Peculiar Distribution of Tumorous Xanthomas in an Adult Case of Erdheim-Chester Disease Complicated by Atopic Dermatitis

Erdheim-Chester disease is a rare non-Langerhans form of histiocytosis with multiple organ involvement. Approximately 20% of patients have xanthoma-like lesions, usually on the eyelids. We report a case of Erdheim-Chester disease in a 32-year-old male who showed peculiar xanthomatous skin lesions and also had atopic dermatitis. His skin manifestations included ring-like yellowish tumors on his periorbital regions, rope necklace-like tumors on his neck, and spindle-shaped tumors on his right preauricular region and cubital fossas. He also had exophthalmos and diabetes insipidus. Chronic eczematous lesions were present on the flexor aspect of his extremities, and his serum eosinophil numbers and immunoglobulin E levels were elevated. A histological examination of his right neck tumor showed foamy macrophages and touton-type giant cells, which were positive for CD68 and CD163 and negative for S-100 and CD1a. We suggest that the complication of atopic dermatitis may have contributed to the uncommon clinical features in this case

Gadolinium silicide/silicon composite with excellent high-rate performance as lithium-ion battery anode

Novel composite materials consisted of elemental Si and rare-earth metal silicides, Sm–Si, Gd–Si, and Dy–Si, were synthesized and were evaluated for the first time as a high-performance anode material of Li-ion battery. Thick-film electrodes of the silicide/Si composites were prepared by an arc melting method and a successive gas-deposition method. Among them, the Gd–Si/Si composite electrode exhibited reversible Li-insertion/extraction reactions and the best cycling performance: the initial Coulombic efficiency was 80% and the discharge capacity at the 1000th cycle was 840 mA h g–1. In addition to this, the composite electrode delivered a superb high-rate performance with the capacity of 2100 mA h g–1 even at the high current rate of 12.0 A g–1 (4.8C). The remarkable performances demonstrated that the gadolinium silicide is favorable to significantly enhance anode properties of Si-based composite electrodes

1250nm帯モード同期クロム・フォルステライトレーザーを光源とした第2高調波発生光顕微鏡によるヒト顔皮膚の老化性真皮コラーゲン構造変化のその場観察

In vivo visualization of human skin aging is demonstrated using a Cr:Forsterite (Cr:F) laser-based, collagen-sensitive second harmonic generation (SHG) microscope. The deep penetration into human skin, as well as the specific sensitivity to collagen molecules, achieved by this microscope enables us to clearly visualize age-related structural changes of collagen fiber in the reticular dermis. Here we investigated intrinsic aging and/or photoaging in the male facial skin. Young subjects show dense distributions of thin collagen fibers, whereas elderly subjects show coarse distributions of thick collagen fibers. Furthermore, a comparison of SHG images between young and elderly subjects with and without a recent life history of excessive sun exposure show that a combination of photoaging with intrinsic aging significantly accelerates skin aging. We also perform image analysis based on two-dimensional Fourier transformation of the SHG images and extracted an aging parameter for human skin. The in vivo collagen-sensitive SHG microscope will be a powerful tool in fields such as cosmeceutical sciences and anti-aging dermatology.博士（医学）・乙第1311号・平成25年5月29

Transient improvement of urticaria induces poor adherence as assessed by Morisky Medication Adherence Scale-8.

Poor adherence to medication is a major public health challenge. Here, we aimed to determine the adherence to oral and topical medications and to analyze underlying associated factors using the translated Japanese version of Morisky Medication Adherence Scale-8 regarding urticaria treatment. Web-based questionnaires were performed for 3096 registered dermatological patients, along with a subanalysis of 751 registered urticaria patients in this study. The adherence to oral medication was significantly associated with the frequency of hospital visits. Variables that affected the adherence to topical medication included age and experience of drug effectiveness. The rate of responses that "It felt like the symptoms had improved" varied significantly among the dermatological diseases treated with oral medications. Dermatologists should be aware that adherence to the treatment of urticaria is quite low. Regular visits and active education for patients with urticaria are mandatory in order to achieve a good therapeutic outcome by increasing the adherence

Insight into innate immune response in “Yusho”: The impact of natural killer cell and regulatory T cell on inflammatory prone diathesis of Yusho patients

Background: In 1968 in western Japan, polychlorinated biphenyl-contaminated “Kanemi rice oil” was used in cooking, causing food poisoning in many people. More than 50 years have passed since the Yusho incident, and although inflammatory disorders such as suppuration have been observed in Yusho patients, the etiology of this inflammation susceptibility remains obscure. Objectives: To investigate the mechanisms of susceptibility to inflammation in Yusho patients, peripheral immune cell fractions and concentrations of inflammatory cytokines were evaluated in blood samples collected from both Yusho patients and age-matched healthy subjects undergoing medical examination in Nagasaki. Methods: To exclude diagnostic uncertainty, serum levels of polychlorinated biphenyl (PCB), polychlorinated quarterphenyl (PCQ), and polychlorinated dibenzofuran (PCDF) were measured. Immune cell (e.g. natural killer and regulatory T cell) populations were analyzed by flow cytometry. Serum cytokines involved in immune cell activation were measured by ELISA. Results: The relative proportion of natural killer cells was higher in Yusho patients than in healthy subjects, while the proportion of regulatory T cells did not differ between groups. Serum concentrations of IL-36 and IFN-γ were significantly lower in Yusho patients than in healthy subjects. Conversely, serum cytotoxic T lymphocyte-associated antigen-4 (CTLA-4), which is a cytokine related to activated NK cells, was higher in Yusho patients than in healthy subjects and was positively correlated with PCDF blood levels. Conclusion: Increased numbers of NK cells in Yusho patients suggests that the innate immune response has been activated in Yusho patients. The seemingly paradoxical results for CTLA-4 and IFN-γ may reflect counterbalancing mechanisms preventing excessive NK cell activation. This dysregulation of innate immunity might contribute to the inflammation observed in Yusho patients

Evaluación de factibilidad económica y financiera para la importación y comercialización de llantas para vehículos de tres ruedas - 2016

RESUMEN La presente tesis en proyectos de inversión trata del estudio de rentabilidad de la importación y comercialización de llantas para vehículos de tres ruedas en nuestro mercado conocidos como MOTOTAXI especialmente de la marca Bajaj. Contactamos con un fabricante de llantas de la India quien llego a Lima ofreciendo sus productos y en el abanico de su oferta pudimos identificar las llantas para mototaxi, cerramos el negocio por la compra de un contenedor de 20 pies (2 250 llantas) del tamaño 4.00-8. La empresa fue constituida el 29 de septiembre del 2016 con el nombre de JRM TYRES SAC con número de RUC 20601541000 el capital inicial fue de S/. 87 340.00 obtenido a través de un prestamos en el Banco de Crédito del Perú con una TEA de 8.5 %, los socios accionistas son 3 quienes comparten todos los gastos relacionados al proyecto. La demanda en Lima Metropolitana es el 50 % del mercado total en el Perú la diferencia se encuentra distribuida en los demás departamentos del país. No existe una ley que reglamente el servicio que los mototaxis realizan, son las municipales que a través de ordenanzas reglamentan el servicio y la cantidad de estos vehículos. Nuestro producto, no se comercializa en Lima, pero si existen varias marcas que han ingresado al mercado, una de las debilidades es que aún no conocemos exactamente sus cualidades de rendimiento, pero según la información del fabricante estaríamos compitiendo con la llanta mejor posicionada en el mercado local (MRF). Se ha realizado el estudio de rentabilidad del proyecto, dando como resultados la viabilidad del proyecto de inversión, con la meta inicial de importar 4 contenedores de 20 ft por año y comercializar cada contenedor en 3 meses. Para nuestro segundo año esperamos tener posicionada nuestra marca e iniciar actividades en otros rubros, ya que el fabricante tiene un gran abanico de productos.ABSTRACT The present thesis in investment projects is about the studying of the economic profitability of import and selling tyres to three wheeler vehicles in our market, knowing as “mototaxi”, mainly Bajaj brand. We did contact with one maker of this type of tyres from India who arrived to Lima offering his products and we can found the three wheeler tyres is their product catalog, we close a business for the purchase of one (20 feet) container (2 250 units) of 4.00 – 8 tyres. The business was establish in September 29th, 2016 under the name of JRM TYRES SAC, with RUC number 20601541000, our initial capital was S/. 127 340 obtained by bank loan in the Bank of Credit of Peru (BCP) with an interest of TEA of 8.5 %, the shareholder partners are three people whom they face all the expenses of the project. The demand in Lima area is 50% of the global market in Peru, the other 50% is located around the others departments of Peru. There is not a law that regulates the service of the mototaxis do; however the municipalities through ordinances are regulate the services and the quantity of these vehicles in each district. Our product is not selling in Lima under the same name and brand, but there are many brands that are entry at the local market. One of our weaknesses is that we do not know exactly their qualities of the performance but according to the manufacturer the tyres are as same as the best tyres in our market (MRF). We did the studies of the cost effectiveness of our project, and the results are positives, with the target of import four containers per year and sell it every three months. For our second year we will hope to have our brand positioned and start other activities of selling different kinds of tyres in other areas, because the manufacturer has a good variety of products

Japanese guidelines for atopic dermatitis 2020.

Atopic dermatitis (AD) is a disease characterized by relapsing eczema with pruritus as a primary lesion, which is frequently encountered in clinical practice. Skin barrier dysfunction leads to enhanced skin irritability to non-specific stimuli and epicutaneous sensitization. In the lesion site, a further inflammation-related reduction in skin barrier function, enhanced irritability and scratching-related stimuli deteriorate eczema, leading to vicious cycle of inflammation. The current strategies to treat AD in Japan from the perspective of evidence-based medicine consist of three primary measures: (i) the use of topical corticosteroids and tacrolimus ointment as the main treatment for the inflammation; (ii) topical application of emollients to treat the cutaneous barrier dysfunction; and (iii) avoidance of apparent exacerbating factors, psychological counseling and advice about daily life. The guidelines present recommendations to review clinical research articles, evaluate the balance between the advantages and disadvantages of medical activities, and optimize medical activity-related patient outcomes with respect to several important points requiring decision-making in clinical practice

Poor adherence to medication as assessed by the Morisky Medication Adherence Scale-8 and low satisfaction with treatment in 237 psoriasis patients

Previously we assessed the medication adherence for oral and topical remedies by a translated Japanese version of the Morisky Medication Adherence Scale-8 (MMAS-8) together with socioeconomic backgrounds in 3096 Japanese dermatological patients, and found the medication adherence, especially to topical drugs, was poor in these patients. In order to elucidate the disease-specific sociomedical factors, we further sub-analyzed the medication adherence in 237 psoriasis patients and compared it with that in other dermatological diseases such as atopic dermatitis, urticaria or tinea. This study was conducted among patients registered in monitoring system and 3096 eligible patients were enrolled. Our web-based questionnaire included the following items such as age, sex, annual income, main health-care institution, experience of effectiveness by oral or topical medication, overall satisfaction with treatment, and MMAS-8 for oral or topical medication. Mean adherence score by MMAS-8 was 5.2 for oral and 4.3 for topical medication. More patients with psoriasis used a university hospital and fewer used a private clinic compared with those with the other skin disease patients. Experience of drug effectiveness by oral medication and overall satisfaction with treatment was lower in psoriasis patients than in other patients. In oral medication, significantly better adherence was observed in those of higher age and with higher annual income. The adherence to medication, especially to topical drugs, was poor in 237 psoriasis patients. We speculated that some severe psoriasis patients were not sufficiently treated systemically and were resistant to topical therapy, leading to poor adherence