Case Report Adult Dermatomyositis with Bleeding Ulcer in the Pharynx

Dermatomyositis (DM) is one of the idiopathic inflammatory myopathies caused by complement-mediated vasculopathy or vasculitis in the muscle. Although the gastrointestinal (GI) mucosa has been reported to be involved as a result of vasculitis or vasculopathy, ulceration in the pharynx is a rare manifestation of DM. A 54-year-old woman complaining of muscle weakness in the extremities, low-grade fever, and dysphagia was diagnosed as having DM. Despite medical treatment with corticosteroids and immunosuppressive agents, her DM progressed rapidly, leading to exacerbation of the dysphagia. About 3 weeks after undergoing tracheostomy as a preventive measure against aspiration, the patient developed intractable respiratory tract hemorrhage. Repeated laryngoendoscopy revealed a bleeding ulceration in the pharynx that required hemostasis with electric cautery under general anesthesia. No bleeding recurred thereafter. Histopathologically, the pharynx exhibited nonspecific inflammatory cell infiltration in the muscle tissue. This rare manifestation may be considered in cases of DM with unexplainable airway bleeding

ショウゲキセイ オンキョウ バクロゴ ノ ナイジ ニ オケル JNK カッセイカ

京都大学0048新制・論文博士博士(医学)乙第12247号論医博第1963号新制||医||970(附属図書館)UT51-2008-L172(主査)教授 清水 章, 教授 金子 武嗣, 教授 渡邉 大学位規則第4条第2項該当Doctor of Medical ScienceKyoto UniversityDA

Rectification of elastic waves in a thin plate

We propose a rectifier of elastic waves in a thin plate, which is made of an elastically isotropic material containing a periodic array of triangular holes as scatterers, and demonstrate numerically that it works both for the symmetric and anti-symmetric Lamb waves as well as shear horizontal waves. The rectification is caused by the geometric effects on wave scattering due to the asymmetric scatterers, while the interplay between the mode conversion and interference effects among the scattered waves owing to the periodic arrangement of scatterers complicates it. The mechanism makes it possible to rectify the typical elastic waves in the system above the threshold frequency corresponding to the wavelength equivalent to the periodicity of scatterers