Borehole water and hydrologic model around the Nojima fault, SW Japan

International audienceThe active fault drilling at Nojima Hirabayashi after the 1995 Hyogoken-nanbu (Kobe) earthquake (MJMA = 7.2) provides us with a unique opportunity to investigate subsurface fault structure and the in-situ properties of fault and fluid. The borehole intersected the fault gouge of the Nojima fault at a depth interval of 623m to 625m. The lithology is mostly Cretaceous granodiorite with some porphyry dikes. The fault core is highly permeable due to fracturing. The borehole water was sampled in 1996 and 2000 from the depth interval between 630 and 650 m, just below the fault core. The chemical and isotopic compositions were analyzed. Carbon and oxygen isotope ratios of carbonates from the fault core were analyzed to estimate the origin of fluid. The following conclusions were obtained. (1) The ionic and isotopic compositions of borehole water did not change from 1996 to 2000. They are mostly derived from local ground water as mentioned by Sato and Takahashi (2000). (2) Geochemical speciation revealed that the borehole water was derived from a relatively deep reservoir, which may be situated at a depth of 3 to 4 km where the temperature is about 80-90 ̊C. (3) The shallower part of the Nojima fault (shallower than the reservoir depth) has not been healed from the hydrological viewpoints 5 years after the event, in contrast to the rapid healing detected by S wave splitting (Tadokoro and Ando, 2002). (4) Precipitation of calcite from present borehole water since drilling supports the idea of precipitation of some calcite in coseismic hydraulic fractures in the fault core (Boullier et al., 2004). (5) Carbon and oxygen isotope ratios of calcite indicated that the meteoric water flux had been localized at the fault core. (6) A difference in the carbon isotope ratio between the footwall and the hangingwall suggests that the fault has been acted as a hydrologic barrier, although the permeability along the fault is still high

Structural evolution of the Nojima fault (Awaji Island, Japan) revisited from the GSJdrill hole at Hirabayashi.

International audienceFollowing the Hyogoken Nanbu earthquake (Januray 17, 1995, Mw = 7.2), three drillholes were sunk through the Nojima Fault (Awaji Island, Japan). Textural andpetrographic studies of the Geological Survey of Japan (GSJ) drill cores allow recognition of two deformation episodes. The first one is older than the deposition of the Middle to LateEocene Kobe Group, corresponds to a left-lateral movement on the Nojima fault and is expressed by pseudotachylytes, kinking of biotite crystals in the low-strain rocks and anintense laumontite hydrothermal alteration. The second one displaces the basal unconformity of the Kobe group, corresponds to a right-lateral reverse displacement and is expressed atleast by carbonate-filled hydraulic fractures and thin gouge zones. Different important deformation mechanisms are recorded by the fault rocks, but questions relating to theattribution of deformation and alteration features to one or other deformation episodes remain unresolved

cis9, trans11-Conjugated Linoleic Acid Differentiates Mouse 3T3-L1 Preadipocytes into Mature Small Adipocytes through Induction of Peroxisome Proliferator-activated Receptor γ

Dietary conjugated linoleic acid (CLA) has been reported to exhibit a number of therapeutic effects in animal models and patients, such as anti-hypertensive, anti-hyperlipidemic, anti-arteriosclerotic, anti-carcinogenic, and anti-diabetic effects. However, the underlying mechanism is not well-characterized. In the present study, the effects of cis(c)9, trans(t)11-CLA on the differentiation of mouse 3T3-L1 preadipocytes into mature adipocytes were examined. Treatment with c9, t11-CLA in the presence of insulin, dexamethasone, and 3-isobutyl-1-methyl-xanthine (differentiation cocktail) significantly stimulated the accumulation of triacylglycerol. The microscopic observation of cells stained by Oil Red O demonstrated that c9, t11-CLA increases the amount and proportion of small mature adipocytes secreting adiponectin, a benign adipocytokine, when compared to the differentiation cocktail alone. Furthermore, c9, t11-CLA increased bioactive peroxisome proliferator-activated receptor γ (PPARγ) levels in a nuclear extract of 3T3-L1 cells, suggesting the enhancing effect of this fatty acid on the nuclear transmission of PPARγ, a master regulator of adipocyte differentiation, in 3T3-L1 cells. These results suggest that the therapeutic effects of c9, t11-CLA on lifestyle-related diseases are partially due to the enhanced formation of small adipocytes from preadipocytes via PPARγ stimulation

甲状腺癌リンパ節転移との鑑別が困難であった頸部神経鞘腫の１例

A female patient in her 60s visited her previous doctor because of a right cervical mass that exist for 7 years and gradually increased in size. As she was suspected of cervical lymph node metastasis of thyroid cancer, she was referred to our hospital. At the initial visit, a 5-cm right cervical mass and enlargement of the right lobe of the thyroid gland were observed. Fine needle aspiration cytology was performed on both, but no malignant findings were observed. To confirm the diagnosis and improve the patient’s appearance, a right lobectomy of the thyroid gland and resection of the right cervical mass were performed. A rapid intraoperative histological examination of the cervical mass revealed a schwannoma. The right thyroid tumor was diagnosed as follicular adenoma. Her postoperative course was good, and after several years of follow-up, patient consultation was terminated. Neurolemmoma is a benign tumor arising from Schwann cells in the nerve sheath, and it occurs frequently throughout the head and neck region, with 25%-45% of cases occurring in this region. Cervical schwannomas are characterized by irritation of the vagus nerve, brachial plexus, and sympathetic nerves. However, many patients present with only a painless neck mass, as in this case. Although the mass can be diagnosed by puncture aspiration cytology in some cases, sufficient specimens are often unavailable, and the diagnosis is made preoperatively in about half of all cases. Differential diagnoses of an anterior cervical mass include malignant lymphoma, cervical lymph node metastases of malignant tumors, submandibular gland tumors, and tuberculous lymph node metastases. In this patient, we also considered lymph node metastasis of thyroid cancer. However, a histological examination did not detect malignancy in either the thyroid gland or neck mass, and we considered that the thyroid follicular adenoma and the cervical schwannoma occurred independently. We report our experience of cervical schwannoma combined with thyroid tumor which was suspected of lymph node metastasis of thyroid cancer

Pretransplant serum hepatitis C virus RNA levels predict response to antiviral treatment after living donor liver transplantation.

[Background]Given the limited efficacy and high adverse event rate associated with treatment of recurrent hepatitis C after liver transplantation, an individualized treatment strategy should be considered. The aim of this study was to identify predictors of response to antiviral therapy for hepatitis C after living donor liver transplantation (LDLT) and to study the associated adverse events. [Methods]A retrospective chart review was performed on 125 hepatitis C virus (HCV)-positive LDLT recipients who received interferon plus ribavirin and/or peginterferon plus ribavirin therapy at Kyoto University between January 2001 and June 2011. [Results]Serum HCV RNA reached undetectable levels within 48 weeks in 77 (62%) of 125 patients, and these patients were defined as showing virological response (VR). Of 117 patients, 50 (43%) achieved sustained VR (SVR). Predictive factors associated with both VR and SVR by univariate analysis included low pretransplant serum HCV RNA levels, a non-1 HCV genotype, and low pretreatment serum HCV RNA levels. In addition, LDLT from ABO-mismatched donors was significantly associated with VR, and white cell and neutrophil counts before interferon therapy were associated with SVR. Multivariate analysis showed that 2 variables–pretransplant serum HCV RNA level less than 500 kIU/mL and a non-1 HCV genotype–remained in models of both VR and SVR and that an ABO mismatch was associated with VR. No variables with a significant effect on treatment withdrawal were found. [Conclusions]Virological response to antiviral therapy in patients with hepatitis C recurring after LDLT can be predicted prior to transplant, based on pretransplant serum HCV-RNA levels and HCV genotype. LDLT from ABO-mismatched donors may contribute to more efficacious interferon therapy

AYA-generation lung cancer in a patient presenting with spontaneous pneumothorax : A case report

Background : Surgery for young patients（i.e., <２０ years of age）with early-stage lung cancer is extremely rare. To the best of our knowledge, only a few cases of lung cancer initially presented with spontaneous pneumothorax. Here, we report a case of AYA（adolescent and young adult）-generation lung cancer in a patient who presented with spontaneous pneumothorax. Case : An １８-year-old male was admitted to our hospital for new-onset left pneumothorax. Chest computed tomography incidentally revealed a pure ground-glass nodule（pGGN）in the left lower lobe（S８）with a bulla near the nodule. While chest tube drainage improved his condition, pneumothorax recurred two weeks later, prompting surgical for video-assisted partial resection of the left lung. Intraoperative findings showed that the bulla and nodule were distant. Histopathologic analysis was consistent with a diagnosis of adenocarcinoma in situ with a bleb. Conclusion : This study highlights the importance of considering the possibility of lung cancer in patients with irregular chest shadows, even those less than２０years of age. Computed tomography plays an important role in the diagnosis of lung cancer in patients with spontaneous pneumothorax

Post‐transplant Lymphoproliferative Disorders After Liver Transplantation: A Retrospective Cohort Study Including 1954 Transplants

Post-transplant lymphoproliferative disorders (PTLDs) are life-threatening neoplasms after organ transplantation. Because of their rarity and multiple grades of malignancy, the incidence, outcomes, and clinicopathological features affecting patient survival after liver transplantation (LT) remain unclear. We reviewed 1954 LTs in 1849 recipients (1990-2020), including 886 pediatric (<18 years of age) and 963 adult recipients. The following clinicopathological factors were studied: age, sex, liver etiologies, malignancy grades, Epstein-Barr virus status, performance status (PS), Ann Arbor stage, international prognostic index, and histopathological diagnosis. Of 1849 recipients, 79 PTLD lesions (4.3%) were identified in 70 patients (3.8%). After excluding 3 autopsy cases incidentally found, 67 (45 pediatric [5.1%] and 22 adult [2.3%]) patients were finally enrolled. Comorbid PTLDs significantly worsened recipient survival compared with non-complicated cases (P < 0.001). The 3-year, 5-year, and 10-year overall survival rates after PTLD diagnosis were 74%, 66%, and 58%, respectively. The incidence of PTLDs after LT (LT-PTLDs) was significantly higher (P < 0.001) with earlier onset (P = 0.002) in children, whereas patient survival was significantly worse in adults (P = 0.002). Univariate and multivariate analyses identified the following 3 prognostic factors: age at PTLD diagnosis ≥18 years (hazard ratio [HR], 11.2; 95% confidence interval [CI], 2.63-47.4; P = 0.001), PS ≥2 at diagnosis (HR, 6.77; 95% CI, 1.56-29.3; P = 0.01), and monomorphic type (HR, 6.78; 95% CI, 1.40-32.9; P = 0.02). A prognostic index, the “LT-PTLD score, ” that consists of these 3 factors effectively stratified patient survival and progression-free survival (P = 0.003 and <0.001, respectively). In conclusion, comorbid PTLDs significantly worsened patient survival after LT. Age ≥18 years and PS ≥2 at PTLD diagnosis, and monomorphic type are independent prognostic factors, and the LT-PTLD score that consists of these 3 factors may distinguish high-risk cases and guide adequate interventions

中毒性多結節性甲状腺腫

A woman in her 80s who was diagnosed with multiple thyroid tumors and subclinical hyperthyroidism 1 year previously was referred to our outpatient clinic due to deteriorated hyperthyroidism. She was diagnosed with dilated cardiomyopathy 4 years ago. Her cardiac function has been stabilized with medical conservative treatment. Blood autoantibody levels, including TSAb and TRAb, were within normal ranges. Ultrasonography and computed tomography revealed multiple tumor lesions in both thyroid lobes. Tc-99m scintigraphy showed multiple hot nodules in both thyroid lobes. Because the patient’s thyroid function had deteriorated, we selected surgical total thyroidectomy rather than radioisotope treatment as the most appropriate treatment. Histopathological examination of the resected specimen demonstrated multiple nodular lesions with a maximum size of 23 mm and a microlesion of papillary carcinoma 2 mm in diameter in the thyroid. A few days after surgery, thyroid function blood levels declined to the normal range

横隔膜縫縮術により著明な呼吸機能改善を得た横隔膜弛緩症の１例

A woman in her seventies visited the hospital two months after experiencing dyspnea on exertion. After chest radiographs and computed tomography of the chest showed elevation of the right diaphragm, she was referred to our department for further examination and management. Respiratory function tests revealed restricted ventilatory impairment with a vital capacity （VC） of 1.28 L and a %VC of 54.0%. Since there was no evidence of organic disease causing diaphragmatic paralysis and a slight movement of the diaphragm, we diagnosed the patient with right diaphragmatic eventration. Since she was symptomatic, we decided to treat her surgically. She was operated under general anesthesia, left lateral recumbency, single lung ventilation, and lateral open chest between the eighth ribs. The relaxed diaphragm was elevated, horizontal mattress sutures were placed. Considering the risk of diaphragm rupture, a 2-mm thick Gore-Tex sheet was fixed to the chest wall and diaphragm in a tent-like manner. The patient was discharged from the hospital on the fourth postoperative day. A chest radiograph postoperatively showed good diaphragmatic movement. Respiratory function tests also showed marked improvement, with a VC of 2.00 L and %VC of 86.3%. The patient’s subjective symptoms have disappeared, and she is currently outpatient observation