Magnetic transition due to the inter-singlet spin-exchange interaction and elastic softening by the interplay of electric quadrupoles in the distorted kagome lattice antiferromagnet Tb3Ru4Al12

The distorted kagome lattice antiferromagnet Tb3Ru4Al12 with a hexagonal structure has the Néel temperature TN = 22 K. To clarify the 4 f -electronic state and an influence of electric quadrupoles in Tb3Ru4Al12, ultrasonic measurements on a single-crystalline sample at zero magnetic field and under fields were carried. A characteristic elastic softening of the transverse modulus C66 originating from a quadrupole interaction was found. The crystal electric field parameters were determined to reproduce C66, magnetic susceptibilities, and magnetization curves. The obtained level scheme is that the ground and first excited states are singlets, despite the existence of both the magnetic transition and the quadrupole interaction, indicating that Tb3Ru4Al12 is a curious compound. The positive sign of the quadrupole-quadrupole coupling constant for C66 indicates a ferroquadrupolar-type interaction of the electric quadrupole Oxy or O2 2. The anisotropic magnetic field dependencies of TN in the field along [100] and [001] were also clarified.This work was supported by JSPS KAKENHI Grants No.17H06136, No. 18KK0078, and No. 19K03719. This work was also supported by CResCent (Chirality Research Center) in Hiroshima University (the MEXT program for promoting the enhancement of research universities, Japan) and by JSPS Core-to-Core Program, A. Advanced Research Networks. The work was supported by Projects No. 19-00925S and No. 19-07931Y of the Czech Science Foundation and by MGML within the Program of Czech Research Infrastructures (Project No. LM2018096)

初期治療としてのブレオマイシン, エトポシドおよびシスプラチン併用化学療法に対して良好な反応を示した転移性胚細胞腫瘍の予後解析

The objective of this study was to evaluate the efficacy of first-line bleomycin, etoposide and cisplatin (BEP) chemotherapy in Japanese patients with metastatic germ cell tumors (GCTs). Between 1996 and 2006, 88 male patients with metastatic GCTs were treated with first-line BEP at our institution. Of these 88, 47 (16, seminoma; 31, nonseminoma), who did not receive high-dose chemotherapy following BEP because of the normalization of serum tumor markers, were included in this study. The primary site was the testis in 42 patients, retroperitoneum in 3, and mediastinum in 2. The full-dose regimen used for BEP consisted of cisplatin 20 mg/m2 on days 1 to 5, etoposide 100 mg/m2 on days 1 to 5, and bleomycin on days 2, 9 and 16. Therapeutic outcome was assessed according to several clinicopathological parameters. Following 2 to 4 cycles of BEP (median, 4 cycles), alpha-fetoprotein, beta-human chorionic gonadotropin and lactate dehydrogenase were normalized in all 47 patients. Eighteen patients (38.3%) achieved a complete response (CR) after BEP alone, while BEP resulted in a partial response and stable disease in the remaining 23 (48.9%) and 6 (12.8%), respectively. In addition, surgical resection of the residual tumors following BEP was performed in 15 patients, of whom 12 (80.0%) and 3 (20.0%) achieved pathological and surgical CR, respectively. At a median follow-up of 27 months, all patients were alive; however, disease recurrence occurred in 5 (seminoma, 1; nonseminoma, 4), and all these 5 were subsequently treated with high-dose chemotherapy as salvage therapy. In this series, 1-, 3- and 5-year recurrence-free survival rates were 95.0, 91.4 and 79.2%, respectively, and, there was no significant difference in recurrence-free survival between patients with seminoma and those with nonseminoma. These findings suggested that patients with metastatic GCTs, regardless of histological subtype (i.e., seminoma or nonseminoma), who showed favorable response to first-line BEP chemotherapy, could achieve an excellent prognostic outcome.1996年から2006年の間に初回化学療法としてブレオマイシン, エトポシドおよびシスプラチン併用化学療法(BEP療法)を施行した転移性胚細胞腫瘍 88例中, BEP療法に対して良好な反応を示したため, 引き続き大量化学療法を施行しなかった47例を対象に, その治療成績を検討した。47例の組織型はセミノーマおよび非セミノーマが, それぞれ16および31例で, 原発部位は精巣, 後腹膜および縦隔が, それぞれ42, 3および2例であった。BEP療法を 2～4コース(中央値, 4コース)施行後, AFP, β-HCGおよびLDHは全例において正常化し, 18, 23および6例を, それぞれCR, PRおよび SDと診断した。残存病巣を有する29例中15例に対して外科切除を施行し, 12および3例が, それぞれ病理学的および外科的CRと診断された。経過観察期間の中央値は27ヵ月で全例が生存中であるが, 5例に再発を認めた。再発症例には, 救済化学療法として大量化学療法を全例に施行した。47例の1, 3および5年非再発率は, それぞれ95.0, 91.4および79.2%であり, セミノーマおよび非セミノーマ症例の非再発率に有意差を認めなかった。以上より, 初回化学療法としてのBEP療法に良好な反応を示した転移性胚細胞腫瘍症例に対しては, 必要に応じて外科療法および強力な救済化学療法を追加することで, 優れた治療成績を挙げることが可能であるものと考えられた

Anesthetic management using peripheral nerve block in patients with factor XI deficiency: a case report

Abstract Factor XI deficiency is rare but may cause life-threatening bleeding during the perioperative period. The clinical manifestation of factor XI deficiency is characterized by bleeding tendency. This unpredictable bleeding tendency makes anesthetic management difficult. We report a case of a partial duodenectomy in a patient with factor XI deficiency. The patient was scheduled for duodenectomy because of a duodenal tumor. When checked for coagulation before surgery, the patient was found to have a remarkably prolonged activated partial thrombin time, and further investigation revealed factor XI deficiency. Fresh frozen plasma was transfused before surgery, and general anesthesia and peripheral nerve block were performed. In the present case of factor XI deficiency, supplementation with clotting factor and proper anesthetic management were important to prevent severe complications

Bacterial contamination upon the opening of injection needles

Abstract Introduction Two opening methods are used for injection needle products: the “peel-apart method” where the adhesive surface of the packaging mount is peeled off, and the “push-off top method,” where the needle hub is pressed against the mount to break it. However, the risks of bacterial contamination as a result of opening method remain unknown. The aim of our study was to evaluate the bacterial contamination of needle hubs upon the opening of injection needles by the peel-apart or push-off top method under various conditions. Methods Bacterial contamination upon the opening of injection needles was examined in two materials, paper and plastic. Various concentrations of Staphylococcus aureus were applied to the mount and were maintained under wet or dry conditions. Injection needles were opened using the peel-apart or push-off top method. Needle hub contamination was examined using agar medium colony counting. Clinically assumed conditions (the hands and saliva of anesthesiologists) were also evaluated. Data were statistically examined using the Cochran-Mantel-Haenszel, Jonckheere, and Fisher’s exact tests. Results The lateral surfaces of needle hubs were contaminated using the push-off top method, but not by the peel-apart method, in a manner that was dependent on S. aureus concentrations. No significant differences were observed between mount materials. Needle hub contamination was significantly more severe for the wet than for the dry opening portion. The clinically assumed condition study revealed that the lateral and bottom surfaces of the needle hub were contaminated significantly more in the saliva contamination group than in the dry and wet hand groups. Conclusions The bacterial contamination of needle hubs may occur upon the opening of injection needles when the push-off top method is used and may be affected by hands contaminated with saliva under clinical conditions