The Pathogenesis of Tuberculous Meningitis. A Criticism of Rich's Focus-theory

この論文は国立情報学研究所の学術雑誌公開支援事業により電子化されました。1) The pathogenesis of tuberculous meningitis was studied by the preparation of the spreading specimens of meninges. 2) The tuberculous meningitis in infant succeeded to primary tuberculosis will break out by the cerebrospinal fluid infection from multiple caseous foci in meninges, which were formed in the walls of meningeal arteriols in the early dissemination. 3) Sometimes caseous foci in brains and choroid plexuses were found, but these foci are not essential as the cause of meningitis. 4) There will be rarely some cases, in which bacilli will be discharged in the subarachnoid space from the caseous foci in brains. In such cases tuberculous meningitis apt to be chronic and to relapse in spite of the adequate therapy

Non-local mean field effect on nuclei near Z=64 sub-shell

Evolutions of single-particle energies and Z=64 sub-shell along the isotonic chain of N=82 are investigated in the density dependent relativistic Hartree-Fock (DDRHF) theory in comparison with other commonly used mean field models such as Skyrme HF, Gogny HFB and density dependent relativistic Hartree model (DDRMF). The pairing is treated in the BCS scheme, except for Gogny HFB. It is pointed out that DDRHF reproduces well characteristic features of experimental $Z$-dependence of both spin orbital and pseudo-spin orbital splittings around the sub-shell closure Z=64. Non-local exchange terms of the isoscalar $\sigma$ and $\omega$ couplings play dominant roles in the enhancements of the spin-orbit splitting of proton 2d states, which is the key ingredient to give the Z=64 sub-shell closure properly. On the other hand, the $\pi$ and $\rho$ tensor contributions for the spin-orbit splitting cancel each other and the net effect becomes rather small. The enhancement of the sub-shell gaps towards Z=64 is studied by the DDRHF, for which the local terms of the scalar and vector meson couplings are found to be important.Comment: 4 figure

Microscopic description of nuclei in the middle of the pf-shell by a shell model calculation with G-matrix interaction

Energy levels and electromagnetic properties of with $N=28\sim 30$ nuclides are studied in terms of a large-scale shell model calculation, which contains no newly adjusted parameters. The Kuo-Brown $G$-matrix interaction is shown to reproduce energy levels of 205 low-lying states of these nuclei. We evaluate effective charges by incorporating the core-polarization effects caused by the coupling to GQR's. We then compute E2 moments and transition probabilities. The M1 moments and transition rates are calculated by quoting the effective $g$-factors of Towner, which are obtained by taking into account the meson-exchange and the core-polarization mechanisms. By this microscopic calculation most of the E2 properties and the magnetic moments are reproduced. Although there are agreements and disagreements in the M1 transition rates, the general tendency is reproduced. The $(e,e')$ and $(p,p')$ excitation from the ground state to some low-lying $2^+$ states is also discussed.Comment: 63 pages (LaTeX, to be published in Nucl. Phys. A

FDR-gem plus S-1 with RT for pancreatic cancer

Purpose: This study was conducted to identify the maximum-tolerated dose (MTD) of fixed-dose-rate gemcitabine (FDR-gem) administered concurrently with S-1 and radical radiation for locally advanced pancreatic cancer (LAPC) and to provide efficacy and safety data. Methods: Patients with unresectable pancreatic cancer confined to the pancreatic region were treated with FDR-gem (300-400mg/m2, 5mg/m2/min) on days 1, 8, 22, 29 and 60mg/m2 of S-1 orally on days 1-14, 22-35. A total radiation dose of 50.4 Gy (1.8 Gy/day, 28fractions) was delivered concurrently. Results: Twenty-five patients were enrolled; all were evaluable for toxicity assessment. In phase I, eight patients were treated in sequential cohorts of three to five patients per dose level. The MTD was reached at level 2, and dose-limiting toxicities were neutropenia and thrombocytopenia. The recommended doses were 300mg/m2 of gemcitabine and 60mg/m2 of S-1 daily. The overall response rate was 25% and disease control rate (partial response plus stable disease) was 92%. The progression-free survival was 11.0 months. The median overall survival and 1-year survival rate were 16.0 months and 73%, respectively. Conclusion: The combination of FDR-gem and S-1 with radiation is a feasible regimen that shows favorable antitumor activity with an acceptable safety profile in patients with LAPC

Symptomatic periesophageal vagal nerve injury by different energy sources during atrial fibrillation ablation

BackgroundSymptomatic gastric hypomotility (SGH) is a rare but major complication of atrial fibrillation (AF) ablation, but data on this are scarce.ObjectiveWe compared the clinical course of SGH occurring with different energy sources.MethodsThis multicenter study retrospectively collected the characteristics and clinical outcomes of patients with SGH after AF ablation.ResultsThe data of 93 patients (67.0 ± 11.2 years, 68 men, 52 paroxysmal AF) with SGH after AF ablation were collected from 23 cardiovascular centers. Left atrial (LA) ablation sets included pulmonary vein isolation (PVI) alone, a PVI plus a roof-line, and an LA posterior wall isolation in 42 (45.2%), 11 (11.8%), and 40 (43.0%) patients, respectively. LA ablation was performed by radiofrequency ablation, cryoballoon ablation, or both in 38 (40.8%), 38 (40.8%), and 17 (18.3%) patients, respectively. SGH diagnoses were confirmed at 2 (1–4) days post-procedure, and 28 (30.1%) patients required re-hospitalizations. Fasting was required in 81 (92.0%) patients for 4 (2.5–5) days; the total hospitalization duration was 11 [7–19.8] days. After conservative treatment, symptoms disappeared in 22.3% of patients at 1 month, 48.9% at 2 months, 57.6% at 3 months, 84.6% at 6 months, and 89.7% at 12 months, however, one patient required surgery after radiofrequency ablation. Symptoms persisted for >1-year post-procedure in 7 patients. The outcomes were similar regardless of the energy source and LA lesion set.ConclusionsThe clinical course of SGH was similar regardless of the energy source. The diagnosis was often delayed, and most recovered within 6 months, yet could persist for over 1 year in 10%

Neuro-pathological Studies on Tuberculous Meningitis Treated with Streptomycin

この論文は国立情報学研究所の学術雑誌公開支援事業により電子化されました。1. The brains of 18 patients succumbing to tuberculous meningitis were studied neuropathologically. 13 cases had been treated with streptomycin and 5 cases had received no streptomycin. 2. In the chronic cases treated with streptomycin the inflammatory invasion of the base of the brain and the wall of the ventricles was more serious than in the untreated group. One case cured completely and showed almost no pathological lesions in the meninges or in the brain. 3. Primary atrophy of the brain plays an important role in causing hydrocephalus internus. 4. The intravascular spreading of tubercle bacilli in the brain, leading to encephalo-meningitis, could not be neglected. 5. Caseous tubercles were frequently found in the brain