Efficient ultrashort-pulse generation of Yb:YAG laser overcoming the fluorescence spectrum limit by using nonlinear medium

One-hundred-ten-fs and 72-fs pulse-widths were obtained directly from a mode-locked Yb:YAG laser with SESAM and without SESAM, respectively. The laser-spectrum-center and the fluorescence-center were almost same. The oscillation-spectra were much broader than the fluorescence

Network Features and Pathway Analyses of a Signal Transduction Cascade

The scale-free and small-world network models reflect the functional units of networks. However, when we investigated the network properties of a signaling pathway using these models, no significant differences were found between the original undirected graphs and the graphs in which inactive proteins were eliminated from the gene expression data. We analyzed signaling networks by focusing on those pathways that best reflected cellular function. Therefore, our analysis of pathways started from the ligands and progressed to transcription factors and cytoskeletal proteins. We employed the Python module to assess the target network. This involved comparing the original and restricted signaling cascades as a directed graph using microarray gene expression profiles of late onset Alzheimer's disease. The most commonly used method of shortest-path analysis neglects to consider the influences of alternative pathways that can affect the activation of transcription factors or cytoskeletal proteins. We therefore introduced included k-shortest paths and k-cycles in our network analysis using the Python modules, which allowed us to attain a reasonable computational time and identify k-shortest paths. This technique reflected results found in vivo and identified pathways not found when shortest path or degree analysis was applied. Our module enabled us to comprehensively analyse the characteristics of biomolecular networks and also enabled analysis of the effects of diseases considering the feedback loop and feedforward loop control structures as an alternative path

Pulmonary alveolar proteinosis after lung transplantation: Two case reports and literature review

Pulmonary alveolar proteinosis (PAP) affecting transplanted lungs is not well recognized. Herein, we report two cases of PAP after lung transplantation (LTx). The first case was a 4-year-old boy with hereditary pulmonary fibrosis who underwent bilateral LTx and presented with respiratory distress on postoperative day (POD) 23. He was initially treated for acute rejection, died due to infection on POD 248, and was diagnosed with PAP at autopsy. The second case involved a 52-year-old man with idiopathic pulmonary fibrosis who underwent bilateral LTx. On POD 99, chest computed tomography revealed ground-glass opacities. Bronchoalveolar lavage and transbronchial biopsy led to a diagnosis of PAP. Follow-up with immunosuppression tapering resulted in clinical and radiological improvement. PAP after lung transplantation mimics common acute rejection; however, is potentially transient or resolved with tapering immunosuppression, as observed in the second case. Transplant physicians should be aware of this rare complication to avoid misconducting immunosuppressive management

Long-term management and outcome of lung transplantation in Japan

The long-term survival after lung transplantation (LT) is favorable in Japan. However, longterm survivors after LT are subject to late complications, including chronic lung allograft dysfunction (CLAD), malignancy, infection, and chronic kidney disease (CKD) because of the need for lifelong immunosuppression. The rates of single cadaveric LT (CLT) and living-donor lobar LT (LDLLT) are higher than that of bilateral CLT in Japan. Here, we will describe the management of late complications and long-term outcome after LT in Japan. Attention should be paid to not only the phenotype of CLAD but also the difference in CLAD after CLT and after LDLLT as well as the timing of lung re-transplantation for advanced CLAD, especially after single CLT. Since post-transplant lymphoproliferative disorder is the most common malignancy after LT, infection monitoring for infection-related malignancies and appropriate screening are keys to the early diagnosis and treatment of malignancy after LT. The long-term management of infection after LT is also important, especially with regard to community-acquired pathogens, Aspergillus, and cytomegalovirus. When providing long-term care after LT, physicians should be aware of CKD and the timing of renal replacement therapy in cases with severe CKD. The widespread use of computed tomography and dialysis in Japan are beneficial for long-term survivors of LT. The similar survival outcomes of single CLT and LDLLT, compared with bilateral CLT, might contribute to improved long-term survival in Japan. Pulmonologists are encouraged to become further involved in long-term management after LT in Japan

A study of the upper limb motion of patients with spinal cord injury while eating using two types of self-helping device

頸髄損傷者の食事動作に関して,スプーンの使用方法を替えることにより,上肢各関節(肩･肘・前腕・手関節)の角度と運動の範囲がどのように変化するかを明らかにするために,三次元動作解析を行った.対象はC6レベルの頸髄損傷者5人で,「ヨーグルトを食べる」という課題を2種類の自助具(自助具1:母指側使用,自助具2:手掌側使用)を用い実施した.撮影された画像から時間と上肢各関節角度を求め,自助具1,自助具2使用時で比較検討した.結果,自助具1使用時には自助具2使用時と比べ,1回の食事動作におけるすくう動作が占める割合が多い傾向にあった.また,食物をすくう際に肩関節屈曲,肩関節外転の運動が多く必要とされ,一連の動作を通じて前腕が回内方向に移行し,肩関節が屈曲・外転方向に移行することが明らかとなった.以上より,前腕の回外運動が十分可能である場合には手掌側使用の自助具の導入が望ましく,また母指側使用で食事を行う場合には,食物を口へ運ぶ動作だけでなく,すくう動作においても肩関節の運動が必要になることを十分に考慮した上で,自助具の提供やセッティングを行うことが重要であることが示唆された.The purpose of the present experiment was to examine how the upper limb movements (shoulder, elbow, forearm, wrist) of patients with spinal cord injury (C6 level) were affected while using two types (type 1: pronation type, type 2: supination type) of self-helping device. Five subjects were required to eat 5 spoonfuls of yoghurt. We recorded the position of 11 light reflecting markers attached to the subjects' body with three cameras. We divided the eating action into three phases, the scoop phase, reach-to-mouth phase, and reach-to-plate phase. These kinematic landmarks were used to define the dependent variables. We calculated five joint angles (shoulder flexion, shoulder abduction, elbow flexion, forearm supination, wrist extension) with a three-dimensional video-based motion analysis system (APAS System, Ariel Dynamics), and analyzed how they changed at each phase. We compared them while using type 1 and type 2. While using type 1, the scoop phase played a larger part than other phases, and shoulder flexion, shoulder abduction and elbow flexion angles increased, not only in the reach-to-mouth phase but also in the scoop phase, and the supination angle decreased. This result suggests that patients who can supinate their forearm had better use type 2, and also that it is important to consider upper limb movements in the scoop phase when we provide patients with a self-helping device. In this study, however, we focused only on upper limb movements. We also have to analyze head, neck and trunk movements and examine the relationship among upper limb, head, neck and trunk

DV200 Index for Assessing RNA Integrity in Next-Generation Sequencing

Poor quality of biological samples will result in an inaccurate analysis of next-generation sequencing (NGS). Therefore, methods to accurately evaluate sample integrity are needed. Among methods for evaluating RNA quality, the RNA integrity number equivalent (RINe) is widely used, whereas the DV200, which evaluates the percentage of fragments of >200 nucleotides, is also used as a quality assessment standard. In this study, we compared the RINe and DV200 RNA quality indexes to determine the most suitable RNA index for the NGS analysis. Seventy-one RNA samples were extracted from formalin-fixed paraffin-embedded tissue samples (n=30), fresh-frozen samples (n=25), or cell lines (n=16). After assessing RNA quality using the RINe and DV200, we prepared two kinds of stranded mRNA sequencing libraries. Finally, we calculated the correlation between each RNA quality index and the amount of library product (1(st) PCR product per input RNA). The DV200 measure showed stronger correlation with the amount of library product than the RINe (R2=0.8208 for the DV200 versus 0.6927 for the RINe). Receiver operating characteristic curve analyses revealed that the DV200 was the better marker for predicting efficient library production than the RINe using a threshold of >10 ng/ng for the amount of the 1(st) PCR product per input RNA (cutoff value for the RINe and DV200, 2.3 and 66.1%; area under the curve, 0.99 and 0.91; sensitivity, 82% and 92%; and specificity, 93% and 100%, respectively). Our results indicate that NGS libraries prepared using RNA samples with the DV200 value>66.1% exhibit greater sensitivity and specificity than those prepared with the RINe values>2.3. These findings suggest that the DV200 is superior to the RINe, especially for low-quality RNA, because it is a more consistent assessment of the amount of the 1(st) NGS library product per input

Japan College of Rheumatology 2009 guidelines for the use of tocilizumab, a humanized anti-interleukin-6 receptor monoclonal antibody, in rheumatoid arthritis

The introduction of biological agents targeting tumor necrosis factor-alpha (TNF-α) has brought about a paradigm shift in the treatment of rheumatoid arthritis (RA). Although these anti-TNF agents have excellent efficacy against RA, a substantial number of patients still show inadequate responses. In Western countries, such patients are already being treated with new classes of antirheumatic drugs such as abatacept and rituximab. Tocilizumab (TCZ) is a humanized monoclonal antibody developed in Japan against the human interleukin-6 (IL-6) receptor. TCZ does not only alleviate the signs and symptoms of RA but also seems to prevent progressive bone and joint destruction. However, there is a concern that TCZ might increase the risk of adverse events such as infections since IL-6 plays a pivotal role in the immune system. Calculating the relative risks of specific adverse outcomes with TCZ use remains difficult, due to insufficient patient numbers enrolled in clinical trials to date. This review presents tentative guidelines for the use of TCZ for RA patients prepared by the Japan College of Rheumatology and based on results of clinical trials in Japan and Western countries. The guidelines are intended as a guide for postmarketing surveillance and clinical practice, and will be revised periodically based on the surveillance

Successful treatment of COVID‐19‐related acute respiratory distress syndrome with a rare blood type: A case report

Extracorporeal membrane oxygenation is indispensable for critically severe COVID-19 patients. However, it would be inapplicable to patients with a rare blood type or blood transfusion refusal. In that case, severely conservative fluid management with the sacrifice of renal functions and hydrocortisone therapy should be considered for better oxygenation