Pepper mild mottle virus intended for use as a process indicator for drinking water treatment: Present forms and quantitative relations to norovirus and rotavirus in surface water.

Pepper mild mottle virus (PMMoV) has been proposed as a potential indicator of human enteric viruses in environmental water and for viral removal during drinking water treatment. To investigate the occurrence and present forms of PMMoV and quantitative relations to norovirus GII and rotavirus A (RVA) in surface waters, 147 source water samples were collected from 21 drinking water treatment plants (DWTPs) in Japan between January 2018 and January 2021, and the concentrations of viruses in suspended and dissolved fractions were measured using real-time RT-PCR. PMMoV was detected in 81-100 % of samples in each sample month and observed concentrations ranged from 3.0 to 7.0 log10 copies/L. The concentrations of PMMoV were higher in dissolved fraction compared to suspended fractions, while different partitioning was observed for NoV GII depending on seasons. The concentrations of PMMoV were basically higher than those of norovirus GII (1.9-5.3 log10 copies/L) and RVA (1.9-6.6 log10 copies/L), while in 18 samples, RVA presented higher concentrations than PMMoV. Partial regions of VP7, VP4, and VP6 of the RVA in the 18 samples were amplified using nested PCR, and the genotypes were determined using an amplicon-based next-generation sequencing approach. We found that these source water samples included not only human RVA but also various animal RVA and high genetic diversity due to the existence of animal RVA was associated with a higher RVA concentration than PMMoV. Our findings suggest that PMMoV can be used as an indicator of norovirus GII and human RVA in drinking water sources and that the indicator performance should be evaluated by comparing to zoonotic viruses as well as human viruses.

Rapid progression of a coronary artery aneurysm caused by IgG4-related disease.

BACKGROUND: IgG4-related disease (IgG4-RD) is a recently recognized fibro-inflammatory disorder that can affect almost any organ. IgG4-RD has also been reported in coronary arteries as periarteritis. IgG4-related coronary periarteritis may cause coronary artery aneurysms, and IgG4-related coronary artery aneurysms (IGCAs) are life-threatening. We describe a case of a patient with IGCA that highlights the usefulness and limitations of various IGCA evaluation modalities and provides insight into disease pathophysiology. CASE SUMMARY: A 60-year-old man with IgG4-RD diagnosed 2 years before and with IGCA at the proximal right coronary artery (RCA) on coronary angiography (CAG) 9 months prior to admission to the hospital presented with acute coronary syndrome. Emergent CAG revealed the rapid progression of IGCA at the RCA, an obstruction of the diagonal branch, and stenosis of the left anterior descending artery (LAD) and the high lateral branch (HL). The patient underwent percutaneous coronary intervention for the diagonal branch. The RCA aneurysm was resected and bypassed with a saphenous vein graft (SVG); coronary bypass grafting (left internal mammary artery to LAD and SVG to HL) was performed. Pathological findings showed inflammatory cell infiltration and disruption of the elastic plate. CONCLUSION: IGCAs require careful follow-up with computed tomography scans for early detection of aneurysmal enlargement.

Synergistic Effects of In-Situ Exsolved Ni-Ru Bimetallic Catalyst on High-Performance and Durable Direct-Methane Solid Oxide Fuel Cells.

Direct-methane solid oxide fuel cells (CH4-SOFCs) have gained significant attention as methane, the primary component of natural gas (NG), is cheap and widely available and the natural gas infrastructures are relatively mature. However, at intermediate temperatures (e.g., 600-650 °C), current CH4-SOFCs suffer from low performance and poor durability under a low steam-to-carbon ratio (S/C ratio), which is ascribed to the Ni-based anode that is of low catalytic activity and prone to coking. Herein, with the guidance of density functional theory (DFT) studies, a highly active and coking tolerant steam methane reforming (SMR) catalyst, Sm-doped CeO2-supported Ni-Ru (SCNR), was developed. The synergy between Ni and Ru lowers the activation energy of the first C-H bond activation and promotes CHx decomposition. Additionally, Sm doping increases the oxygen vacancy concentration in CeO2, facilitating H2O adsorption and dissociation. The SCNR can therefore simultaneously activate both CH4 and H2O molecules while oxidizing the CH* and improving coking tolerance. We then applied SCNR as the CH4-SOFC anode catalytic reforming layer. A peak power density of 733 mW cm-2 was achieved at 650 °C, representing a 55% improvement compared to that of pristine CH4-SOFCs (473 mW cm-2). Moreover, long-term durability testing, with >2000 h continuous operation, was performed under almost dry methane (5% H2O). These results highlight that CH4-SOFCs with a SCNR catalytic layer can convert NG to electricity with high efficiency and resilience.

[Radical Resection Followed by Chemotherapy for Intrahepatic Cholangiocarcinoma with Lymph Node Metastases-Report of a Long-Term Survivor].

We report a case of intrahepatic cholangiocarcinoma(ICC)with lymph node metastases in which long-term survival was achieved after surgery followed by chemotherapy. A 69-year-old man underwent left hepatectomy, extrahepatic bile duct resection, and lymph node dissection for ICC located mainly in segment 4 of the liver with enlarged lymph nodes in the hepatoduodenal ligament. The histopathologically confirmed diagnosis was ICC(T2N1M0, Stage ⅣA)with 3 positive lymph nodes(No. 12a1, No. 12p1, and No. 12p2). He received chemotherapy with gemcitabine(GEM)plus cisplatin(CDDP)for 9 months, followed by GEM monotherapy for 4 months, and then S-1 monotherapy was started. A right lung nodule was detected 12 months after the initiation of S-1 monotherapy. He received GEM plus S-1 therapy for 28 months, followed by S-1 monotherapy, leading to disappearance of the lung nodule. He remains alive and well without disease 78 months after surgery. Our experience in this case suggests that radical resection followed by chemotherapy may provide a survival benefit in selected patients who have ICC with nodal disease.

Preoperative controlling nutritional status score predicts systemic disease recurrence in patients with resectable biliary tract cancer.

INTRODUCTION: This study aimed to evaluate the association between the preoperative Controlling Nutritional Status (CONUT) score, survival outcomes, and recurrence pattern in patients with resectable biliary tract cancer (BTC). METHODS: A total of 224 BTC patients (gallbladder, n = 69; intrahepatic bile ducts, n = 26; perihilar bile ducts, n = 72; distal bile duct, n = 57) who underwent surgery with curative intent were enrolled. The best cutoff point of the preoperative CONUT score in discriminating survival was determined using χ2 scores. The sites of recurrence were subclassified as locoregional or distant. RESULTS: Patients were subdivided into the CONUT-low (score ≤ 3, n = 156) and the CONUT-high (score > 3; n = 68) groups. In-hospital mortality occurred more frequently in the CONUT-high group than in the CONUT-low group (7.4% vs. 1.3%; p = 0.028). A high preoperative CONUT score was independently associated with worse overall survival (hazard ratio [HR] 1.906, p = 0.001), worse disease-specific survival (HR 1.840, p = 0.006), and worse recurrence-free survival (HR 1.680, p = 0.005). Recurrence developed in 110 (49.1%) patients. A high preoperative CONUT score was independently associated with a higher risk of distant recurrence (HR 2.245, p = 0.001), but not locoregional recurrence. The incidences of distant recurrence at 5 years were 55.4% and 34.2% in the CONUT-high and CONUT-low groups, respectively (p = 0.001). CONCLUSIONS: The preoperative CONUT score independently predicts survival outcomes and may serve as a surrogate marker of aggressive systemic disease recurrence in patients with resectable BTC.

[Surgery for Cholangiocarcinoma with Superficial Spread and Lymph Node Metastasis-Report of a Long-Term Survivor Who Had Positive Proximal Ductal Resection Margins with Carcinoma In Situ].

A 66-year-old man was referred to our hospital with fever and abdominal pain. CT showed a mass in the intrapancreatic bile duct but no wall thickness in the perihilar bile ducts. Neither regional lymphadenopathy nor distant metastasis was observed. Biliary cytology showed adenocarcinoma. The diagnosis was distal cholangiocarcinoma, and pancreatoduodenectomy was performed. Intraoperative frozen section examination of the ductal resection margins at the right and left hepatic ducts was positive for carcinoma in situ, and the operation ultimately completed with R1 resection. Histological examination confirmed a diagnosis of cholangiocarcinoma with superficial spread and a single positive lymph node. Adjuvant chemotherapy with S-1 was administered for 1 year. Anastomotic recurrence at the hepaticojejunostomy was found 5 years after resection; biopsy specimens revealed adenocarcinoma. Thereafter, S-1 chemotherapy was resumed, and the patient remains alive and well 9 years and 1 month after resection.

[A Case of Intraductal Papillary Mucinous Adenocarcinoma with Hepatic Dysfunction Due to Tumor Perforation into the Bile Duct].

A 58-year-old woman presented with a complaint of weight loss. Abdominal computed tomography showed dilatation of the biliary and pancreatic ducts and a mural nodule in the pancreatic duct. The diagnosis was intraductal papillary mucinous neoplasm(IPMN). Endoscopic retrograde cholangiopancreatography(ERCP)and cholangioscopy revealed a fistula between the common bile duct and the IPMN. A sudden increase in hepatobiliary enzymes was noted preoperatively. ERCP showed that the common bile duct was obstructed by mucus. A nasobiliary drainage tube was inserted into the bile duct endoscopically and kept open by daily tube washing, and the liver dysfunction improved. Total pancreatectomy, splenectomy, and regional lymph node dissection were performed. Histological examination confirmed that the primary tumor was mixed invasive intraductal papillary mucinous adenocarcinoma. The patient remains alive and well with no evidence of recurrence 18 months after resection.

[Two Operations for Intrahepatic Recurrence of Biliary Cystadenocarcinoma-A Long-Term Survivor].

We report a case of biliary cystadenocarcinoma in which long-term survival was achieved after 2 operations for intrahepatic recurrence. A 72-year-old man with biliary cystadenocarcinoma located mainly in segment 3 of the liver underwent left hepatectomy, extrahepatic bile duct resection, and lymph node dissection. Seven years and 9 months after the initial resection, he underwent partial liver resection(segment 5)for intrahepatic recurrence detected by computed tomography. Fifteen years and 7 months after the initial resection, he underwent repeat partial resection of the liver(segment 5)for intrahepatic recurrence. Histologically, these tumors were confirmed to be recurrence of biliary cystadenocarcinoma. He remains alive and well with no further recurrence 21 years and 6 months after the initial resection. This case and a literature review suggest that hepatic resection is a useful treatment option for intrahepatic recurrence of biliary cystadenocarcinoma.

Nanocomposite Catalyst for High-Performance and Durable Intermediate-Temperature Methane-Fueled Metal-Supported Solid Oxide Fuel Cells.

CH4-fueled metal-supported solid oxide fuel cells (CH4-MS-SOFCs) are propitious as CH4 is low-priced and readily available, and its renewable production is possible, such as biomethane. However, the current CH4-MS-SOFCs suffer from either poor power density or short durable operation, which is ascribed to the low catalytic activity and poor coking tolerance of the metallic anode support. Herein, we have deliberately designed and synthesized a highly active nanocomposite catalyst, Sm-doped CeO2-supported Ni, as the internal steam methane reforming catalyst, to optimize CH4-MS-SOFCs. Both power densities and durability of optimized CH4-MS-SOFCs have been dramatically enhanced compared to the pristine CH4-MS-SOFCs. The optimized CH4-MS-SOFCs deliver the highest performances among all zirconia-based CH4-MS-SOFCs. Furthermore, the operating temperature has been reduced to 600 °C. At 600 °C, a viable peak power density of >350 mW/cm2 is achieved, which is more than three times as high as the pristine CH4-MS-SOFCs. Furthermore, the optimized CH4-MS-SOFC achieves >1000 h of stable operation.

High-Performance, Thermal Cycling Stable, Coking-Tolerant Solid Oxide Fuel Cells with Nanostructured Electrodes.

Solid oxide fuel cells (SOFCs) are a promising solution to a sustainable energy future. However, cell performance and stability remain a challenge. Durable, nanostructured electrodes fabricated via a simple, cost-effective method are an effective way to address these problems. In this work, both the nanostructured PrBa0.5Sr0.5Co1.5Fe0.5O5+δ (PBSCF) cathode and Ni-Ce0.8Sm0.2O1.9 (SDC) anode are fabricated on a porous yttria-stabilized zirconia (YSZ) backbone via solution infiltration. Symmetrical cells with a configuration of PBSCF|YSZ|PBSCF show a low interfacial polarization resistance of 0.03 Ω cm2 with minimal degradation at 700 °C for 600 h. Ni-SDC|YSZ|PBSCF single cells exhibit a peak power density of 0.62 W cm-2 at 650 °C operated on H2 with good thermal cycling stability for 110 h. Single cells also show excellent coking tolerance with stable operation on CH4 for over 120 h. This work offers a promising pathway toward the development of high-performance and durable SOFCs to be powered by natural gas.

Comparison of physical image qualities and artifact indices for head computed tomography in the axial and helical scan modes.

This study aimed to validate the clinically demonstrated equivalency of the axial and helical scan modes (AS and HS, respectively) for head computed tomography (CT) using physical image quality measures and artifact indices (AIs). Two 64-row multi-detector row CT systems (CT-A and CT-B) were used for comparing AS and HSs with detector rows of 64 and 32. The modulation transfer function (MTF), noise power spectrum (NPS), and slice sensitivity profile were measured using a CT dose index corresponding to clinical use. The system performance function (SPF) was calculated as MTF2/NPS. The AI of streak artifacts in the skull base was measured using an image obtained of a head phantom, while the AI of motion artifacts was measured from images obtained during the head phantom was in motion. For CT-A, the 50%MTFs were 7% to 9% higher in the HS than the AS, and the higher MTFs of HS associated NPS increases. For CT-B, the MTFs and NPSs were almost equivalent between the AS and HS, respectively. Consequently, the SPFs of AS and HS were nearly identical for both CT systems. For both CT systems, the skull base AI did not differ significantly between AS and HS, while the motion AIs of HS were significantly better than of AS. The superior motion AI in the HS indicated the effectiveness of HS on moving patients.

Successful Surgical Intervention for Recurring Severe Hepatic Encephalopathy Caused by Portosystemic Collaterals After Living-Donor Liver Transplantation: A Case Report.

INTRODUCTION: Portosystemic collaterals (PsC) are a common finding in patients with cirrhosis who need liver transplantation (LT), and PsCs may cause several problems before and after LT. We report a case of successful surgical treatment of severe hepatic encephalopathy (HE) caused by PsC after living-donor LT (LDLT). CASE: A 71-year-old woman with hepatocellular carcinoma underwent LDLT for chronic hepatitis C virus infection at 64 years of age. The splenocaval collateral vein was ligated during LDLT to prevent portal flow steal. A recurrent episode of coma due to HE was triggered 7 years after LDLT and gradually became refractory to any drug treatments. Contrast-enhanced computed tomography revealed the development of the right gastroepiploic vein (RGEV), which flowed to the inferior vena cava via the inferior mesenteric vein (IMV). Owing to the chronic kidney disease (estimated glomerular filtration rate, 11-31 mL/min), interventional radiology (IVR) was not indicated, so surgical treatment was selected to treat the symptom. PsC was resected at the point of the RGEV and IMV, just before flowing into the IVC with vascular staplers. Antegrade portal blood flow was obtained by ultrasonography 2 days after surgery, and the patient was discharged from the hospital 26 days after the operation. After discharge, she has had no recurrent episode of HE. CONCLUSION: Surgical resection of the PsC was effective for treatment of HE caused by shunt flow after LDLT.

Giant Fold Gastritis Induced by Epoprostenol Infusion in Patients With Pulmonary Arterial Hypertension.

BACKGROUND: Epoprostenol infusion is the strongest and most convincing therapeutic strategy for severe pulmonary arterial hypertension (PAH). This study investigated the gastrointestinal side effects of epoprostenol. Methods and Results: The study group of 12 patients treated with epoprostenol (epoprostenol group) and 4 patients without epoprostenol (control group) underwent stomach barium examination, which revealed that the prevalence of giant fold gastritis was significantly higher in the patients treated with epoprostenol (75% in epoprostenol group vs. 0% in control group; P=0.019). CONCLUSIONS: Giant fold gastritis may be an important side effect of epoprostenol infusion.

Comparative evaluation of image quality among different detector configurations using area detector computed tomography.

The 320-detector row computed tomography (CT) system, i.e., the area detector CT (ADCT), can perform helical scanning with detector configurations of 4-, 16-, 32-, 64-, 80-, 100-, and 160-detector rows for routine CT examinations. This phantom study aimed to compare the quality of images obtained using helical scan mode with different detector configurations. The image quality was measured using modulation transfer function (MTF) and noise power spectrum (NPS). The system performance function (SP), based on the pre-whitening theorem, was calculated as MTF2/NPS, and compared between configurations. Five detector configurations, i.e., 0.5 × 16 mm (16 row), 0.5 × 64 mm (64 row), 0.5 × 80 mm (80 row), 0.5 × 100 mm (100 row), and 0.5 × 160 mm (160 row), were compared using a constant volume CT dose index (CTDIvol) of 25 mGy, simulating the scan of an adult abdomen, and with a constant effective mAs value. The MTF was measured using the wire method, and the NPS was measured from images of a 20-cm diameter phantom with uniform content. The SP of 80-row configuration was the best, for the constant CTDIvol, followed by the 64-, 160-, 16-, and 100-row configurations. The decrease in the rate of the 100- and 160-row configurations from the 80-row configuration was approximately 30%. For the constant effective mAs, the SPs of the 100-row and 160-row configurations were significantly lower, compared with the other three detector configurations. The 80- and 64-row configurations were adequate in cases that required dose efficiency rather than scan speed.

[Mixed Type Liposarcoma with Intra-Abdominal Bleeding - Report of a Case].

A 71-year-old man presented with sudden abdominal pain. He had past history of atrial fibrillation, cerebral infarction and heart-valve replacement and received anticoagulant therapy with warfarin. Computed tomography of the abdomen revealed bloody ascites and a huge mass in contact with the third portion of the duodenum. The mass was encapsulated and consisted of a solid component with calcification and hematoma. Under the preoperative diagnosis of gastrointestinal stromal tumor with intra-abdominal bleeding, laparotomy was performed. Intraoperative findings revealed the tumor arising from the right mesocolon and excision of the tumor with right hemicolectomy was performed. Histologic examination confirmed a diagnosis of mixed type liposarcoma. No postoperative complication was observed and he was discharged home on the 8th postoperative day. He remains alive and well with no evidence of disease 52 months after resection.

[Evaluation of low-contrast detectability in low-dose chest computed tomography].

We investigated whether low-contrast resolution evaluation can be applied to chest (lung field) computed tomography (CT) images that are commonly reconstructed using filter kernels with strong frequency emphasis and displayed at wide window widths. We assumed low dose chest CT examinations and set the current-time product to 5 and 10 mAs. The visual detection study was performed by five radiological technologists using water phantom images in which the simulated low contrast objects (disc objects) were implanted. In addition, values of the low contrast detectability index (LCDI) based on a signal-to-noise ratio theorem were calculated from the modulation transfer factor, noise power spectrum, and the object's spectrum for each combination of object size, contrast, current-time product, and kernel. The detectability results correlated well with the LCDI values and correlated less well with the contrast-to-noise ratio results. These results were consistent with the results of past reports on abdomen images. Therefore, our results indicated that low contrast sensitivity can be applied to chest CT images as well as abdominal ones.

[Examination of motion artifacts for helical and non-helical scanning modes in head CT].

For head computed tomography (CT), non-helical scanning has been recommended even in the widely used multi-slice CT (MSCT). Also, an acute stroke imaging standardization group has recommended the non-helical mode in Japan. However, no detailed comparison has been reported for current MSCT with more than 16 slices. In this study, we compared the non-helical and helical modes for head CT, focusing on temporal resolution and motion artifacts. The temporal resolution was evaluated by using temporal sensitivity profiles (TSPs) measured using a temporal impulse method. In both modes, the TSPs and temporal modulation transfer factors (MTFs) were measured for various pitch factors using 64-slice CT (Aquilion 64, Toshiba). Two motion phantoms were scanned to evaluate motion artifacts, and then quantitative analyses for motion artifacts and helical artifacts were performed by measuring multiple regions of interest (ROIs) in the phantom images. In addition, the rates of artifact occurrence for retrospective clinical cases were compared. The temporal resolution increased as the pitch factor was increased. Remarkable streak artifacts appeared in the non-helical images of the motion phantom, in spite of the equivalent effective temporal resolution. In clinical analysis, results consistent with the phantom studies were shown. These results indicated that the low pitch helical mode would be effective for emergency head CT with patient movement.

Complex hydrides with (BH(4))(-) and (NH(2))(-) anions as new lithium fast-ion conductors.

Some of the authors have reported that a complex hydride, Li(BH(4)), with the (BH(4))(-) anion exhibits lithium fast-ion conduction (more than 1 x 10(-3) S/cm) accompanied by the structural transition at approximately 390 K for the first time in 30 years since the conduction in Li(2)(NH) was reported in 1979. Here we report another conceptual study and remarkable results of Li(2)(BH(4))(NH(2)) and Li(4)(BH(4))(NH(2))(3) combined with the (BH(4))(-) and (NH(2))(-) anions showing ion conductivities 4 orders of magnitude higher than that for Li(BH(4)) at RT, due to being provided with new occupation sites for Li(+) ions. Both Li(2)(BH(4))(NH(2)) and Li(4)(BH(4))(NH(2))(3) exhibit a lithium fast-ion conductivity of 2 x 10(-4) S/cm at RT, and the activation energy for conduction in Li(4)(BH(4))(NH(2))(3) is evaluated to be 0.26 eV, less than half those in Li(2)(BH(4))(NH(2)) and Li(BH(4)). This study not only demonstrates an important direction in which to search for higher ion conductivity in complex hydrides but also greatly increases the material variations of solid electrolytes.