Characterization of foreign exchange market using the threshold-dealer-model

We introduce a deterministic dealer model which implements most of the empirical laws, such as fat tails in the price change distributions, long term memory of volatility and non-Poissonian intervals. We also clarify the causality between microscopic dealers' dynamics and macroscopic market's empirical laws.Comment: 10pages, 5figures, 1table, Proceedings of APFA

IN VIVO PEPTIDES POSITIVELY SELECT AND FINE-TUNE T CELLS

The affinity for TCR interactions with self-peptide/MHC complexes (pMHC) in the thymus critically affects immature thymocytes that newly express TCRs. Previous fetal thymus organ culture experiments have indicated that difference in the affinity for thymic TCR/pMHC interactions not only determines thymocyte fate between positive and negative selection, but also affects Ag responsiveness of positively selected thymocytes. In the current study, we examined whether TCR/pMHC affinity during positive selection in the thymus would further affect Ag responsiveness of mature T cells in the periphery. To do so, OVA peptide variants were in vivo administered to TAP1-deficient OT-I/TCR-transgenic mice in which T cell development was otherwise arrested at CD4+CD8+ thymocytes because of the lack of self-pMHC presentation in thymic APCs. We found that a group of peptide variants induced the transient generation of OT-I CD8+ T cells in the thymus and the periphery. We also noticed that the affinity threshold for positive and negative selection detected in adult mice in vivo was higher than that measured in fetal thymus organ culture experiments in vitro. Interestingly, we further found that the affinity for positively selecting peptides proportionally affected TCR responsiveness of peripheral naive CD8+ T cells. These results indicate that in vivo administration of a peptide can promote T cell selection in the thymus and the affinity for TCR/pMHC interaction during positive selection fine-tunes Ag responsiveness of peripheral T cells

A NuSTAR and XMM-Newton Study of the Two Most Actively Star-forming Green Pea Galaxies (SDSS J0749+3337 and SDSS J0822+2241)

We explore X-ray evidence for the presence of active galactic nuclei (AGNs) in the two most actively star-forming Green Pea galaxies (GPs), SDSS J0749+3337 and SDSS J0822+2241, which have star-formation rates (SFRs) of $123~M_\odot$ yr$^{-1}$ and $78~M_\odot$ yr$^{-1}$, respectively. The GPs have red mid-infrared (MIR) spectral energy distributions and higher 22 $\mu$m luminosities than expected from a proxy of the SFR (H$\alpha$ luminosity), consistent with hosting AGNs with 2-10 keV luminosities of $\sim10^{44}$ erg s$^{-1}$. We thus obtain and analyze the first hard ($>$ 10 keV) X-ray data observed with NuSTAR and archival XMM-Newton data below 10 keV. From the NuSTAR $\approx$20 ksec data, however, we find no significant hard X-ray emission. By contrast, soft X-ray emission with 0.5--8 keV luminosities of $\approx10^{42}$ erg s$^{-1}$ is significantly detected in both targets, which can be explained only by star formation (SF). A possible reason for the lack of clear evidence is that a putative AGN torus absorbs most of the X-ray emission. Applying a smooth-density AGN torus model, we determine minimum hydrogen column densities along the equatorial plane ($N_{\rm H}^{\rm eq}$) consistent with the non-detection. The results indicate $N_{\rm H}^{\rm eq} \gtrsim 2\times10^{24}$ cm$^{-2}$ for SDSS J0749+3337 and $N_{\rm H}^{\rm eq} \gtrsim 5\times10^{24}$ cm$^{-2}$ for SDSS J0822+2241. Therefore, the GPs may host such heavily obscured AGNs. Otherwise, no AGN exists and the MIR emission is ascribed to SF. Active SF in low-mass galaxies is indeed suggested to reproduce red MIR colors. This would imply that diagnostics based on MIR photometry data alone may misidentify such galaxies as AGNs.Comment: 12 pages, 3 tables, 5 figures, accepted for publication in Ap

Operative Outcome of Cardiac Surgery in Patients with Liver Cirrhosis

Introduction: A retrospective study was performed to investigate the relationship between the severity of liver cirrhosis and the outcome of cardiac surgery. Methods and Results: Twenty-one patients with liver cirrhosis underwent cardiac surgery in our institution. According to the Child-Pugh classification, 13 patients were in class A, 7 in class B, and 1 in class C. Coronary artery bypass grafting was performed in 7 patients, surgery for valvular disease in 10 and other procedures in 4. Major postoperative complications occurred in 8%, 29%, and 100% for Child-Pugh class A, B, and C, respectively. Preoperative hemoglobin level was significantly lower in the patients with postoperative complications. None of 4 patients underwent coronary revascularization using off-pump procedure or mini-pump system experienced major complication. The operative mortality was 0%, 14%, and 0% for Child-Pugh class A, B, and C, respectively. Conclusions: Although the overall mortality rate in patients with liver cirrhosis was acceptable in our study, the incidence of severe complications, such as prolonged ventilation, mediastinitis and irreversible hepatic insufficiency was problematic in Child-Pugh class B and class C patients. Application of less invasive cardiac surgery, such as mini-pump system or off-pump procedure will improve the operative outcome in such patient group.長崎大学学位論文 学位記番号:博（医）甲第1,272号学位授与年月日:平成20年7月16

A Case of Drug-induced Agranulocytosis Diagnosed by Re-administration of Clopidogrel

Clopidogrel is an antiplatelet drug that is frequently used for coronary artery disease and cerebrovascular disease. Hematologic adverse effect is less common with clopidogrel than ticlopidine. A ５８-year-old man was treated with clopidogrel as antiplatelet therapy under the diagnosis of cerebral infarction. Six weeks later, he was transported to our emergency department with fever, sore throat and respiratory distress. Blood test showed marked leukopenia（neutrophil ５１/mm３）. A diagnosis of sepsis with acute epiglottitis and tonsillitis was made by blood culture and contrast-enhanced computed tomography. Clopidogrel was discontinued due to thrombocytopenia. After administration of antibacterial drugs and granulocyte colony-stimulating factor under ventilator in the Intensive Care Unit, the infection improved with the recovery of the neutrophil count. Clopidogrel was restarted, but he developed leukopenia and high fever again２weeks later. Histopathology of bone marrow revealed a marked decrease in myeloid cells, and he was diagnosed as drug-induced agranulocytosis due to clopidogrel. After withdrawal of clopidogrel and supportive therapy for febrile neutropenia, neutrophils recovered. Although clopidogrel associated agranulocytosis is a very rare adverse event, it can be serious and regular blood count monitoring is necessary after initiation of clopidogrel

Trans-omics Impact of Thymoproteasome in Cortical Thymic Epithelial Cells

The thymic function to produce self-protective and self-tolerant T cells is chiefly mediated by cortical thymic epithelial cells (cTECs) and medullary TECs (mTECs). Recent studies including single-cell transcriptomic analyses have highlighted a rich diversity in functional mTEC subpopulations. Because of their limited cellularity, however, the biochemical characterization of TECs, including the proteomic profiling of cTECs and mTECs, has remained unestablished. Utilizing genetically modified mice that carry enlarged but functional thymuses, here we show a combination of proteomic and transcriptomic profiles for cTECs and mTECs, which identified signature molecules that characterize a developmental and functional contrast between cTECs and mTECs. Our results reveal a highly specific impact of the thymoproteasome on proteasome subunit composition in cTECs and provide an integrated trans-omics platform for further exploration of thymus biology

地域中核病院から病理解剖を依頼したALS

An 82-year-old man, who developed dysphagia several months ago, presented Tokushima University Hospital and was diagnosed of ALS in December 2019. The patient got gradually worse and became bedridden in May 2020. He was admitted into Tokushima University Hospital suffering an aspiration pneumonia in June 2020. The pneumonia rapidly improved with a treatment ; however, the patient failed to be treated at home against his wish and was transferred to Kaminaka Hospital. We accepted his wish for refusing mechanical ventilation or tube feeding. Later, we requested autopsy consent from the patient. He did not refuse our proposal ; therefore, we presearched transporters capable to deceased bodies and contacted the division of pathology in Tokushima University. 60 days later, the patient died due to a suddenly developed putamen hemorrhage. After getting the family's consent, as previously arranged, we transferred the deceased body to Tokushima University and accomplished an autopsy. Although the number of autopsies is declining, we suggest that hospital collaboration may help perform autopsies

Nephrotoxicity with VCM and Nephrotoxins

There is a growing concern about the relationship between vancomycin-associated nephrotoxicity (VAN) and concomitant use of nephrotoxins. We examined this relationship by combined retrospective analyses of two real-world databases. Initially, the FDA Adverse Event Reporting System (FAERS) was analyzed for the effects of concomitant use of one or more nephrotoxins on VAN and the types of combinations of nephrotoxins that exacerbate VAN. Next, electronic medical records (EMRs) of patients who received vancomycin (VCM) at Tokushima University Hospital between January 2006 and March 2019 were examined to confirm the FAERS analysis. An elevated reporting odds ratio (ROR) was observed with increases in the number of nephrotoxins administered (VCM + one nephrotoxin, adjusted ROR (95% confidence interval [CI]) 1.67 [1.51–1.85]; VCM + ≥ 2 nephrotoxins, adjusted ROR [95% CI] 1.54 [1.37–1.73]) in FAERS. EMRs analysis showed that the number of nephrotoxins was associated with higher incidences of VAN [odds ratio: 1.99; 95% CI: 1.42–2.78]. Overall, concomitant use of nephrotoxins was associated with an increased incidence of VAN, especially when at least one of those nephrotoxins was a renal hypoperfusion medication (furosemide, non-steroidal anti-inflammatory drugs, and vasopressors). The concomitant use of multiple nephrotoxins, especially including renal hypoperfusion medication, should be avoided to prevent VAN

Concomitant Use of Multiple Nephrotoxins including Renal Hypoperfusion Medications Causes Vancomycin-Associated Nephrotoxicity: Combined Retrospective Analyses of Two Real-World Databases

There is a growing concern about the relationship between vancomycin-associated nephrotoxicity (VAN) and concomitant use of nephrotoxins. We examined this relationship by combined retrospective analyses of two real-world databases. Initially, the FDA Adverse Event Reporting System (FAERS) was analyzed for the effects of concomitant use of one or more nephrotoxins on VAN and the types of combinations of nephrotoxins that exacerbate VAN. Next, electronic medical records (EMRs) of patients who received vancomycin (VCM) at Tokushima University Hospital between January 2006 and March 2019 were examined to confirm the FAERS analysis. An elevated reporting odds ratio (ROR) was observed with increases in the number of nephrotoxins administered (VCM + one nephrotoxin, adjusted ROR (95% confidence interval [CI]) 1.67 [1.51-1.85]; VCM + ≥2 nephrotoxins, adjusted ROR [95% CI] 1.54 [1.37-1.73]) in FAERS. EMRs analysis showed that the number of nephrotoxins was associated with higher incidences of VAN [odds ratio: 1.99; 95% CI: 1.42-2.78]. Overall, concomitant use of nephrotoxins was associated with an increased incidence of VAN, especially when at least one of those nephrotoxins was a renal hypoperfusion medication (furosemide, non-steroidal anti-inflammatory drugs, and vasopressors). The concomitant use of multiple nephrotoxins, especially including renal hypoperfusion medication, should be avoided to prevent VAN

高齢で発症した重症筋無力症は重症化しやすい

Objective: The continuous increase in the number of patients presenting with late-onset myasthenia gravis (LOMG) underscores the need for a better understanding of the clinical course and the establishment of an optimal therapeutic strategy. We aimed to clarify factors associated with clinical outcomes in LOMG. Methods: We retrospectively reviewed the clinical profiles of 40 patients with early-onset MG (EOMG) (onset age: 49 years or younger), 30 patients with non-elderly LOMG (onset age: 50–64 years), and 28 patients with elderly LOMG(onset age: 65 years or older) and compared the subgroups according to onset age and thymus status. The evaluated parameters were MGFA classification before treatment, MG-ADL score, complicating diseases, antibody titer, treatment, and MGFA post-intervention status. Results: Elderly LOMG patients showed transition to generalized symptoms at a higher frequency and underwent thymectomyless frequently than EOMG and non-elderly LOMG patients (p < 0.001). The frequencies of crisis and plasmapheresis were significantly lower in thymectomized LOMG patients without thymoma than in thymectomized LOMG patients with thymoma or non-thymectomized LOMG patients (p < 0.01, P < 0.05, respectively). However, the outcome was not significantly different. All of the thymectomized LOMG patients without thymoma presenting with hyperplasia or thymic cyst had a favorable clinical course. Conclusions: Our study showed that elderly LOMG patients are more prone to severity, suggesting that they require aggressive immunomodulatory therapy