Benign Symmetric Lipomatosis: A Patient Report

Benign symmetric lipomatosis (BSL) is a disease characterized by symmetrical and diffuse adipose tissue deposits on the neck, shoulder, chest, abdomen and groin. It is comparatively common in the Mediterranean basin, but rare in Japan. We report on a 53-year-old male patient with BSL along with a review of the literature. The lesions were distributed bilaterally in the submandibular, neck and upper back region. This patient had consumed an excessive amount of alcohol with elevated liver enzymes including aspartate aminotransferase (133 IU/L), alanine aminotransferase (159 IU/L) and gamma-glutamyl transpeptidase (355 IU/L). The liver function was normalized after a 1-year restriction of alcohol consumption through life management. Tumors in the posterior and anterior cervical regions were resected. The patient is still in a good condition at 3 years and 5 months after the operation

L-NAME誘発性高血圧ラットの血圧に対する亜硝酸塩とニフェジピンの相互作用

食品成分で血管拡張作用を示す一酸化窒素（NO）を産生する亜硝酸塩と臨床的に汎用されているジヒドロピリミジン系のカルシウム拮抗薬の併用投与による血圧と、それぞれの成分の体内動態に対する相互作用について検討した。SD系雄性ラットに一酸化窒素合成阻害剤（L-NAME）を3 週間投与し、内因性NO産生不足高血圧ラットを作成した。本ラットに亜硝酸塩（経口投与）とニフェジピン（腹腔内投与）を単独、または併用投与し60分間の血圧を測定した。さらに、血液中の亜硝酸イオンと硝酸イオン量、およびニフェジピン濃度をHPLC法により測定した。その結果、血圧は両成分とも投与量依存的な効果を示し、併用投与では血圧降下作用が増強した。その際の、血中ニフェジピン濃度は単独と併用で有意差を認めなかった。しかし、血漿中の亜硝酸イオンは単独に比べ併用投与でTmaxの遅延とCmaxの増加が認められた。以上のことから、亜硝酸塩とニフェジピンの併用は血圧に対して相互作用を示すことが明らかになった。また、この相互作用はニフェジピンが亜硝酸塩（または、亜硝酸塩から生成されたNO）の代謝や消失に影響を与えたことによる薬物動態学的な相互作用であることが示唆された

Spontaneous adrenocorticotropic hormone (ACTH) normalisation due to tumour regression induced by metyrapone in a patient with ectopic ACTH syndrome: case report and literature review

Abstract Background Ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) is caused by tumours releasing ACTH. Ectopic ACTH-producing tumour regression is rarely induced using steroidogenesis inhibitors. We presented a case of EAS in which ACTH production by a lung tumour was reduced by metyrapone (MTP) and also reviewed previous cases of ectopic ACTH production suppressed via steroidogenesis inhibition. Case presentation A 71-year-old female with general fatigue, central obesity and impaired glucose tolerance was diagnosed with Cushing’s syndrome due to elevated ACTH (192.9 pg/mL; normal range, 7.2–63.3 pg/mL), cortisol (73.1 μg/dL; 6.4–21.0 μg/dL) and 24-h urinary free cortisol (UFC) (6160 μg/day; 11.2–80.3 μg/day) levels. Chest computed tomography identified a solid 26.6 × 22.9 × 30.0 mm tumour with a cavity in the upper lobe of the left lung. There was no adrenal gland enlargement. Tumour markers were not significantly elevated; ACTH levels were not suppressed by 8-mg dexamethasone. A corticotropin-releasing hormone stimulation test revealed blunted ACTH response (basal ACTH, 204.6 pg/mL; highest ACTH level during the 120-min stimulation test, 214.0 pg/mL). She was diagnosed with EAS due to a lung lesion. MTP treatment was started to reduce cortisol production. ACTH levels and cortisol and UFC levels were normalised and the ACTH-producing lung tumour was ablated after MTP treatment. In several reported cases, plasma ACTH levels reduced during steroidogenesis inhibitor treatment for EAS. Among the 10 patients, three cases of pheochromocytoma, one of thymic carcinoid and one of islet cell carcinoma were reported. In four cases, the tumour was not detected. In our case, the pathology of the lung tumour was unknown because of lack of tumour cells in biopsy. The patients were treated with ketoconazole (KTZ) and/or MTP and exhibited ACTH and cortisol/UFC suppression, but tumour regression was observed only in our case. Conclusion MTP and/or KTZ may reduce ACTH and cortisol production. The tumour spontaneously regressed after MTP treatment, indicating that MTP may reduce the tumour size without surgery. The mechanisms of therapeutic effects of steroidogenesis inhibitors and prognosis of spontaneous remission should be elucidated further via molecular biology studies

New Material Exploration to Enhance Neutron Intensity below Cold Neutrons: Nanosized Graphene Flower Aggregation

It is proposed that nanosized graphene aggregation could facilitate coherent neutron scattering under particle size conditions similar to nanodiamonds to enhance neutron intensity below cold neutrons. Using the RIKEN accelerator-driven compact neutron source and iMATERIA at J-PARC, we performed neutron measurement experiments, total neutron cross-section and small-angle neutron scattering on nanosized graphene aggregation. For the first time, the measured data revealed that nanosized graphene aggregation increased the total neutron cross-sections and small-angle scattering in the cold neutron energy region. This is most likely due to coherent scattering, resulting in higher neutron intensities, similar to nanodiamonds

Appropriate numerical conditions for practical LES of actual high rise building

This paper was reviewed and accepted by the APCWE-IX Programme Committee for Presentation at the 9th Asia-Pacific Conference on Wind Engineering, University of Auckland, Auckland, New Zealand, held from 3-7 December 2017