Paecilomyces lilacinus-induced Scleritis Following Bleb-associated Endophthalmitis after Trabeculectomy

Paecilomyces lilacinus (P. lilacinus) is a rare cause of fungal scleritis. We herein report a case of P. lilacinus-induced scleritis following bleb-associated endophthalmitis after trabeculectomy that was successfully treated with surgical excision of the affected sclera in combination with antifungal medication. An 85-year-old female underwent trabeculectomy of the left eye. A dellen formed in the corneal periphery due to limbal elevation of the filtering bleb and progressed to an infectious corneal ulcer, leading to blebitis. Eight days after the onset of blebitis, the patient was diagnosed with endophthalmitis, which resolved after vitrectomy. The growth of P. lilacinus was identified on swabs of the conjunctiva and the corneal specimen. Scleritis developed after the resolution of the endophthalmitis, and an early excision of the affected sclera, in addition to antifungal medication, resolved it completely. However, the scleritis recurred in a different region of the left eye. After 7 months of antifungal medication, the left eye showed no residual infection. When treating P. lilacinus-induced scleritis, surgical excision of the affected sclera has been shown to be an effective treatment strategy. Nevertheless, it is possible that the infection may recur in another part of the eyeball after the complete resolution of the primary lesion

Body sway increases immediately after strabismus surgery.

The purposes of this study were to examine whether body sway is altered immediately after strabismus surgery in children and to find preoperative clinical factors associated with body sway. In a prospective study, body sway was measured on 1-3 days before surgery and on the third day after surgery; for the measurements, computerized static stabilometry was carried out on 28 consecutive patients with strabismus (age range: 3 to 12 years old; mean: 7.4) who underwent strabismus surgery under general anesthesia. The linear length of the sway path (cm), the linear length of the sway path in a particular unit of time (cm/second), and the area of the sway path (cm2), indicative of the extent of body sway, all increased significantly among a total of 28 patients in both conditions of the patient's eyes open and closed, as well as among those in a subgroup of 16 patients with exotropia, after they had undergone strabismus surgery (p &#60; 0.05, Wilcoxon signed ranks test). The center of pressure along the Y axis of orientation from the toe to the heel was found to deviate significantly toward the heel postoperatively, as compared with the preoperative center in the subgroup of 16 patients with exotropia (p &#60; 0.05). Before surgery, 15 patients with no stereoacuity exhibited a greater amount of body sway when their eyes were open than did 13 patients with measurable stereoacuity (p &#60; 0.05, Mann-Whitney U-test). In the subgroup of 16 patients with exotropia when their eyes open, 3 patients with abnormal head posture exhibited more extensive body sway than did 13 patients without abnormal head posture (p &#60; 0.05). Body sway was found to significantly increase immediately after strabismus surgery in children with strabismus. Stereoacuity and abnormal head posture are 2 clinical factors associated with preoperative postural instability.</p

進行大腸癌における大腸ステント留置術と集学的治療の検討

学位の種別: 課程博士審査委員会委員 : (主査)東京大学教授 渡邉 聡明, 東京大学教授 大友 邦, 東京大学准教授 藤城 光弘, 東京大学講師 鈴木 亮, 東京大学講師 伊地知 秀明University of Tokyo(東京大学

Effects of Extracellular Acidification on Intracellular pH and ATP-Induced Calcium Mobilization in Rabbit Lens Epithelial Cells

Effects of extracellular acidification on intracellular pH (pHi) and ATP-induced calcium mobilization were investigated in rabbit lens epithelial cells. Primary-cultured lens epithelial cells of Japanese white rabbits were used. Intracellular calcium ([Ca2+]i) and pHi were measured by using fluorescent dyes, fura-2 acetoxymethylester (fura-2 AM) and 2',7'-bis (carboxyethyl)-5,6-carboxyfluorescein acetoxymethylester (BCECF AM), respectively. The addition of 10 ?mol/L ATP produced an initial peak followed by a sustained increase in [Ca2+]i in a standard artificial aqueous humor at extracellular pH (pH0) 7.40. The initial peak was abolished by pretreatment with 1 ?mol/L thapsigargin, whereas the sustained increase was attenuated in a Ca2+-free solution or by pretreatment with 100 ?mol/L verapamil. Acidification of the pH0 from 7.40 to 6.80 decreased the pHi from 7.21 to 7.03, and enhanced both the initial peak and sustained increase in [Ca2+]i. These results suggest that acidification of pH0 significantly affects the pHi and modifies the ATP-induced [Ca2+]i transient in rabbit lens epithelial cells

Super responder of critical COVID-19 case

This report presents a case of a 74-year-old man who showed dramatic therapeutic response to treatment of coronavirus infectious disease-19 (COVID-19) pneumonia. He reported four-day history of sustained fever and acute progressive dyspnea. He developed severe respiratory failure, underwent urgent endotracheal intubation and showed marked elevation of inflammatory and coagulation markers such as c-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH) and D-dimer. Chest computed tomography (CT) demonstrated diffuse consolidation and ground glass opacity (GGO). We diagnosed critical COVID-19 pneumonia with detailed sick contact history and naso-pharyngeal swab of a reverse-transcriptase-polymerase-chain reaction (RT-PCR) assay testing. He received anti-viral drug, anti-interleukin (IL-6) receptor antagonist and intravenous methylprednisolone. After commencing combined intensive therapy, he showed dramatic improvement of clinical condition, serum biomarkers and radiological findings. Early diagnosis and rapid critical care management may provide meaningful clinical benefit even if severe case

A Randomized Phase 2 Trial of Antibiotic Prophylaxis Versus No Intervention for Muscle Biopsy in A Neurology Department

Muscle biopsy can be used to confirm the diagnosis of neuromuscular diseases. However, it is unclear whether antibiotic prophylaxis prior to muscle biopsy is needed to prevent surgical site infection (SSI). We are conducting a phase 2, single-center, open-labeled, prospective randomized trial to clarify the need for antibiotic prophylaxis in patients at low risk for SSI undergoing muscle biopsy. Patients will be randomized to an antibiotic prophylaxis group or a control group, and the incidence of SSI will be compared between the groups. Our findings will clarify the need for antibiotic prophylaxis in this patient population

Self-Expandable Metal Stent Placement as a Bridge to Laparoscopic or Open Surgery for Obstructive Colorectal Cancer: Short-Term Outcomes of Nineteen Consecutive Cases

Purpose Laparoscopic colorectal resection is a feasible and less invasive procedure with short-term advantages compared with open surgery; however, the evidence for its efficacy for treating obstructive colorectal cancer (CRC) is lacking. In this study, we aimed to determine short-term outcomes of SEMS placement for obstructive CRC followed by laparoscopic colorectal resection.Methods As of August 2013, 51 patients with obstructive CRC underwent stent insertion. Thirty-two patients received palliation therapy not intended for tumor resection. After decompression of the proximal intestine, nine and 10 patients underwent laparoscopic and open surgery, respectively. Clinicopathological, intraoperative, and postoperative data were retrospectively collected.Results There were no differences in resection rates and curabilities between the two groups. All surgeries were performed with a single-stage anastomosis, and no anastomotic leakage was observed. There was one patient with abdominal morbidity in the open group (Open) and none in the Lap group. There was no mortality in either group. Time to flatus (3.4 ± 1.8 days, Lap; 2.6 ± 1.1 days, Open) and time to oral intake (7.9 ± 2.5 days, Lap; 7.7±1.9 days, Open) were similar between the groups. Postoperative hospitalization times for the Lap group were shorter, but the difference was not statistically significant (15.2 ± 3.9 days, Lap; 21 ± 11.7 days, Open, p = 0.21).Conclusion Our findings indicate that laparoscopic surgery combined with preoperative stent placement is feasible as well as safe compared with open surgery for obstructive CRC

The Far-Infrared Surveyor (FIS) for AKARI

The Far-Infrared Surveyor (FIS) is one of two focal plane instruments on the AKARI satellite. FIS has four photometric bands at 65, 90, 140, and 160 um, and uses two kinds of array detectors. The FIS arrays and optics are designed to sweep the sky with high spatial resolution and redundancy. The actual scan width is more than eight arcmin, and the pixel pitch is matches the diffraction limit of the telescope. Derived point spread functions (PSFs) from observations of asteroids are similar to the optical model. Significant excesses, however, are clearly seen around tails of the PSFs, whose contributions are about 30% of the total power. All FIS functions are operating well in orbit, and its performance meets the laboratory characterizations, except for the two longer wavelength bands, which are not performing as well as characterized. Furthermore, the FIS has a spectroscopic capability using a Fourier transform spectrometer (FTS). Because the FTS takes advantage of the optics and detectors of the photometer, it can simultaneously make a spectral map. This paper summarizes the in-flight technical and operational performance of the FIS.Comment: 23 pages, 10 figures, and 2 tables. Accepted for publication in the AKARI special issue of the Publications of the Astronomical Society of Japa