Tubulointerstitial nephritis complicating IVIG therapy for X-linked agammaglobulinemia

BACKGROUND: Patients with X-linked agammaglobulinemia (XLA) develop immune-complex induced diseases such as nephropathy only rarely, presumably because their immunoglobulin (Ig) G concentration is low. We encountered a patient with XLA who developed tubulointerstitial nephritis during treatment with intravenous immunoglobulin (IVIG). CASE PRESENTATION: A 20-year-old man was diagnosed with XLA 3 months after birth and subsequently received periodic γ-globulin replacement therapy. Renal dysfunction developed at 19 years of age in association with high urinary β2-microglobulin (MG) concentrations. A renal biopsy specimen showed dense CD3-positive lymphocytic infiltration in the tubulointerstitium and tubular atrophy, while no IgG4-bearing cell infiltration was found. Fibrosclerosis and crescent formation were evident in some glomeruli. Fluorescent antibody staining demonstrated deposition of IgG and complement component C3 in tubular basement membranes. After pulse steroid therapy was initiated, urinary β2-MG and serum creatinine concentrations improved. CONCLUSION: Neither drug reactions nor collagen disease were likely causes of tubular interstitial disorder in this patient. Although BK virus was ruled out, IgG in the γ-globulin preparation might have reacted with a pathogen present in the patient to form low-molecular-weight immune complexes that were deposited in the tubular basement membrane

〈Cases Reports〉Recurrent focal intestinal perforation in extremely-low-birth-weight infant

[Abstract] In recent years, the incidence of focal intestinal perforation (FIP) has been increasing, as the survival rate of extremely-low-birth-weight(ELBW) infants has been rising. We present a case of an ELBW infant who suffered three recurrences of FIP in a very short period of time. The patient was a female infant who was born at 24 weeks and 2 days of gestation, with a birth weight of 579 g. On her 22^nd day of life, abdominal X-rays revealed free air, which suggested intestinal perforation, and an intraperitoneal drainage tube was placed. Intraperitoneal lavage was performed on day 28 of life,and the drained fluid was turbid with feces, suggesting a recurrence of perforation. On day 30 of life, laparotomy revealed a perforation of approximately 1cm in diameter located at 6 cm from the ileocecum on the oral side. The X-ray taken on day 34 again revealed free air, and, through another laparotomy, a new perforation was found at about 15 cm from the stoma on the oral side. This case provides suggestions that may shed light on our approach to determine the pathogenesis of FIP, especially since no other case of FIP recurring three times has ever been reported

Transient crater growth in granular targets : An experimental study of low velocity impacts into glass sphere targets

We experimentally studied the formation and collapse processes of transient craters. Polycarbonate projectiles with mass of 0.49 g were impacted into the soda-lime glass sphere target (mean diameters of glass spheres are not, vert, similar36, 72, and 220 μm, respectively) using a single-stage light-gas gun. Impact velocity ranged from 11 to 329 m s−1. We found that the transient crater collapses even at laboratory scales. The shape (diameter and depth) of the transient crater differs from that of the final crater. The depth–rim diameter ratios of the final and transient craters are 0.11–0.14 and 0.26–0.27, respectively. The rim diameter of both the transient and final crater depends on target material properties; however, the ratio of final to transient crater diameter does not. This suggests that target material properties affect the formation process of transient craters even in the gravity regime, and must be taken into account when scaling experimental results to planetary scales. By observing impacts into glass sphere targets, we show that although the early stage of the excavation flow does not depend on the target material properties, the radial expansion of the cavity after the end of vertical expansion does. This suggests that the effect of target material properties is specifically important in the later part of the crater excavation and collapse

Impacts of Oceanic Preexisting Conditions on Predictions of Typhoon Hai-Tang in 2005

We investigated the impact of variations in oceanic preexisting conditions on predictions of Typhoon Hai-Tang (2005) by using a coupled atmosphere-ocean model with 6-km horizontal resolution and providing the oceanic initial conditions on 12 July from 1997 to 2005 to the model. Variations in oceanic preexisting conditions caused variation in predicted central pressure of nearly 18 hPa at 72 h, whereas sea-surface cooling (SSC) induced by Hai-Tang caused a predicted central pressure difference of about 40 hPa. Warm-core oceanic eddies up to a few hundred kilometers across and a deep mixed layer climatologically distributed in the western North Pacific led to high mixed-layer heat potential, which increased latent heat flux, water vapor, and liquid water contents around Hai-Tang's center. These increases were closely associated with Hai-Tang's intensification. SSC negatively affected the eyewall, whereas variations in oceanic preexisting conditions remarkably affected spiral rainbands and the magnitude of SSC

Interactions between Typhoon Choi-wan (2009) and the Kuroshio Extension System

We investigated interactions between Typhoon Choi-wan (2009) and the Kuroshio Extension system with a coupled atmosphere-wave-ocean model in 14 numerical simulations performed with initial conditions obtained from daily oceanic reanalysis data for the northwestern Pacific Ocean from September 12 to September 25, 2009. Preexisting oceanic conditions affected the simulated central pressure and the inner-core axisymmetric structure of the simulated typhoon differently during the intensification, mature, and decaying phases, but they had little impact on the simulated track. Among the simulations, the simulated central pressure range during the mature phase was ~10 hPa. Simulated central pressure was highly correlated with the axisymmetric mean horizontal specific humidity flux between radii of 50 and 150 km and altitudes of 20 to ~2000 m, suggesting that this flux has potential as a new metric for predicting tropical cyclone intensity. Variations in preexisting oceanic conditions in the Kuroshio Extension region on the simulated atmospheric and oceanic horizontal fields affected the typhoon and a nearby stationary front differently. Around the stationary front, the impact on hourly precipitation was closely related to that on surface wind speed, whereas the impact on surface temperature was greatly affected by that on sea surface temperature through the latent heat flux

CO2 capture by polymeric membranes composed of hyper-branched polymers with dense poly(oxyethylene) comb and poly(amidoamine)

Due to CO2-philic nature of polyoxyethylene (POE), a dense POE comb structure was tethered onto PMMA backbone to develop CO2 separation membranes over N2. The resulting hyper-branched polymers displayed preferential CO2 permeation. When the polymer thin layer was formed on a high gas permeable polydimethylsiloxane (PDMS) support by a spray-coating manner, the resulting thin film composite (TFC) membranes displayed very high CO2 permeability. However, the CO2 selectivity, which was the permeability ratio of CO2 over N2, was moderate and lower than 50. To enhance the selectivity, poly(amidoamine) (PAMAM) was introduced to the hyper-branched polymers in the CO2-selective layer of the TFC membranes. The CO2 selectivity increased from 47 to 90 with increasing PAMAM content to 40 wt%, and it was drastically enhanced to 350 with PAMAM content of 50 wt%. Differential scanning calorimetry (DSC) and laser microscope revealed formation of PAMAM-rich domain at the higher amine content, where CO2 could readily migrate in comparison to the other polymeric fractions