed on day 3. Pleural and pericardial biopsy revealed non-specific inflammation without evidence of malignant cells. Everolimus was discontinued and replaced by mycophenolate mofetil on day 4. Significant clinical improvement was observed after discontinuation of everolimus, and follow-up echocardiography and chest radiography showed no recurrence of the pericardial or pleural effusion after discharge.

The prevalence of causative organisms of community-acquired urethritis in an age group at high risk for sexually transmitted infections in Korean Soldiers.

OBJECTIVES: This study was designed to evaluate the causative organisms in young male soldiers with clinical signs and symptoms after sexual contact that suggests a diagnosis of urethritis. METHODS: Between June 2012 and January 2015, male patients with urethritis symptoms that had resulted from sexual contact within 3 months participated in this study. All patients were evaluated using urinalysis and were screened for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), Ureaplasma urealyticum (UU), Mycoplasma genitalium (MG), Mycoplasma hominis (MH), herpes simplex virus (HSV) type II and Trichomonas vaginalis (TV) using multiplex PCR (mPCR) assay in order to detect sexually transmitted infections (STI) or pathogens. RESULTS: A total of 436 male patients aged 18-28 years were included in the study. The median age was 22.0 years. The prevalence of STI pathogens were as follows: NG in 19.0%, CT in 36.6%, UU in 24.0%, MG in 21.5%, MH in 6.1%, HSV type II in 1.6%, TV in 0.2% and indeterminate STI pathogens in 9.4%. Coinfection of NG with non-NG was detected in 5.7% of the participants, while the coinfection rates for STI pathogens were: with CT in 3.4%, with UU in 2.7%, with MG in 0.2% and with MH in 0.2%. CONCLUSIONS: CT was the most prevalent STI pathogen and coinfections of NG with non-NG appeared less frequently. The young male soldiers with urethritis should be administered suitable antibiotics for STI pathogens that were found by mPCR results, rather than an experimental combination of antibiotics for coinfections.

Investigation on quench initiation and propagation characteristics of GdBCO coil co-wound with a stainless steel tape as turn-to-turn metallic insulation.

This paper investigates the quench initiation and propagation characteristics of a metallic insulation (MI) coil by conducting thermal quench tests for a GdBCO single-pancake coil co-wound with a stainless steel tape as the turn-to-turn MI. The test results confirmed that the MI coil exhibited superior thermal and electrical stabilities compared to the conventional coils co-wound with organic insulation material because the operating current could flow along the radial direction due to the existence of a turn-to-turn contact when a local hot spot was generated. The results of the quench test at a heater current (Ih) of 12, 13, and 14 A indicate that the MI coil possesses a self-protecting characteristic resulting from the "current bypass" through the turn-to-turn contact. However, the test coil was not self-protecting at Ih = 15 A because the Joule heat energy generated by the radial current flow was not completely dissipated due to the characteristic resistance of the metallic insulation tape and the non-superconducting materials, including the substrate, stabilizer, and buffer layers within the high-temperature superconductor (HTS) tape. Even though the MI coil possesses superior thermal and electrical stability relative to those of conventional HTS coils co-wound with an organic material as turn-to-turn insulation, it is essential to consider the critical role of the Joule heat energy resulting from the operating current and stored magnetic energy as well as the characteristic resistances in order to further develop self-protective 2G HTS magnets.

A novel no-insulation winding technique of high temperature-superconducting racetrack coil for rotating applications: A progress report in Korea university.

This paper presents our recent progress on core technology development for a megawatt-class superconducting wind turbine generator supported by the international collaborative R&D program of the Korea Institute of Energy Technology Evaluation and Planning. To outperform the current high-temperature-superconducting (HTS) magnet technology in the wind turbine industry, a novel no-insulation winding technique was first proposed to develop the second-generation HTS racetrack coil for rotating applications. Here, we briefly report our recent studies on no-insulation (NI) winding technique for GdBCO coated conductor racetrack coils in the following areas: (1) Charging-discharging characteristics of no-insulation GdBCO racetrack coils with respect to external pressures applied to straight sections; (2) thermal and electrical stabilities of no-insulation GdBCO racetrack coils encapsulated with various impregnating materials; (3) quench behaviors of no-insulation racetrack coils wound with GdBCO conductor possessing various lamination layers; (4) electromagnetic characteristics of no-insulation GdBCO racetrack coils under time-varying field conditions. Test results confirmed that this novel NI winding technique was highly promising. It could provide development of a compact, mechanically dense, and self-protecting GdBCO magnet for use in real-world superconducting wind turbine generators.

Prevalence and Clinical Relevance of Exon 2 Deletion of COMMD1 in Bedlington Terriers in Korea.

BACKGROUND: Deletion of exon 2 of copper metabolism domain containing 1 (COMMD1) results in copper toxicosis in Bedlington terriers (CT-BT). OBJECTIVES: This study was conducted to identify the prevalence and clinical relevance of the COMMD1 mutation in Bedlington terriers in Korea. ANIMALS: A total of 105 purebred Bedlington terriers (50 males, 55 females) from the kennels and pet dog clubs in Korea were examined during the period 2008-2013. METHODS: A multiplex PCR was carried out to detect exon 2 deletion of COMMD1. Clinical analysis was performed on each genetic group, and clinical status of the dogs was followed up to estimate survival probability. RESULTS: Of the 105 samples, 52 (49%) were wild-type homozygote, 47 (45%) were heterozygote, and 6 (6%) were mutant-type homozygote. Plasma alanine aminotransferase (ALT) activity was increased in the mutant-type homozygous group >2 years of age (P < .0001). The survival probability of 6 mutant-type homozygotes surviving 2.5 years was 0.67, and 4 years was 0.5. CONCLUSIONS AND CLINICAL IMPORTANCE: Results show the prevalence and clinical relevance of exon 2 deletion of COMMD1 and could help establish a structured selective breeding program to prevent CT-BT in Korea.

Association Interleukin-4 and Interleukin-4 Receptor Gene Polymorphism and Acute Rejection and Graft Dysfunction After Kidney Transplantation.

BACKGROUND: Cytokine genotypes have previously been studied in patients undergoing solid organ transplantation; certain polymorphisms have been implicated in the development of acute rejection (AR) and graft dysfunction (GD). Allograft outcomes determined, in part, by alloimmune responses is mainly mediated by T-cell responses, activated and driven by cytokines. Interleukin-4 (IL-4) is one such cytokine, which exerts its biological effects through binding to the IL-4 receptor (IL-4R) complex on target cells. In the present study, we investigated whether polymorphisms of the IL-4 and/or IL-4R gene were associated with susceptibility to acute AR and GD after kidney transplantation. METHODS: We analyzed 2 single nucleotide polymorphism (SNPs) of IL-4 (rs2243250 and rs2070874) and 3 SNPs of IL-4R (rs1801275, rs2107356, and rs1805010) in 344 kidney transplant recipients. These patients included 62 of whom had developed AR and 215 of whom had GD in 1 year after kidney transplantation. RESULTS: The AR group included 62 patients (45 men and 17 women). There was a statistically significant difference in the male-to-female ratio and the use of tacrolimus in the AR group. The GD group included 215 patients. Patients who developed GD were more likely to be older and have an underlying cause of end-stage renal disease that was unknown compared with patients who did not have GD, the cause of which was typically known. Among the SNPs examined, 1 of the SNPs in the IL-4R gene (ie, rs1801275) showed a statistical association with AR (co-dominant model, P = .061; dominant model, P = .019; and log-addictive model, P = .029). In addition, 1 of the IL-4R SNPs (ie, rs2107356) was statistically associated with GD (dominant model, P = .034). No significant difference in the IL-4 genotype was observed between the AR/GD and non-AR/non-GD subjects. CONCLUSIONS: One IL-4R gene polymorphism (rs1801275) was associated with AR. In addition, a separate IL-4R SNP (rs2107356) was statistically associated with GD after kidney transplantation.

Twinstar/cofilin is required for regulation of epithelial integrity and tissue growth in Drosophila.

Regulation of actin assembly and depolymerization is important for the organization of epithelia. Recent studies have shown that the actin-capping proteins are required to prevent cell extrusion and inappropriate activation of Yorkie (Yki) activity in Drosophila, implicating the importance of actin regulation for epithelial integrity and Yki-dependent tissue growth. However, the role of Twinstar (Tsr), the Drosophila homolog for cofilin/actin depolymerization factor (ADF), in epithelial integrity and Hippo signaling is unknown. Here we demonstrate that reduction of Tsr by RNA interference (RNAi) or mutant clones in wing imaginal disc induces not only F-actin accumulation but also ectopic expression of Wingless (Wg) and Yki target gene expanded (ex). Knockdown of Yki in Tsr-depleted cells reduced the level of ectopic Wg expression. Reduced Tsr also led to downregulation of cell junction proteins and extrusion of affected cells from the basal part of the epithelium. Rho GTPase 1 was upregulated in Tsr-depleted tissue, supporting the Tsr function in the inhibition of cell extrusion from the epithelium. Tsr is also required for blocking cell death and c-Jun N-terminal kinase (JNK) signaling. Ectopic JNK activation induced caspase activation but did not cause cell extrusion. Further, the invasiveness of Tsr-depleted cells was not suppressed by inhibition of cell death or JNK signaling. In contrast, Yki upregulation was significantly suppressed by cell death inhibition. Taken together, our data suggest that Tsr is required for cell survival and tissue growth by regulating JNK and Yki signaling while maintaining the epithelial integrity by controlling cell junctions. This study provides an insight into potential roles of ADF/cofilin in invasive cell migration and tumor suppression in higher animals.

Analytical and experimental investigation of electrical characteristics of a metallic insulation GdBCO coil.

This paper presents results, experimental and analytical, of the electrical characteristics of GdBCO single-pancake coils co-wound with a brass tape as metallic insulation (MI coil). The GdBCO pancakes were subjected to sudden discharge, charge-discharge, and over-current tests. The sudden discharge and charge-discharge test results of the MI coil demonstrated that MI coils can be charged and discharged significantly faster than non-insulated coils that are wound only with GdBCO tape. In over-current tests at 150 A (1.25I(c)), the MI coil exhibited better electrical behavior, i.e., self-protecting features, than its counterpart co-wound with Kapton tape, an insulator. Moreover, the experimental and analytical results are in agreement, validating the use of a concise equivalent parallel-RL circuit model for the MI coil to characterize its electrical behavior. Overall, the MI winding technique is highly promising to help build compact, mechanically robust, and self-protecting magnets composed of REBCO pancake coils. With no organic material in the winding, MI REBCO pancakes will be immune to neutron radiation damage, making the MI winding technique a viable option for fusion reactors, such as for toroidal field, poroidal field magnets, and central solenoid.

Mesenteric vasculitis after G-CSF administration in a severe neutropenic patient with systemic lupus erythematosus.

Granulocyte colony-stimulating factor (G-CSF) is commonly used with neutropenic patients to accelerate recovery. G-CSF is a hematopoietic cytokine that regulates the proliferation and differentiation of neutrophil precursors, and is known as a safe and effective treatment for chemotherapy-induced neutropenia. However, we encountered a case in which a patient with systemic lupus erythematosus (SLE) developed mesenteric vasculitis after G-CSF administration. The patient was a 36-year-old female admitted with fever, arthralgia, and generalized erythematous rash. Despite symptomatic improvement with a high-dose steroid, severe neutropenia persisted for three weeks, precipitating a decision to use G-CSF to enhance recovery. Mesenteric vasculitis developed 15 hours after administration of G-CSF injection. Because the response of immune cells such as neutrophils and T cells is uncontrolled and dysfunctional in patients with lupus, G-CSF therapy should be used with caution.