Slope inequalities for irregular cyclic covering fibrations

Let $f:S\to B$ be a finite cyclic covering fibration of a fibered surface. We study the lower bound of slope $\lambda_{f}$ when the relative irregularity $q_{f}$ is positive.Comment: 24page

Local delta invariants of weak del Pezzo surfaces with the anti-canonical degree ≥5\geq 5

The delta invariant interprets the criterion for the K-(poly)stability of log terminal Fano varieties. In this paper, we determine the whole local delta invariant for all weak del Pezzo surfaces with the anti-canonical degree $\geq 5$.Comment: 75 page

Reactive oxygen metabolites as a biomarker of congenital heart disease in children

　Brain natriuretic peptide (BNP), as a hematological biomarker, has been widely used in congenital heart disease (CHD). However, its sensitivity and specificity vary depending on age and pathological condition. In the present study, we assessed whether reactive oxygen metabolites (ROMs) and biological antioxidant potential (BAP), as oxidative stress indicators, could be new biomarkers in CHD.　Forty-two patients diagnosed with CHD were enrolled in this study. The levels of ROMs, BAP, BNP, cardiac muscle creatinine kinase, and heart-type fatty acid-binding protein were measured using the findings of echocardiography. The ROM and BNP levels were significantly higher than the standard reference levels. The estimated Qp/Qs correlated mildly with BNP and ROM levels. The medication caused a significant decrease in BNP and ROM levels. The optimal decision, Qp/Qs greater than 1.5, estimated from receiver operator characteristic (ROC) curves was 371 U.CARR (58% sensitivity, 90% specificity) for ROMs, and that for BNP was 28.4 pg/ml (97% sensitivity 45% specificity). Direct comparison of ROMs and BNP did not show significantly different area under the curve values.　ROM levels can be a new biomarker for oxidative stress evaluation in children with CHD at almost the same sensitivity as the previous biomarkers, and an effective indicator when combined with other biomarkers and indicators

Sulfamethoxazole / Trimethoprim confer no change on the clinical course of Kawasaki disease

Kawasaki disease (KD) is one of the most common vasculitis in childhood, but its etiology is still unknown. We hypothesized that Sulfamethoxazole / Trimethoprim (S/T) would inhibit overproduction of cytokine due to heat shock protein produced by intestinal bacteria in patients with KD and improve the clinical course of KD indirectly. We have conducted a prospective study to assess the usefulness of S/T for KD. For patients with KD (S/T group, N=23), we use S/T in addition to the standard treatment in the guidelines such as intravenous immunoglobulin (IVIG) and moderate dose aspirin. The control group (non S/T group, N=32) is patients with KD treated with the standard treatment in the guidelines. The baseline characteristics did not demonstrate notable differences between the two groups. We compare duration of fever, rate of initial IVIG failure, the day of illness membranous desquamation appeared, and the occurrence of coronary artery lesion (CAL) between two groups. Membranous desquamation appeared rather earlier in S/T group than in non S/T group (11.4±3.0 day of illness vs 12.9±3.5 day of illness, P=0.078), but there was no statistically significant difference. Duration of fever (39±59 hours vs 42±57 hours, P=0.41), rate of initial IVIG failure (26% vs 31%, P=0.30), and number of CAL (8.6% vs 9.3%, P=0.87) were found no significant difference between two groups. These data indicated that the use of S/T in acute phase of KD didn\u27t improve any clinical course of KD

Long-term survival with RAS-associated autoimmune leukoproliferative disorder with somatic KRAS mutation:A case report

　RAS -associated autoimmune leukoproliferative disorder (RALD) is a recently reported rare nonmalignant autoimmune disorder. The characteristic clinical findings of RALD include monocytosis, leukocytosis, lymphoproliferation, and autoimmune phenomena. RALD is defined by somatic mutations in KRAS or NRAS . It is a new disease that was reported by Niemela and Takagi in 2011. The prognosis and incidence are currently unknown and the treatment strategy has not yet been established.　Here we describe the long-term survival of a patient with who displayed a somatic KRAS G12D mutation. His clinical features and labolatory data were overlapped with juvenile myelomonocytic leukemia and chronic myelomonocytic leukemia. Mercaptopurine hydrate, hydroxycarbamide and azacitizine were administered to control white blood cell count and improve clinical symptoms. He had a long survival time without hematopoietic stem cell transplantation