Modest Expansion of Vβ2+CD4+ T Cells and No Expansion of Vβ7+CD4+ T Cells in a Subgroup of Kawasaki Disease Patients with Erythematic BCG Inoculation Site Lesions

Background: The similarities between Kawasaki disease (KD) and superantigen (SA) diseases indicate that a microbial SA might cause KD. Viral diseases can trigger an endogenous SA.Methods: We evaluated expression of Vβ2 (responding to staphylococcal TSST-1) and Vβ7 (responding to the endogenous SA induced by type-1 interferon or Epstein-Barr virus infection) on T cells from 70 KD patients along with the following control subjects: 18 non-vasculitic patients (NVs), 7 patients with anaphylactoid purpura (AP), and two with neonatal TSS-like exanthematous disease (NTED), a typical SA disease. We examined the correlation of clinical features of KD with Vβ2+ or Vβ7+CD4+T cell populations.Results: The Vβ2+CD4+T cell rates were comparable between KD patients (9.9±2.9%) and NVs (9.0±1.8%), but were lower in AP patients (6.6±1.8%). However, the Vβ2+CD4+T cell rate was significantly higher in KD patients with erythematic BCG inoculation site lesions (10.8±3.2%) than in those without (8.8±2.1%) and NVs (9.0±1.8%), but much lower than in NTED patients (25.2%, 16.9%). Multivariate linear regression analysis with elevation of Vβ2 expression as a dependent variable revealed significant correlations with BCG. In contrast, Vβ7+CD4+T cell rates were not significantly different between KD patients and other study subjects.Conclusion: While we were unable to find evidence supporting the involvement of the endogenous SA in the pathogenesis of KD in this study, modest expansion of the Vβ2+CD4+T cell population in a subgroup of KD with erythematic BCG inoculation site lesions implies the involvement of a microbial agent(s) different from TSST-1 as well as immunopathological heterogeneity of KD. (249 words

Efficient point cloud data processing in shipbuilding: Reformative component extraction method and registration method

To survive in the current shipbuilding industry, it is of vital importance for shipyards to have the ship components’ accuracy evaluated efficiently during most of the manufacturing steps. Evaluating components’ accuracy by comparing each component’s point cloud data scanned by laser scanners and the ship’s design data formatted in CAD cannot be processed efficiently when (1) extract components from point cloud data include irregular obstacles endogenously, or when (2) registration of the two data sets have no clear direction setting. This paper presents reformative point cloud data processing methods to solve these problems. K-d tree construction of the point cloud data fastens a neighbor searching of each point. Region growing method performed on the neighbor points of the seed point extracts the continuous part of the component, while curved surface fitting and B-spline curved line fitting at the edge of the continuous part recognize the neighbor domains of the same component divided by obstacles’ shadows. The ICP (Iterative Closest Point) algorithm conducts a registration of the two sets of data after the proper registration’s direction is decided by principal component analysis. By experiments conducted at the shipyard, 200 curved shell plates are extracted from the scanned point cloud data, and registrations are conducted between them and the designed CAD data using the proposed methods for an accuracy evaluation. Results show that the methods proposed in this paper support the accuracy evaluation targeted point cloud data processing efficiently in practice

Clinical outcomes of sigmoid colon volvulus: identification of the factors associated with successful endoscopic detorsion

Background/Aims: Although multiple treatment options exist for the management of sigmoid colon volvulus, no study has examined the factors associated with successful endoscopic detorsion. This study aimed to examine the clinical course of patients with sigmoid colon volvulus and to identify factors related to successful endoscopic detorsion.Methods: This study included 30 cases (21 patients) of sigmoid volvulus from among 545 cases of intestinal obstruction at a single center. We retrospectively examined the clinical course and the factors associated with the possibility of endoscopic detorsion of sigmoid colon volvulus.Results: The rate of laxative use among the study participants was 76.2%; the rate of comorbid neuropsychiatric disorders was 61.9%; and 57.1% of patients had a history of open abdominal surgery. All patients were initially treated with endoscopic detorsion, and this procedure had a 61.9% success rate. The recurrence rate after detorsion was as high as 46.2%, but detorsion during revision endoscopy was possible in all cases. Statistical analysis revealed that the absence of abdominal tenderness (P=0.027), the use of laxatives (P=0.027), and a history of open abdominal surgery (P=0.032) were factors predictive of successful endoscopic detorsion.Conclusions: The results of our study are consistent with previous reports with respect to the success rate of endoscopic detorsion, the subsequent recurrence rate, and the proportion of patients requiring surgical treatment. In addition, we identified the absence of abdominal tenderness, the use of laxatives, and history of open abdominal surgery as factors predicting successful endoscopic detorsion of sigmoid colon volvulus

Efficacy and safety of endoscopic procedures for common bile duct stones in patients aged 85 years or older: A retrospective study.

The Endoscopic procedures for common bile duct (CBD) stones are reportedly safe in the elderly patients. However, the definition of the elderly is different in each report. If the elderly are defined as people aged 85 years or older, data on the effectiveness and safety of endoscopic retrograde cholangiopancreatography (ERCP) for CBD stones are limited. This study investigated the efficacy and safety of endoscopic procedures for CBD stones in patients aged 85 years or older. 1,016 consecutive ERCP procedures were performed at our institution from January 2009 to December 2014. Of these, 235 cases with CBD stones were finally analyzed. Group A patients were younger than 85 years and Group B patients were 85 years or older. Patient background, details of endoscopic therapy, complications, and related factors were retrospectively reviewed for 185 cases in Group A, and 50 cases in Group B. Patients in Group B showed high rates of dementia and cerebrovascular disorders and larger CBD stones and diameters, in comparison with patients in Group A. The complete removal rate of bile duct stones was slightly higher in Group A. However, there was no difference between the two groups in recurrence rate of CBD stones, complication and mortality rates, and length and cost of hospitalization. Despite some differences between the two groups, endoscopic procedures for CBD stones in patients aged 85 years or older can be performed effectively and safely without increasing medical costs