410 research outputs found
X-ray Measurements of the Particle Acceleration Properties at Inward Shocks in Cassiopeia A
We present new evidence that the bright non-thermal X-ray emission features
in the interior of the Cassiopeia A supernova remnant (SNR) are caused by
inward moving shocks based on Chandra and NuSTAR observations. Several bright
inward-moving filaments were identified using monitoring data taken by Chandra
in 2000-2014. These inward-moving shock locations are nearly coincident with
hard X-ray (15-40 keV) hot spots seen by NuSTAR. From proper motion
measurements, the transverse velocities were estimated to be in the range
2,100-3,800 km s for a distance of 3.4 kpc. The shock velocities
in the frame of the expanding ejecta reach values of 5,100-8,700 km
s, slightly higher than the typical speed of the forward shock.
Additionally, we find flux variations (both increasing and decreasing) on
timescales of a few years in some of the inward-moving shock filaments. The
rapid variability timescales are consistent with an amplified magnetic field of
0.5-1 mG. The high speed and low photon cut-off energy of the
inward-moving shocks are shown to imply a particle diffusion coefficient that
departs from the Bohm regime ( 3-8) for the few
simple physical configurations we consider in this study. The maximum electron
energy at these shocks is estimated to be 8-11 TeV, smaller than the
values of 15-34 TeV inferred for the forward shock. Cassiopeia A is
dynamically too young for its reverse shock to appear to be moving inward in
the observer frame. We propose instead that the inward-moving shocks are a
consequence of the forward shock encountering a density jump of 5-8
in the surrounding material.Comment: 16 pages, 8 figures, accepted for publication in Ap
A Case of Cystic Basal Cell Carcinoma Which Shows a Homogenous Blue/Black Area under Dermatoscopy
Basal cell carcinoma (BCC) is the most common skin tumor and contains several different histopathological types. Here, we report a case of cystic basal cell carcinoma, which is relatively rare and might be clinically misdiagnosed. A dermatoscopic examination of the case revealed a homogenous blue/black area usually not seen in BCC. We reviewed 102 BCC cases resected and diagnosed at Sapporo Medical University Hospital between April 2005 and March 2010. Among them, only three were the cystic type
A Retrospective Analysis of Transfusion Management for Obstetric Hemorrhage in a Japanese Obstetric Center
Background. Since cryoprecipitate, fibrinogen concentrate, or recombinant activated factor VII is not approved by public medical insurance in Japan, we retrospectively assessed blood product usage in patients with obstetric hemorrhage at our tertiary obstetric center. Material and Methods. 220 patients with obstetric hemorrhagic disorders who underwent blood product transfusion in our institution during a 5-year period were reviewed for the types and volumes of blood products transfused. Results. There was a significant positive correlation (P< 0.001) between the volume of RCC (red blood cell concentrate) transfused and that of FFP (fresh frozen plasma), irrespective of underlying obstetric disorders. The median of FFP to RCC ratio in each patient was 1.3–1.4, when 6 or more units of RCC were transfused. Conclusions. In transfusion for massive obstetric hemorrhage in terms of appropriate supplementation of coagulation factors, the transfusion of RCC : FFP = 1 : 1.3–1.4 may be desirable
A case of axillary lymphadenitis caused by Mycobacterium intracellulare in an immunocompetent patient
Axillary lymphadenitis caused by non-tuberculous mycobacteria is rare and has been reported in immunocompromised hosts. Herein, we report the case of a 67-year-old man without immunodeficiency who developed right axillary lymphadenitis caused by Mycobacterium intracellulare and showed a small nodular shadow in the left pulmonary apex. Biopsy of the right axillary lymph node revealed several epithelioid granulomas, and the culture of the lymph node aspirate yielded Mycobacterium intracellulare. The lymph node lesion and left lung apex shadow resolved spontaneously after careful outpatient monitoring. This case suggests that axillary lymphadenitis could be caused by Mycobacterium intracellulare in an immunocompetent patient
Eating-related distress and need for nutritional support of families of advanced cancer patients: A nationwide survey of bereaved family members
Background: A number of advanced cancer patients are suffering from physical and psychosocial burdens because of cancer cachexia, and these burdens also greatly impact on their family members and relationships between patients and family members. It is necessary to consider the psychosocial impact of cancer cachexia on family members of advanced cancer patients. Methods: A cross-sectional anonymous nationwide survey was conducted involving 925 bereaved family members of cancer patients who had been admitted to 133 inpatient hospices throughout Japan. Results: A total of 702 bereaved family members returned the questionnaires (response rate, 75.9%). Concerning eating-related distress, 'I served what the patient wanted without consideration of calories and nutritional composition' was highest (75.1%), and 'I tried making many kinds of meals for the patient' and 'I was concerned about planning meals for the patient every day' followed (63.0% and 59.4%, respectively). The top 5 of the 19 items were categorized as 'fighting back'. Need for nutritional support was high (72.2%), and need for explanations about the reasons for anorexia and weight loss of patients was moderate (41.4%). Explanatory factor analysis of eating-related distress identified the following four domains: (factor 1) feeling that family members forced the patient to eat to avoid death, (factor 2) feeling that family members made great efforts to help the patient eat, (factor 3) feeling that eating was a cause of conflicts between the patient and family members, and (factor 4) feeling that correct information was insufficient. Results of multiple logistic regression analysis showed that spouse, fair/poor mental status, factors 1, and 4 were identified as independent determinants of major depression (odds ratio [OR] 3.27 [95% confidence interval (CI) 1.24-8.60], P=0.02; OR 4.50 [95% CI 2.46-8.25], P<0.001; OR 2.51 [95% CI 1.16-5.45], P=0.02; OR 2.33 [95% CI 1.13-4.80], P=0.02, respectively). Conclusions: A number of family members of advanced cancer patients experienced high levels of eating-related distress and had a need for nutritional support
- …