One autopsy case of an elderly traffic accident victim with Tetralogy of Fallot

The case of a61-year-old male traffic accident victem with Tetralogy of Fallot (TOF) is reported. The autopsy revealed massive hemorrhages in the subcutaneous tissue, muscle, and subarachnoidal space. Furthermore, multiple fractures of ribs, sternum and thoracic vertebrae were observed. Histopathological examination revealed changes characteristic of trauma, such as acute lung congestion, acute renal cortical necrosis, and embolization in the lungs and kidney. These autopsy and histological observations indi-cated that traumatic shock was cause of his death. Moreover, histologically, we observed changes due to his congenital heart disease, such as right ventricular hypertrophy, heart failure cells in the lungs, sclerosis of the liver, and hyaline degeneration in the kidney. Furthermore, ischemic changes, shrinkage or loss of neurons, were seen in hippocampus, and swelling of astrocytes in both cortex and hippocampus were also observed. These observations lead us to speculate that a hypoxic episode may have caused his accidental death while driving

Immunohistochemical diagnosis and significance of forensic neuropathological changes

Immunohistochemistry is very useful when investigating the cause of death. Ischemic cell changes in the hippocampal neurons were not obvious in the brains damaged by hypoxic injury. However, it is suggested that even a moderate hypoxia, which may affect the neuronal proteins and metabolism, induced astrocytes is in the CA3 and CA4 regions, and that in patients with a history of hypoxic attacks neuronal damage may be severe even several hours after ischemic injury. Furthermore, hsp70 expression was found in the CA2, CA3 and CA4 regions of long-term survivors after severe hypoxic / ischemic injury. In forensic practice, detailed information about the duration and extent of a hypoxic / ischemic injury is often unavailable, so that immunohistochemical detection of hsp70 and glial cell staining can be of great value in diagnosing not only the hypoxic / ischemic injury during the process of death but also the victim’s past history of hypoxic attacks. In diffuse axonal injury, degeneration of axon and myelin, such as swelling and waving, were observed in survivors of more than 8 hours. Retraction balls appeared in survivors of more than 1 days. In longer term survivors, such as 3 or 5 months, breakdown of myelin and fat-granule cells were observed. In addition, retraction balls were also found. Immunohistochemical staining of 200 kD neurofilament was a very useful method to examine axonal changes, because antisera is specific for degenerative neurofilaments. In our study, all cases which had pathological findings of diffuse axonal injury (DAI)were associated with focal head injuries. From the immunohistochemical staining of neurons in the hippocampus, it was suggested that neurons in the hippocampus were injured by diffuse brain damage. Furthermore, repairing and protective mechanisms occurred especially from CA2 toCA4. It was considered that neuronal damage in diffuse brain injury was elucidated not only morphologically but also functionally. Therefore, in cases of suspected diffuse brain damage, it is recommended to examine the neuronal changes in addition to observing the findings of diffuse axonal injury. Immunohistochemical staining of the carotid body is potentially very useful for necropsy diagnosis, since it provides a method to detect evidence of mechanical asphyxia in suspected cases of manual and/or ligature strangulation

Development of a cluster of LXC containers

The consensus algorithms were designed to reach agreements in distributed systems trying to maintain a certain tolerance to failures. An application derived from these algorithms is ETCD, a type of key-value storage that provides a safe and reliable way to save data shared in a network of servers, allowing the preser- vation of the information in spite of the possible fall of the involved nodes . My thesis shows the design and operation of these algorithms, and addresses the question of how to man- age the ETCD database and which features involves, as well as recommendations of configuration settings to achieve the best performance of the system. Finally, an academic practice is presented, aimed to network students that would want to have a deeper knowledge about consensus algorithms applications in a distributed system

PACAP centrally mediates emotional stress-induced corticosterone responses in mice

Pituitary adenylate cyclase-activating polypeptide (PACAP) is a pleiotropic neuropeptide widely distributed in the nervous system. Recently, PACAP was shown to be involved in restraint stress-induced corticosterone release and concomitant expression of the genes involved in hypothalamic–pituitary–adrenal (HPA) axis activation. Therefore, in this study, we have addressed the types of stressors and the levels of the HPA axis in which PACAP signaling is involved using mice lacking PACAP (PACAP−/−). Among four different types of stressors, open-field exposure, cold exposure, ether inhalation, and restraint, the corticosterone response to open-field exposure and restraint, which are categorized as emotional stressors, but not the other two, was markedly attenuated in PACAP−/− mice. Peripheral administration of corticotropin releasing factor (CRF) or adrenocorticotropic hormone induced corticosterone increase similarly in PACAP and wild-type mice. In addition, the restraint stress-induced c-Fos expression was significantly decreased in the paraventricular nucleus (PVN) and medial amygdala (MeA), but not the medial prefrontal cortex, in PACAP−/− mice. In the PVN of PACAP−/− mice, the stress-induced c-Fos expression was blunted in the CRF neurons. These results suggest that PACAP is critically involved in activation of the MeA and PVN CRF neurons to centrally regulate the HPA axis response to emotional stressors

Lower-dose prescriptions in the post-marketing situation and the influencing factors thereon.

The dosage of pharmaceuticals is determined through the process of clinical development and approval review based on clinical trial results; however, the information obtained from clinical trials before approval is limited. Some pharmaceutical products are used at doses lower than those approved for post-marketing use. The aim of this study was to reveal the actual state of lower-dose prescriptions for post-marketing clinical use of pharmaceuticals. We investigated the factors related to the deviation based on therapeutic area, detailed statement of the approved dosage, clinical data package, and post-marketing requirement. Among the new molecular entities approved in Japan between January 2005 and December 2014, we identified products that are orally administered and have the same daily dose for different indications, if any. For these products, we collected information on the actual daily dose from the medical information databases of Medical Data Vision Co., LTD. and JammNet Co., LTD. Products whose dose was lower than the approved dose (maintenance dose excluding the initial dose) in ≥ 30% prescriptions in 2015 were defined here as "lower-dose prescription drugs." We identified 27 lower-dose prescription drugs out of 113 products investigated. The results of the multivariate analysis revealed that factors related to the Anatomical Therapeutic Chemical classification and the detailed statement of the approved dosage significantly influenced the occurrence of lower-dose prescription, whereas the factors related to clinical data package and post-marketing requirements did not. These results suggest the limitation in determining an optimal dosage for the actual clinical use of a drug based on the information obtained from clinical trials conducted before approval, emphasizing the importance of reexamining the optimal dosage that is applicable to a greater number of patients after marketing, if necessary. We believe that the utilization of real-world data could be of help in this regard

Laboratory observation of shear stress recovery in rock joints asperity considering joint compaction and dilatancy

Understanding the shear stress recovery mechanism during the stick-slip motion is a fundamental requirement for predicting the sliding behavior of rock joints. In this study, slide-hold-slide (SHS) type direct shear experiments under constant normal stress are performed on granite joints with significant roughness components to investigate the effects of compaction and dilation on the shear stress recovery. The shear stress recovery of rock joints is contributed by the growth of the contact area induced by the compaction during the hold period and the enhancement of dilation work during the re-shear process. The contact area reaches the maximum value under relatively low normal stress after the long hold period. Then, the dilation gradually contributes to the shear stress recovery because the welded asperities or grains are assembled, and the slide needs to ride over these bonded areas. The surface roughness plays a significant role in the shear stress recovery since the initial aperture and asperity morphology affect the compaction and dilation. The greater magnitude of shear stress recovery observed on rougher surfaces can be attributed to the effective normal closure during the hold period and significant dilation after the long hold periods

Modeling the shearing behavior of discontinuous rock mass incorporating dilation of joint aperture

The shearing characteristics of rock joints govern the mechanical performance of discontinuous rock masses. The present study investigated the normal compression and shear behavior of rock joints through cyclic compression tests and direct shear tests. The irreversible relationship between the normal stress and the normal closure was confirmed by cyclic compression tests on rock joints. An elastoplastic model was proposed incorporating the aperture variation. A modified version of the critical state framework was developed for modeling the shearing and dilation behavior. Specifically, the initial state of the rock joints was determined according to the stress history. The proposed model for the mechanical behavior of rock joints was validated by predicting the experimental results. A parameter analysis was also performed to highlight the difference in the shear behavior of the rock joints due to the difference in the initial apertures