Treatment for Churg-Strauss Syndrome: Induction of Remission and Efficacy of Intravenous Immunoglobulin Therapy

ABSTRACTChurg-Strauss syndrome (CSS) is characterized by the presence of asthma, eosinophilia, and small-vessel vasculitis with granuloma. It is a distinct entity, as determined from all classifications of systemic vasculitis. The poor prognostic factors in CSS are renal insufficiency, cardiomyopathy, severe gastrointestinal (GI) tract, and central nervous systems (CNS) involvement. The initial management of CSS should include a high dose of a corticosteroid: prednisone at 1 mg/kg/day or its equivalent for methylprednisolone with tapering over 6 months. In patients with severe or rapidly progressing CSS, the administration of methylprednisolone pulse at 1 g/body/day for 3 days is recommended. When corticosteroid therapy does not induce remission, or when patients have poor prognostic factors, immunosuppressive cytotoxic therapy is indicated. However, some patients with severe CSS often show resistance to conventional treatment. We think that IVIG therapy is a hopeful candidate for second-line treatment for CSS patients, particularly in the case of neuropathy and/or cardiomyopathy, which are resistant to conventional therapy. However, there is not much evidence supporting the effectiveness of IVIG in CSS, and the mechanisms underlying the action of IVIG remain unclear. Now we are performing clinical trials of IVIG therapy for CSS patients who are resistant to conventional treatment, through a nationwide double-blinded placebo-controlled study in Japan

Radial Transport Characteristics of Fast Ions Due to Energetic-Particle Modes inside the Last Closed-Flux Surface in the Compact Helical System

The internal behavior of fast ions interacting with magnetohydrodynamic bursts excited by energetic ions has been experimentally investigated in the compact helical system. The resonant convective oscillation of fast ions was identified inside the last closed-flux surface during an energetic-particle mode (EPM) burst. The phase difference between the fast-ion oscillation and the EPM, indicating the coupling strength between them, remains a certain value during the EPM burst and drives an anomalous transport of fast ions

Present Status in the Development of 6 MeV Heavy Ion Beam Probe on LHD

In order to measure the potential in Large Helical Device (LHD), we have been developing a heavy ion beam probe (HIBP). For probing beam, gold beam is used, which is accelerated by a tandem accelerator up to the energy of 6 MeV. The experiments for calibration of beam orbit were done, and experimental results were compared with orbit calculations. The experimental results coincided fairly with the calculation results. After the calibration of the beam orbit, the potential in plasma was tried to measure with the HIBP. The experimental data showed positive potential in a neutral beam heating phase on the condition of ne ? 5 × 10^18 m^-3, and the increase of potential was observed when the additional electron cyclotron heating was applied to this plasma. The time constant for this increase was about a few tens ms, which was larger than a theoretical expectation. In the spatial position of sample volume, we might have an ambiguity in this experiment

Anti-Aβ Drug Screening Platform Using Human iPS Cell-Derived Neurons for the Treatment of Alzheimer's Disease

Background:Alzheimer's disease (AD) is a neurodegenerative disorder that causes progressive memory and cognitive decline during middle to late adult life. The AD brain is characterized by deposition of amyloid β peptide (Aβ), which is produced from amyloid precursor protein by β- and γ-secretase (presenilin complex)-mediated sequential cleavage. Induced pluripotent stem (iPS) cells potentially provide an opportunity to generate a human cell-based model of AD that would be crucial for drug discovery as well as for investigating mechanisms of the disease. Methodology/Principal Findings:We differentiated human iPS (hiPS) cells into neuronal cells expressing the forebrain marker, Foxg1, and the neocortical markers, Cux1, Satb2, Ctip2, and Tbr1. The iPS cell-derived neuronal cells also expressed amyloid precursor protein, β-secretase, and γ-secretase components, and were capable of secreting Aβ into the conditioned media. Aβ production was inhibited by β-secretase inhibitor, γ-secretase inhibitor (GSI), and an NSAID; however, there were different susceptibilities to all three drugs between early and late differentiation stages. At the early differentiation stage, GSI treatment caused a fast increase at lower dose (Aβ surge) and drastic decline of Aβ production. Conclusions/Significance:These results indicate that the hiPS cell-derived neuronal cells express functional β- and γ-secretases involved in Aβ production; however, anti-Aβ drug screening using these hiPS cell-derived neuronal cells requires sufficient neuronal differentiation

Isotope effects on transport in LHD

Isotope effects are one of the most important issues for predicting future reactor operations. Large helical device (LHD) is the presently working largest stellarator/helical device using super conducting helical coils. In LHD, deuterium experiments started in 2017. Extensive studies regarding isotope effects on transport have been carried out. In this paper, the results of isotope effect studies in LHD are reported. The systematic studies were performed adjusting operational parameters and nondimensional parameters. In L mode like normal confinement plasma, where internal and edge transport barriers are not formed, the scaling of global energy confinement time (τE) with operational parameters shows positive mass dependence (M0.27; where M is effective ion mass) in electron cyclotron heating plasma and no mass dependence (M0.0) in neutral beam injection heating plasma. The non-negative ion mass dependence is anti-gyro-Bohm scaling. The role of the turbulence in isotope effects was also found by turbulence measurements and gyrokinetic simulation. Better accessibility to electron and ion internal transport barrier (ITB) plasma is found in deuterium (D) plasma than in hydrogen (H). Gyro kinetic non-linear simulation shows reduced ion heat flux due to the larger generation of zonal flow in deuterium plasma. Peaked carbon density profile plays a prominent role in reducing ion energy transport in ITB plasma. This is evident only in plasma with deuterium ions. New findings on the mixing and non-mixing states of D and H particle transports are reported. In the mixing state, ion particle diffusivities are higher than electron particle diffusivities and D and H ion density profiles are almost identical. In the non-mixing state, ion particle diffusivity is much lower than electron diffusivity. Deuterium and hydrogen ion profiles are clearly different. Different turbulence structures were found in the mixing and non-mixing states suggesting different turbulence modes play a role

Calculation of the moisture diffusion coefficient at the adhesive interface of double cantilever beam specimens by studying the fracture surfaces

Adhesives used in aircrafts degrade because of moisture. To understand the fractures at the adhesive interface, moisture diffusion coefficients must be estimated, which is challenging and has not yet been reported. In this study, we prepared double cantilever beam specimens using an aluminum adherend and epoxy adhesives, immersed them in a hot bath, and observed the resultant fracture surfaces. The distance of moisture penetration at the interface was estimated from the fracture morphology, and the diffusion coefficient for moisture penetration into the adhesive was measured using a bulk immersion test. Both these values were used to determine the moisture diffusion coefficient at the adhesive interface, which was ∼3 times higher than that of the bulk. The relationship between immersion temperature and moisture diffusion coefficient of the adhesive interface adhered to the Arrhenius equation, as same as that of bulk

Insights into chemical reactions of graphitic carbon nitride with alkali halides

The calcination of nitrogen-rich molecules, such as melamine and urea, with inorganic salts, results in chemical modifications of graphitic carbon nitride (g-CN), a polymeric photocatalyst driven by visible-light illumination. Alkali halides are abundant and low-cost additives for that purpose and enhance photocatalytic activity. The precursors or condensed carbon nitride polymer react with the salts, even below their melting point; however, the mechanistic understanding of the reaction of g-CN with alkali halides is still unknown. In this study, we investigated reactions of melon, a linear polymer of heptazine monomers, with NaCl, employing Fourier-transform infrared (IR) spectroscopy in solid and gas phases, solid-state nuclear magnetic resonance spectroscopy, temperature-programmed desorption mass spectrometry (TPD-MS), and thermogravimetry. The reaction of melon with NaCl at 500 °C substitutes a fraction of amino groups with cyanamide moiety and deprotonates NH groups bridging heptazine monomers. The formation of NH _4 Cl during the calcination implied that NaCl reacted with NH _3 that had evolved as a result of the condensation of melon molecules. TPD-MS and gas-phase IR confirmed the presence of NH _3 as well as H _2 O and CO _2 above 400 °C. These gaseous molecules and NaCl lead to NaHCO _3 via the Solvay process reactions. NaHCO _3 is decomposed into Na _2 CO _3 at the calcination temperature. The base and gaseous H _2 O finally cause OH ^− . The resultant hydroxyl anion introduces cyanamide groups into the melon, deprotonates the NH groups, and decomposes a fraction of the polymer into isocyanic acid via the formation of sodium cyamelurate as an intermediate. The reaction mechanisms proposed in this study will promote the molecular understanding of the roles of additives in the modification of the chemical structure of g-CN photocatalysts