207 research outputs found

    Increased serum HO-1 in hemophagocytic syndrome and adult-onset Still's disease: use in the differential diagnosis of hyperferritinemia

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    Heme oxygenase-1 (HO-1), an inducible heme-degrading enzyme, is expressed by macrophages and endothelial cells in response to various stresses. Because ferritin synthesis is stimulated by Fe(2+), which is a product of heme degradation, we examined the relation between HO-1 and ferritin levels in the serum of patients with hemophagocytic syndrome (HPS), adult-onset Still's disease (ASD), and other diseases that may cause hyperferritinemia. Seven patients with HPS, 10 with ASD, 73 with other rheumatic diseases, 20 with liver diseases, 10 recipients of repeated blood transfusion because of hematological disorders, and 22 healthy volunteers were enrolled. Serum HO-1 and ferritin levels were determined by ELISA. Expression of HO-1 mRNA and protein by peripheral blood mononuclear cells (PBMCs) was determined by real-time PCR and immunocytochemical techniques, respectively. Serum levels of HO-1 were significantly higher in patients with active HPS and ASD than in the other groups (P < 0.01). HO-1 levels were not elevated in patients with other causes of hyperferritinemia but were moderately elevated in patients with dermatomyositis/polymyositis. Among patients with HPS and ASD, serum HO-1 levels correlated closely with serum ferritin levels, and the levels of both returned to normal after therapy had induced remission. Increased expression of HO-1 mRNA was confirmed in PBMCs from some patients with HPS and ASD. Hyperferritinemia correlated closely with increased serum HO-1 in patients with HPS and ASD but not other conditions, indicating that measurement of serum HO-1 and ferritin levels would be useful in the differential diagnosis of hyperferritinemia and perhaps also in monitoring disease activity in HPS and ASD

    Management of vocal fold lesions in difficult laryngeal exposure patients in phonomicrosurgery.

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    [Objectives]Endolaryngeal microsurgery using a direct laryngoscope is a well-established procedure in phonosurgery. Adequate laryngeal exposure is essential, but in some cases sufficient view of the glottis cannot be obtained, leading to treatment failure. This study reports how to manage vocal fold lesions in difficult laryngeal exposure (DLE) cases. [Methods]From 2003 to 2009, 212 patients underwent endolaryngeal microsurgery at Kyoto Medical Center and Kyoto University Hospital. Phonomicrosurgery was performed under sniffing (Boyce–Jackson) position with triangular shaped laryngoscope for laryngeal exposure. However, in DLE cases, the posture and laryngoscope were modified as needed to adequately expose the lesion. Fiberoptic laryngeal surgery (FLS) with local anesthesia was also used for the most difficult cases. [Results]The number of the patients with DLE was 14 (6.6%). Endolaryngeal microsurgery was possible in DLE cases by selecting the appropriate posture and laryngoscope. However, the procedure could not be completed in two patients with an anterior web and a vocal fold cyst, both of which required a subsequent revision procedure. Fiberoptic laryngeal surgery with topical anesthesia was a feasible alternative for these cases. [Conclusions]Phonosurgery was possible even in DLE cases. It is important to modify the setup of direct laryngoscopy as needed to obtain adequate exposure. Fiberoptic surgery may also be used in certain difficult cases

    Association of glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS): a cross-sectional study

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    Background While survival of systemic lupus erythematosus (SLE) patients has improved substantially, problems remain in the management of their emotional health. Medium to high-dose glucocorticoid doses are known to worsen emotional health; the effect is unclear among patients receiving relatively low-dose glucocorticoids. This study aims to investigate the association between low glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS). Methods This cross-sectional study drew on data from SLE patients in 10 Japanese institutions. The participants were adult patients with SLE duration of >= 1 year who met LLDAS criteria at the study visit from April 2018 through September 2019. The exposure was the daily glucocorticoid dose (mg oral prednisolone). The outcome was the emotional health score of the lupus patient-reported outcome scale (range: 0 to 100). Multiple linear regression analysis was performed with adjustment for confounders including disease-related damage, activity, and psychotropic drug use. Results Of 192 patients enrolled, 175 were included in the analysis. Their characteristics were as follows: female, 89.7%; median age, 47 years (interquartile range (IQR): 37.0, 61.0). Median glucocorticoid dose was 4.0 mg (IQR 2.0, 5.0), and median emotional health score 79.2 (IQR 58.3, 91.7). Multiple linear regression analysis showed daily glucocorticoid doses to be associated with worse emotional health (beta coefficient = - 2.54 [95% confidence interval - 4.48 to - 0.60], P = 0.01). Conclusions Daily glucocorticoid doses were inversely associated with emotional health among SLE patients in LLDAS. Further studies are needed to determine whether glucocorticoid tapering leads to clinically significant improvements in emotional health

    Imaging of radiation during impurity gas puffing in LHD

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    In LHD, several methods of detachment have been attempted, including impurity gaspuffing [1], and the application of an m/n=1/1 magnetic perturbation [2]. LHD is equipped with an imaging bolometer (IRVB) [3] that views the plasma from an upper port. Two scenarios are shown and compared, Ne puffing and N2 puffing. In the case of Ne puffing, radiation becomes more intense near the helical divertor X-point as the radiation increases. In the case of N2 puffing, a double stripe pattern evolves around the upper helical divertor X-point, which appears to be localized near the gas puff inlet. In addition, probe data also indicates that the drop in divertor flux with N2 is localized, while uniform with Ne

    3D effects of edge magnetic field configuration on divertor/scrape-off layer transport and optimization possibilities for a future reactor

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    This paper assesses the three-dimensional (3D) effects of the edge magnetic field structure on divertor/scrape-off layer transport, based on an inter-machine comparison of experimental data and on the recent progress of 3D edge transport simulation. The 3D effects are elucidated as a consequence of competition between transports parallel (\parallel ) and perpendicular (\bot ) to the magnetic field, in open field lines cut by divertor plates, or in magnetic islands. The competition has strong impacts on divertor functions, such as determination of the divertor density regime, impurity screening and detachment control. The effects of magnetic perturbation on the edge electric field and turbulent transport are also discussed. Parameterization to measure the 3D effects on the edge transport is attempted for the individual divertor functions. Based on the suggested key parameters, an operation domain of the 3D divertor configuration is discussed for future devices