The Efficacy and Safety of Dexmedetomidine for Procedural Sedation in Patients Receiving Local Anesthesia Outside the Intensive Care Unit: A Prospective, Double-Blind, Randomized Clinical Phase III Trial in Japan

Background: Few studies (in other countries than the US) have reported on the efficacy and safety of dexmedetomidine for sedation of patients undergoing surgical or medical procedures under local anesthesia without intubation outside the intensive care unit. We performed a randomized, double-blind study in Japan. Methods: Adult patients were randomly allocated to receive placebo, dexmedetomidine 0.5 μg/kg (DEX 0.5 group), or dexmedetomidine 1.0 μg/kg (DEX 1.0 group) over 10 min. Then, both dexmedetomidine groups received dexmedetomidine 0.2–0.7 μg/kg/h for maintaining an Observer’s Assessment of Alertness/Sedation Scale (OAA/S) score of ≤ 4; however, propofol was administered to rescue patients whose score exceeded this value. The primary endpoint was the percentage of patients who did not require rescue propofol to achieve and maintain an OAA/S score of ≤ 4. Results: In total, 162 patients were included in the placebo (n = 53), DEX 0.5 (n = 53), and DEX 1.0 (n = 56) groups. Propofol was not required in significantly more patients in the dexmedetomidine 0.5 and 1.0 μg/kg groups (52.8% and 57.1%, respectively) compared with the placebo group (1.9%) (P < 0.001 for both). Common adverse events were protocol-defined hypotension, respiratory depression and bradycardia. The incidence of bradycardia was significantly higher in the DEX 0.5 (26.4%) and DEX 1.0 (30.4%) groups than in the placebo group (9.4%) (P = 0.041 and P = 0.008, respectively). Conclusion: We concluded that a loading dose of 0.5 or 1.0 μg/kg dexmedetomidine followed by infusion at a rate of 0.2–0.7 μg/kg/h provided effective and welltolerated sedation in patients undergoing surgical or medical procedures under local anesthesia without intubation. Clinical trials.gov identifier: NCT0143893

Practical study on a new type Buckling-Restrained-Brace

p. 303-311A number of a new type Buckling-Restrained-Brace (T-BRB) using steel mortar planks have been applied to various structures (spatial structures, steel bridges and steel towers) as well as multi-story buildings. The brace has two buckling restraining parts (steel mortar planks), clipping a core plate being under axial forces. These parts are welded together and restrain the core plate of plastic behavior, avoiding the out-of-plane deformation and the buckling. The size of steel mortar plank can be designed corresponding to energy absorption demands, irrespectively the sizes of both end-connections. This paper introduces the applications of a new type BRB to various structures.Oya, T.; Fukasawa, T.; Fujiwara, M.; Kuroiwa, Y.; Arai, J. (2009). Practical study on a new type Buckling-Restrained-Brace. Editorial Universitat Politècnica de València. http://hdl.handle.net/10251/652

青色光は滑膜肉腫に対して活性酸素種によるミトコンドリア機能障害を起こし、アポトーシスとオートファジーを誘導する

Background: Synovial sarcoma (SS) has limited treatment options and there is an urgent need to develop a novel therapeutic strategy to treat SS. Blue light (BL) has been shown to inhibit the growth of several cancer cells. However, the efficacy of BL in soft tissue sarcomas such as SS has not been demonstrated, and the detailed mechanism underlying the antitumor activity of BL is not fully understood. In this study, we investigated the antitumor effect of BL on SS. Methods: Human SS cell lines were continuously irradiated with BL using light-emitting diodes (LEDs) in an incubator for in vitro analysis. The chicken chorioallantoic membrane (CAM) tumors and xenograft tumors in mice were subjected to daily BL irradiation with LEDs. Results: BL caused growth inhibition of SS cells and histological changes in CAM tumors. BL also suppressed the migration and invasion abilities of SS cells. The type of cell death in SS cells was revealed to be apoptosis. Furthermore, BL induced excessive production of reactive oxygen species (ROS) in mitochondria, resulting in oxidative stress and malfunctioned mitochondria. Reducing the production of ROS using N-acetylcysteine (NAC), a ROS scavenger, attenuated the inhibitory effect of BL on SS cells and mitochondrial dysfunction. In addition, BL induced autophagy, which was suppressed by the administration of NAC. The autophagy inhibitor of 3-methyladenine and small interfering RNA against the autophagy marker light chain 3B facilitated apoptotic cell death. Moreover, BL suppressed tumor growth in a mouse xenograft model. Conclusion: Taken together, our results revealed that BL induced apoptosis via the ROS-mitochondrial signaling pathway, and autophagy was activated in response to the production of ROS, which protected SS cells from apoptosis. Therefore, BL is a promising candidate for the development of an antitumor therapeutic strategy targeting SS

Human Adrenocortical Remodeling Leading to Aldosterone-Producing Cell Cluster Generation

Background. The immunohistochemical detection of aldosterone synthase (CYP11B2) and steroid 11β-hydroxylase (CYP11B1) has enabled the identification of aldosterone-producing cell clusters (APCCs) in the subcapsular portion of the human adult adrenal cortex. We hypothesized that adrenals have layered zonation in early postnatal stages and are remodeled to possess APCCs over time. Purposes. To investigate changes in human adrenocortical zonation with age. Methods. We retrospectively analyzed adrenal tissues prepared from 33 autopsied patients aged between 0 and 50 years. They were immunostained for CYP11B2 and CYP11B1. The percentage of APCC areas over the whole adrenal area (AA/WAA, %) and the number of APCCs (NOA, APCCs/mm2) were calculated by four examiners. Average values were used in statistical analyses. Results. Adrenals under 11 years old had layered zona glomerulosa (ZG) and zona fasciculata (ZF) without apparent APCCs. Some adrenals had an unstained (CYP11B2/CYP11B1-negative) layer between ZG and ZF, resembling the rat undifferentiated cell zone. Average AA/WAA and NOA correlated with age, suggesting that APCC development is associated with aging. Possible APCC-to-APA transitional lesions were incidentally identified in two adult adrenals. Conclusions. The adrenal cortex with layered zonation remodels to possess APCCs over time. APCC generation may be associated with hypertension in adults

Influence of dynamic annealing of irradiation defects on the deuterium retention behaviors in tungsten irradiated with neutron

Tungsten (W) samples were damaged by neutron and 6.4 MeV Fe-ion irradiation above 1000 K simulating the divertor operation temperature. Deuterium (D) retention properties were examined by decorating the damaged W with D and subsequent thermal desorption spectroscopy (TDS) measurements. Vacancy clusters were the major D trapping site in the W irradiated with Fe-ion at 873 K, although D retention by vacancy clusters decreased in the W irradiated with Fe-ion at 1173 K due to dynamic annealing. The D de-trapping activation energy from vacancy clusters was found to be 1.85 eV. D retention in neutron damage W was larger than that damaged by Fe-ion due to the uniform distribution of irradiation defects. The D desorption behaviors from neutron damaged W was simulated well by assuming the D de-trapping activation energy to be 1.52 eV

Optical transmittance investigation of 1-keV ion-irradiated sapphire crystals as potential VUV to NIR window materials of fusion reactors

We investigate the optical transmittances of ion-irradiated sapphire crystals as potential vacuum ultraviolet (VUV) to near-infrared (NIR) window materials of fusion reactors. Under potential conditions in fusion reactors, sapphire crystals are irradiated with hydrogen (H), deuterium (D), and helium (He) ions with 1-keV energy and ∼ 1020-m-2 s-1 flux. Ion irradiation decreases the transmittances from 140 to 260 nm but hardly affects the transmittances from 300 to 1500 nm. H-ion and D-ion irradiation causes optical absorptions near 210 and 260 nm associated with an F-center and an F+-center, respectively. These F-type centers are classified as Schottky defects that can be removed through annealing above 1000 K. In contrast, He-ion irradiation does not cause optical absorptions above 200 nm because He-ions cannot be incorporated in the crystal lattice due to the large ionic radius of He-ions. Moreover, the significant decrease in transmittance of the ion-irradiated sapphire crystals from 140 to 180 nm is related to the light scattering on the crystal surface. Similar to diamond polishing, ion irradiation modifies the crystal surface thereby affecting the optical properties especially at shorter wavelengths. Although the transmittances in the VUV wavelengths decrease after ion irradiation, the transmittances can be improved through annealing above 1000 K. With an optical transmittance in the VUV region that can recover through simple annealing and with a high transparency from the ultraviolet (UV) to the NIR region, sapphire crystals can therefore be used as good optical windows inside modern fusion power reactors in terms of light particle loadings of hydrogen isotopes and helium.Iwano K., Yamanoi K., Iwasa Y., et al. Optical transmittance investigation of 1-keV ion-irradiated sapphire crystals as potential VUV to NIR window materials of fusion reactors. AIP Advances 6, 105108 (2016); https://doi.org/10.1063/1.4965927

Evidence for migration of metamorphosing larvae of Anguilla japonica in the Kuroshio

Two sampling surveys of the R/V Tansei Maru were conducted in the Kuroshio region south of Kyushu Island of Japan and to the south in the western North Pacific, to study the distribution patterns of the larval stages of the Japanese eel Anguilla japonica as they approach their recruitment areas in East Asia. Nine fully-grown premetamorphic leptocephali (49.5-58.3mm TL) were collected during November 1996 to the east of Taiwan. During November and December 2000, nine early stage glass eels (51.3-57.0mm TL, pigmentation stage II-IV) that were still in the late metamorphosis stages were collected in the Kuroshio. These findings suggest that metamorphosing Japanese eel leptocephali that recruit to the northern part of their species range migrate in the Kuroshio. They may detrain from the Kuroshio at the pigmentation stage IV-VA and begin their coastal migration

Positive Therapeutic Response to Bevacizumab Plus Paclitaxel in a Patient with Advanced, Life-Threatening Breast Cancer and Carcinomatous Lymphangitis:a Subsequent Treatment Change to Hormone Therapy

We present a case of advanced, life-threatening breast cancer with carcinomatous lymphangitis treatedwith bevacizumab plus paclitaxel. A positive therapeutic response was achieved and the treatment was subsequentlychanged to hormone therapy.The patient was a 53-year-old postmenopausal woman with a non-contributory medical history. She presentedto a nearby hospital with chief complaints of continued exertional dyspnea and coughing since March2012. Physical findings included a palpable mass in the left breast, and the patient was referred and presentedto our hospital in May. Examinations at our hospital revealed left-sided breast cancer (estrogen receptorpositive, progesterone receptor positive, and no amplification of the human epidermal growth factorreceptor 2 by FISH). The patient had bone metastasis and carcinomatous lymphangitis (cT2N3cM1-stageIV). The condition was life threatening, and administration of bevacizumab plus weekly paclitaxel was initiatedwith the expectation of a high response rate. Coughing and dyspnea resolved two weeks later. CTscans were taken in August after the completion of 3 cycles and showed improvement in carcinomatouslymphangitis. No major side effects were observed due to bevacizumab plus weekly paclitaxel. When theCT scans were taken in December after the completion of 6 cycles, the primary lesion and lymph node metastaseswere reduced in size. In the lung field, there was no thickening of the interlobular septa or subpleuralinterstitium, and the findings of carcinomatous lymphangitis were improved. Thus, bevacizumab plus paclitaxelwere discontinued and the treatment was changed to oral letrozole (2.5 mg/day). The patient hasbeen followed up with no recurrence as of March 2013