A case of generalized lymphatic anomaly causing skull-base leakage and bacterial meningitis

Generalized lymphatic anomaly (GLA) is a multifocal lymphatic malformation that affects the skin, thoracic viscera, and bones. A 7-year-old boy presented with fever and disturbance of consciousness, and bacterial meningitis was diagnosed. Computed tomography and magnetic resonance imaging revealed middle skull-base leakage due to lymphatic malformation. Past history included facial palsy due to cystic tumors in the right petrous bone 4 years before onset of meningitis. At that time, pericardial effusion had been found and GLA had been diagnosed by pericardial biopsy. He achieved complete recovery under intensive care with antibiotics and mechanical ventilation. At the 3-year follow-up, the patient was healthy with no recurrence of meningitis. We should consider GLA among the differential diagnoses for osteolytic diseases in the pediatric population

Early combined treatment with steroid and immunoglobulin is effective for serious Kawasaki disease complicated by myocarditis and encephalopathy

Severe-type Kawasaki disease (KD) complicated by serious myocarditis and encephalopathy can be successfully treated without abnormality of the coronary arteries by steroid pulse treatment and intravenous immunoglobulin (IVIg). A 4-year-old Japanese girl was diagnosed with KD due to a 6-day history of fever, rash, flushed lips, conjunctival hyperemia, palmar edema, and cervical lymphadenopathy. The day after initiation of IVIg and aspirin, cardiac gallop rhythm was identified. Cardiac ultrasonography revealed severe left ventricular dysfunction. Disturbance of consciousness, hallucinations, and slurred speech were also observed. Magnetic resonance imaging showed no abnormalities, but electroencephalography revealed high-voltage slow waves. Despite this serious disease, cardiac function and neurological abnormalities showed complete recovery without dilatation of the coronary arteries by steroid pulse treatment and additional IVIg. Follow-up at 15 months revealed no abnormality of the coronary arteries. In conclusion, we suggest that early combined treatment with steroid and IVIg is effective for serious KD complicated by myocarditis and encephalopathy

A case of acute acalculous cholecystitis complicated by primary Epstein-Barr virus infection

Acute acalculous cholecystitis (AAC) is a rare complication of infectious mononucleosis (IM). An immunocompetent 6-year-old Japanese girl complained of epigastralgia during the course of IM. Ultrasonography (US) revealed a markedly thickened and sonolucent gallbladder wall. No gallstones were apparent. Antibodies against Epstein-Barr virus (EBV) confirmed primary EBV infection. Cytomegalovirus immunoglobulin M showed a false-positive result in the acute phase, probably due to cross-reaction to EBV nuclear antigen. We diagnosed her as AAC related with primary EBV infection. She recovered completely by conservative treatment. US should be performed in consideration of the possibility of AAC when a patient with IM complains of epigastralgia

Multiday corticosteroids in cancer chemotherapy delay the diagnosis of and antimicrobial administration for febrile neutropenia: a double-center retrospective study

Abstract Background Medical staff should promptly administer antimicrobials to patients with febrile neutropenia (FN) to decrease the mortality related to cancer chemotherapy. Corticosteroids, which are used in cancer chemotherapy, have a fever-suppressive effect. This effect could lead to a blunt fever response and any local signs of infection, especially in patients receiving multiday corticosteroid administration. The aim of this study was to determine whether multiday corticosteroid administration in cancer chemotherapy delays the diagnosis of and antimicrobial treatment for FN. Methods We conducted a double-center retrospective study in Japanese patients with FN. The patients were divided into two groups based on the corticosteroid administration method, i.e., whether administration was multiday or not. To evaluate the degree of masking on FN by corticosteroids, we assessed the correlation between body temperature variation and time of antimicrobial administration after the initiation of chemotherapy. Risk factors for delayed antimicrobial administration were identified by multiple logistic regression analysis. Results Two hundred thirteen patients were analyzed. The median time required to body temperature reaching 37.5 °C and for antimicrobial administration was longer in the multiday group than in the non-multiday group, with 0.64 and 0.60 days (P = 0.002 and P < 0.001), respectively. Multiday corticosteroid use was identified as an independent risk factor for delayed antimicrobial administration (odds ratio = 3.94; 95% confidence interval = 1.80–8.62; P < 0.001). Conclusions Multiday corticosteroid administration in cancer chemotherapy delayed the diagnosis of and antimicrobial administration for FN. Furthermore, it was the only risk factor for delayed antimicrobial administration. We could thus provide evidence that the diagnosis of and antimicrobial administration for FN in patients receiving multiday corticosteroid administration should not be based on body temperature variation alone

Ecocriticism in Japan

Ecocriticism in Japan provides an answer to the question, "What can ecocriticism do when engaging with Japanese literature and culture?" Engaging works ranging from The Tale of Genji to Abe, Ōe, Ishimure, and Miyazaki, this volume examines works Japanese people and culture in terms of nature and environment.Cover -- Ecocriticism in Japan -- Ecocriticism in Japan -- Contents -- Foreword to Ecocriticism in Japan -- Works Cited -- Acknowledgments -- Introduction -- The Trouble With Harmony -- The Ecological Turn In A Discourse Of Harmony, Or Is It? -- Essays In This Collection -- Notes -- Works Cited -- Chapter 1 -- Walking the Walk -- Reading The Suma Chapters Of -- Exile As Immersion In Ecoscape -- Echoes Of Sacred Snakes And Silkworm Economy In A Ribald Folktale -- Walking The Path Toward Praxis -- Notes -- Works Cited -- Chapter 2 -- Taoka Reiun and Environmental Thought in the Early 1900s -- A Philosophical Foundation For Taoka Reiun's Ecocriticism -- Reiun And The Turn Against Modernity -- Notes -- Works Cited -- Chapter 3 -- Radioactive Discourse and Atomic Bomb Texts -- Radioactive Discourse: A Living Literary Form -- YŌko's -- "unknown" Effects Of The "internal Enemy" -- Hayashi KyŌko's "human Experience Over Time": "proving" Radioactive Anxiety -- Sata Ineko's -- Diversity -- The Possibilities Of Radioactive Discourse After Fukushima -- Notes -- Works Cited -- Chapter 4 -- Abe Kōbō in Ecosophy -- Abe And Guattari: Nature As Machinic Assemblages -- The Woman In The Dunes/man In The Sea And Machines -- Unnatural Participation/nuptial -- Notes -- Works Cited -- Chapter 5 -- Literary Ground Opened in Fissures -- The Great East Japan Earthquake -- KenzaburŌ's Eco-literal Awareness -- Transmutation Of Natural Disaster -- Polyphonic Openness Emerged Through The Cracks In The Narrative Ground -- The Main Shock And Three Aftershocks -- The First Aftershock -- The Second Aftershock -- The Third Aftershock -- Polyphony Of "the Wonder Of The Forest" -- From "i" To "we" -- Notes -- Works Cited -- Chapter 6 -- Ecopolitics and Affect Theory in -- Post-Fukushima Activism -- Justified Paranoia: The Past And Future Of Japan's Nuclear ProgramThe Speech At Yoyogi Park: A Failure To Exceed Contempt -- Reclaiming The Affective Promise Of Shame: The Postwar Constitution And -- Primal Scene -- Notes -- Works Cited -- Chapter 7 -- Nature and Disaster in Murakami Haruki's -- Murakami Haruki's -- Nature And The Environment In Murakami's -- "super-frog Saves Tokyo" -- "all God's Children Can Dance" -- "nature" As Agent -- Notes -- Works Cited -- Chapter 8 -- Horses and Ferns -- Notes -- Works Cited -- Chapter 9 -- Invisible Waves -- Invisible Waves -- Hatakeyama Naoya: On The River And The Land -- Takayama Akira: What About Animals? -- Kimura Yusuke And Shinnami Kyosuke: Being Connected To The Land -- Katagiri Atsunobu: The Meaning Of Flowers -- Okabe Masao: On The Surface Of Things -- Myself: The Scarecrow God -- Note -- Works Cited -- Chapter 10 -- From &lt -- Passion&gt -- to &lt -- Compassion&gt -- -- Translator's Introduction -- Section Two: Toward Tonton Village, Where Drums Resound -- Notes -- Works Cited -- Chapter 11 -- Representations of Nomads in the Works of Ishimure Michiko -- Ishimure Michiko And Displaced Nomadic People -- The Empathic Gaze Of "kugai JŌdo" -- Transposition Of The Nomadic Figures " -- And " -- In The Historical Context -- Wandering Beggars -- A Homonym For "sea Of Sorrow" And "public Space" -- " -- And Other Nomadic Figures In Ishimure's Autobiographical Writings -- Affinity With Nature And A Fear Of Human Society -- Conclusion: From The Sea Of Suffering To A Public Space For Nomadic People -- Notes -- Works Cited -- Chapter 12 -- On the Ideological Manipulation of Nature Inherent in Japanese Popular Culture -- Miyazaki: Contradictions Between Tech-fetishism And Environmental Consciousness -- Ishimure And Hyakuta: Between Reality And Fabrication -- The Will To Change -- Conclusion: Truth And The Real -- Notes -- Works Cited -- Chapter 13A Chaosmos of Condivision -- The Story -- Nuclear Ecosophy -- Radiation Aesthetics -- The Coppelions' Immunity To Radiation And The (trans)national/global Nuclear Order -- The Nuclear Machinic Unconscious -- Coda: A Chaosmos Of Condivision -- Notes -- Works Cited -- Chapter 14 -- Arboreal Unicorns and Other Megaflora -- Biotropes: The Flowering Pear -- Charismatic Megaflora: The Golden Spruce -- Arboreal Agency: Charisma -- Notes -- Works Cited -- Index -- About the ContributorsEcocriticism in Japan provides an answer to the question, "What can ecocriticism do when engaging with Japanese literature and culture?" Engaging works ranging from The Tale of Genji to Abe, Ōe, Ishimure, and Miyazaki, this volume examines works Japanese people and culture in terms of nature and environment.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries

Spin-resolved 3p and 3s core-level photoemission spectra of ferromagnetic nickel

We have measured the spin-resolved 3p and 3s core-level photoemission spectra of ferromagnetic Ni in the whole region of the main peak and the satellites with reliable statistics. The observed spin-polarization spectrum for the 3p core excitation has revealed an overestimation of the 3p-3d interaction in a recent theoretical calculation. It is found that the 3s photoemission spectrum is strongly modified by the hybridization between the 3s3d9 and 3s3d10 states and the spin polarization results from the exchange interaction between the 3s and 3d electrons in the 3s3d9 component