Case Report: Kawasaki disease associated with acute generalized exanthematous pustulosis secondary to carbocysteine

Acute generalized exanthematous pustulosis (AGEP) is an uncommon eruption characterized by sterile pustules on an erythematous background, which is usually associated with drugs. AGEP is described as a self-limiting disease with favorable prognosis. We reported a case of Kawasaki Disease (KD) following AGEP. A 3-year-old male, who was admitted with pustules and five days of fever at our hospital, was diagnosed with AGEP. Despite the skin lesions and fever improving drastically after prednisolone therapy, the fever recurred on hospitalization day 5. The following symptoms suggestive of KD also appeared: bulbar conjunctival hyperemia, cervical lymphadenopathy, erythema of the lips, eruption on his trunk, and erythema and edema of the hands and feet. He was diagnosed with KD and treated with intravenous immunoglobulin. He was discharged on the thirteenth day of hospitalization without cardiac complications. Drug-induced lymphocyte stimulation test revealed carbocysteine as the suspected cause of AGEP, which consequently triggered KD. Because a mucosal lesion is uncommon in AGEP, bulbar conjunctival hyperemia suggested that KD sequentially occurred after AGEP. Since AGEP is benign and self-limited in most cases, it is necessary to differentiate other diseases, including KD, when recurrent fever or rash occurs in the course of AGEP

Dealing with Disasters: Environmental History of Early Modern Cities (Edo, Istanbul, London, Pest, and Prague)

List of ContributorsForeword Introduction The Ordinary and the Extraordinary in Early Modern Cities / Koichi Watanabe trans. by Hisashi Kuboyama Part I: Aspects of Urban Disasters Chapter 1 Typhoon Damage in 1856 Edo: Integrating Archaeology, Climatology and History / Koichi Watanabe, Junpei Hirano, Hiroyuki Ishigami, and Masumi Zaiki trans. by Hisashi Kuboyama Chapter 2 The Great Flood in Pest, 1838 / Csaba Katona Chapter 3 Fire Disasters in European Cities, 1600-1800 David Garrioch Comment Disaster of Beijing in the Qing Dynasty 1644-1911 / Akira Horichi trans. by Yoko Onodera Part II: Disasters and Responses Chapter 4 Prevent the Big Water. Flood Control Measures in Prague (Bohemia) Issued by Public Administrative Bodies in Late 18th Century / Ondřej Hudeček Chapter 5 Citizens’ Awareness of Firefighting in Edo: Analysing Eighteenth-Century Textbooks on Firefighting / Reiji Iwabuchi trans. by Hisashi Kuboyama Part III: Infrastructure as Artificial Nature Chapter 6 The Ordinary Made Extraordinary: The Archaeology of Water Management in a Global City / Sophie Jackson Chapter 7 Management and Civil Engineering of Urban Water Supply and Sewage System in Edo as Seen from Archaeological Excavation / Hiroyuki Ishigami trans. by Mina Ishizu Chapter 8 Dredging the Edo Castle\u27s Moat: a Case of the Okayama-Domain Dredging in 1765 / Reiji Iwabuchi trans. by Naoko Nomoto Chapter 9 Canal, Dredging and Sedimentation in the Lowland Area of East Edo: Considering Physical and Spatial Characteristics of Canals in a Historical Context / Genki Takahashi trans. by Hisashi Kuboyama Part IV: Hinterland and Nature Chapter 10 Flooding in Edo and the Tone-gawa River and Tama-gawa River Systems / Koichi Watanabe trans. by Hisashi Kuboyama Chapter 11 The Great Edo Flood of 1742 and the Okutama Valley / Koichi Watanabe trans. by Hisashi Kuboyama Chapter 12 The Deluge of Istanbul in 1563: a Case of Flood Where There Was No River / Kazuaki Sawai trans. by Yoko Onodera Chapter 13 Storms, Flooding and the Development of London 1300-1500 / Matthew Davies Chapter 14 Bridging London’s River’s General Situation of London, the Thames, the Bridge / Vanessa Hardin

DataSheet1_Noninvasive characterization of peripheral sympathetic activation across sensory stimuli using a peripheral arterial stiffness index.PDF

Introduction: The peripheral arterial stiffness index has been proposed and validated as a noninvasive measure quantifying stimulus intensity based on amplitude changes induced by sympathetic innervation of vascular tone. However, its temporal response characteristics remain unclear, thus hindering continuous and accurate monitoring of the dynamic process of sympathetic activation. This paper presents a study aimed at modeling the transient response of the index across sensory stimuli to characterize the corresponding peripheral sympathetic activation.Methods: The index was measured using a continuous arterial pressure monitor and a pulse oximeter during experiments with local pain and local cooling stimuli designed to elicit different patterns of sympathetic activation. The corresponding response of the index was modeled to clarify its transient response characteristics across stimuli.Results: The constructed transfer function accurately depicted the transient response of the index to local pain and local cooling stimuli (Fit percentage: 78.4% ± 11.00% and 79.92% ± 8.79%). Differences in dead time (1.17 ± 0.67 and 0.99 ± 0.56 s, p = 0.082), peak time (2.89 ± 0.81 and 2.64 ± 0.68 s, p = 0.006), and rise time (1.81 ± 0.50 and 1.65 ± 0.48 s, p = 0.020) revealed different response patterns of the index across stimuli. The index also accurately characterized similar vasomotor velocities at different normalized peak amplitudes (0.19 ± 0.16 and 0.16 ± 0.19 a.u., p = 0.007).Discussion: Our findings flesh out the characterization of peripheral arterial stiffness index responses to different sensory stimuli and demonstrate its validity in characterizing peripheral sympathetic activation. This study valorizes a noninvasive method to characterize peripheral sympathetic activation, with the potential to use this index to continuously and accurately track sympathetic activators.</p

Inner-bond-cleavage approach to figure-eight macrocycles from planar aromatic hydrocarbons

Contemporary synthetic strategies in organic chemistry rely heavily on the stepwise formation of bonds between fragments of the target compound (‘bottom-up’ approach). Figure-eight aromatic macrocycles represent a considerable challenge for the bottom-up approach, and the lack of versatile synthetic routes to such macrocycles prevents the use of their distinctive chiral D2-symmetric structures in advanced materials. Herein, we demonstrate the oxidative cleavage of internal double bonds of planar polycyclic aromatic hydrocarbons enables the scalable, catalytic, and enantioselective synthesis of figure-eight macrocycles. These macrocycles, with incorporated carbonyl groups, serve as a chiral electron-acceptor unit to furnish a thermally activated delayed fluorescence material with efficient circularly polarized luminescence. The inner-bond-cleavage approach is thus an effective alternative to the bottom-up approach, proving access to hitherto inaccessible materials

A novel mutation in IKBKG gene in a female child with incontinentia pigmenti

Incontinentia pigmenti (IP; OMIM# 308300) is a rare inherited disease caused by a mutation of IKBKG, which is also known as NEMO, located on Xq28. IP patients usually present with abnormalities of skin, eyes, nails and central nervous system. The neurological damege, which occur usually from neonatal through the early infantile period, leads to neulogical complication such as development retardation, motor paralysis and epilepsy. However, there has been little study done concerning the effect of therapy for the neural abnormalities. We have investigated the clinical findings in a female IP case with a novel mutation of IKBKG for six years due to disclosing the neurological prognosis and the immunological features. It is hoped that the present study will contribute to a better management of IP patients

Subcortical volumetric alterations in four major psychiatric disorders: a mega-analysis study of 5604 subjects and a volumetric data-driven approach for classification.

Differential diagnosis is sometimes difficult in practical psychiatric settings, in terms of using the current diagnostic system based on presenting symptoms and signs. The creation of a novel diagnostic system using objective biomarkers is expected to take place. Neuroimaging studies and others reported that subcortical brain structures are the hubs for various psycho-behavioral functions, while there are so far no neuroimaging data-driven clinical criteria overcoming limitations of the current diagnostic system, which would reflect cognitive/social functioning. Prior to the main analysis, we conducted a large-scale multisite study of subcortical volumetric and lateralization alterations in schizophrenia, bipolar disorder, major depressive disorder, and autism spectrum disorder using T1-weighted images of 5604 subjects (3078 controls and 2526 patients). We demonstrated larger lateral ventricles volume in schizophrenia, bipolar disorder, and major depressive disorder, smaller hippocampus volume in schizophrenia and bipolar disorder, and schizophrenia-specific smaller amygdala, thalamus, and accumbens volumes and larger caudate, putamen, and pallidum volumes. In addition, we observed a leftward alteration of lateralization for pallidum volume specifically in schizophrenia. Moreover, as our main objective, we clustered the 5,604 subjects based on subcortical volumes, and explored whether data-driven clustering results can explain cognitive/social functioning in the subcohorts. We showed a four-biotype classification, namely extremely (Brain Biotype [BB] 1) and moderately smaller limbic regions (BB2), larger basal ganglia (BB3), and normal volumes (BB4), being associated with cognitive/social functioning. Specifically, BB1 and BB2-3 were associated with severe and mild cognitive/social impairment, respectively, while BB4 was characterized by normal cognitive/social functioning. Our results may lead to the future creation of novel biological data-driven psychiatric diagnostic criteria, which may be expected to be useful for prediction or therapeutic selection