Interleukin-6 as a Potential Therapeutic Target for Pulmonary Arterial Hypertension

Interleukin-6 (IL-6) is a pleiotropic cytokine with a wide range of biologic activities in immune regulation, hematopoiesis, inflammation, and oncogenesis. Recent accumulating evidence indicates a pathologic role for IL-6 in promoting proliferation of both smooth muscle and endothelial cells in the pulmonary arterioles, resulting in development of pulmonary arterial hypertension (PAH). Here, we describe a patient with mixed connective tissue disease and severe, refractory PAH. Her functional activity and hemodynamic parameters dramatically responded to tocilizumab, a humanized monoclonal antibody to human IL-6 receptor, which was aimed at treating multicentric Castleman's disease. It appears that IL-6 blockade may hold promise as an adjunct drug in treatment of PAH in idiopathic form as well as in association with connective tissue disease

Evaluation of contour of unruptured cerebral aneurysm using three-dimensional CT cisternogram.

Angiography is gold standard technique as preoperative examination for unruptured aneurysmal surgery. Neurosurgeons have observed the unexpected irregular shape and size of the aneurysmal dome and neck in many cases of unruptured cerebral aneurysms during aneurysmal microsurgery, and known the discrepancy between the findings of angiography and operative view. We could not find out the report described the preoperative evaluation of outer-wall (contour) of aneurysm. In the present study, we attempted to evaluate the outer-wall of an unruptured cerebral aneurysm using three-dimensional CT cisternogram (3D-CTC) to provide useful preoperative information. The study was performed on three cases of unruptured cerebral aneurysm that were identified incidentally by MR angiography. We performed three-dimensional CT aniography (3D-CTA) and 3D-CTC for each patient. In the present study, we visualized the contours of vessels and aneurysms using a 3D-CTC in three cases of unruptured cerebral aneurysm. We found the discrepancy between the 3D-CTC contour image and the intra-luminal image 3D-CTA image. This method may be useful for the decision of the surgical approach and have the potential to evaluate the anatomical structure of aneurysmal dome and neck preoperatively.</p

Photosynthetic characteristics of phytoplankton off Adelie Land, Antarctica, during the austral summer

The photosynthesis-irradiance characteristics (P-E curves) and quantum yields of natural phytoplankton were investigated in the Southern Ocean off Adelie Land, Antarctica, during the austral summer. Data were acquired at eight stations during a cruise of T/V Umitaka-Maru III. The photosynthetic P-E curves showed low light adaptation of phytoplankton. Mean value (±standard deviation) of the P-E curve parameters, α^*, and I_k, were 0.014 (±0.013) mgC (mg chl. α)^ h^1 (μmol photons m^ s^)^ and 76 (±55) μmol photons m^ s^, respectively. Although phytoplankton were adapted to low irradiance, the phytoplankton in the SCM were not fully adapted to the low irradiance prevailing at those depths. P^*_ in the studied region was low (mean of 0.66 (±0.37) mgC (mg chl. α)^ h^) and generally lower than the previously reported values in waters near the Antarctic Peninsula. The maximum quantum yield varied widely, ranging from 0.001 to 0.038mol C (mol photons absorbed)^ at the surface and from 0.007 to 0.092mol C (mol photons absorbed)^ near the bottom of the euphotic zone. These values were within the range of published data. Comparison of photosynthetic parameters with historical data indicated that primary productivity from remotely sensed data for the whole of the Southern Ocean, based on these field estimates of photosynthetic parameters, has been overestimated

Robust stabilization of running self-sustaining two-wheeled vehicle

金沢大学理工研究域電子情報学系This paper deals with robust stabilization of running self-sustaining two-wheeled vehicle. Recently, some researches about stabilization of two-wheeled vehicle have been reported. These researches have achieved the stabilization running only by the steering control. However, an actual two-wheeled vehicle is running while accompanying stabilization by the rider. We have proposed the stabilization of two-wheeled vehicle in the state of stillness, and have shown the effectiveness. In this research, we compose the control system that aims at the running stabilization of two-wheeled vehicle. We use &Hscr;∞ mixed sensitivity problem to design the controller to achieve stability running even if the mass of two-wheeled vehicle changes. The experimental results show stability running even if the mass of two-wheeled vehicle changed. © 2007 IEEE

A Case of Hypocalcaemia Due to Vitamin D Deficiency in ‘Hikikomori’ Syndrome

Objective: To describe hypocalcaemia due to vitamin D deficiency in ‘hikikomori’ syndrome. Materials and methods: A 37-year-old man with ‘hikikomori’ syndrome for a year was admitted with hypocalcaemia (serum ionic calcium 1.17 mmol/l). Serum 1,25(OH)2-vitamin D3 determined by liquid chromatography–tandem mass spectrometry was depressed at 12.1 pg/ml (29.0 pmol/l) and plasma intact PTH elevated at 324 ng/l. Administration of 1 μg/day 1α(OH)-vitamin D3 and 1 g/day calcium lactate for 1 week normalized calcium and PTH, and raised 1,25(OH)2-vitamin D3 to low normal levels. Conclusion: This is the first report of hypocalcaemia due to vitamin D deficiency in a patient with ‘hikikomori’ syndrome

Which visual questions are difficult to answer? Analysis with Entropy of Answer Distributions

We propose a novel approach to identify the difficulty of visual questions for Visual Question Answering (VQA) without direct supervision or annotations to the difficulty. Prior works have considered the diversity of ground-truth answers of human annotators. In contrast, we analyze the difficulty of visual questions based on the behavior of multiple different VQA models. We propose to cluster the entropy values of the predicted answer distributions obtained by three different models: a baseline method that takes as input images and questions, and two variants that take as input images only and questions only. We use a simple k-means to cluster the visual questions of the VQA v2 validation set. Then we use state-of-the-art methods to determine the accuracy and the entropy of the answer distributions for each cluster. A benefit of the proposed method is that no annotation of the difficulty is required, because the accuracy of each cluster reflects the difficulty of visual questions that belong to it. Our approach can identify clusters of difficult visual questions that are not answered correctly by state-of-the-art methods. Detailed analysis on the VQA v2 dataset reveals that 1) all methods show poor performances on the most difficult cluster (about 10% accuracy), 2) as the cluster difficulty increases, the answers predicted by the different methods begin to differ, and 3) the values of cluster entropy are highly correlated with the cluster accuracy. We show that our approach has the advantage of being able to assess the difficulty of visual questions without ground-truth (i.e. the test set of VQA v2) by assigning them to one of the clusters. We expect that this can stimulate the development of novel directions of research and new algorithms. Clustering results are available online at https://github.com/tttamaki/vqd .Comment: accepted by IEEE access available at https://doi.org/10.1109/ACCESS.2020.3022063 as "An Entropy Clustering Approach for Assessing Visual Question Difficulty

Noninvasive Positive Pressure Ventilation against Reperfusion Pulmonary Edema following Percutaneous Transluminal Pulmonary Angioplasty

A 69-year-old man with chronic thromboembolic pulmonary hypertension (CTEPH) was on amblatory oxygen inhalation therapy (3 L/min) and scheduled for percutaneous transluminal pulmonary angioplasty (PTPA). The patient's New York Heart Association functional status was class III with recent worsening of dyspnea and apparent leg edema. Transthoracic echocardiography revealed right ventricular enlargement with mean pulmonary artery pressure of 42 mmHg. After PTPA, he was complicated with postoperative reperfusion pulmonary edema, and noninvasive positive pressure ventilation (NPPV) was applied immediately. Hypoxemia was successfully treated with 15 days of NPPV. Although mean pulmonary artery pressure was unchanged, his brain natriuretic peptide level decreased from preoperative 390.3 to postoperative 44.3 pg/dL. In addition, total pulmonary resistance decreased from preoperative 18 to postoperative 9.6 wood unit·m2. The patient was discharged on day 25 with SpO2 of 95% on 5 L/min of oxygen inhalation. Because pulmonary edema is a postsurgical life-threatening complication following PTPA, application of NPPV should be considered

Higher prevalence of obstructive airway disease in patients with thoracic or abdominal aortic aneurysm

AbstractBackground and Aim: The risk factors of aortic aneurysm (AA) are comparable with those described for chronic obstructive pulmonary disease. This study was performed to determine whether patients with AA have a higher than average prevalence of obstructive airway disease. Methods: We performed pulmonary function tests in 240 consecutive patients (182 men and 58 women; age, 70 ± 10 years) with thoracic or abdominal AA. The results were compared with those in individuals without obvious cardiovascular disease (control) and in patients with coronary artery disease who were matched for age, gender, smoking status, and other atherosclerotic risk factors. Results: Patients in the AA group had a lower forced expiratory volume in 1 second/forced vital capacity (%) and carbon monoxide diffusing capacity (%/predicted value) than did the control group (P < .01). The proportion of patients with airway obstruction, defined as forced expiratory volume in 1 second/forced vital capacity of 70% or less, was higher in the AA group (100/240; 42%) than in the control (51/223; 23%) and coronary artery disease (43/238; 18%) groups. Multiple logistic regression analysis results revealed that the presence of an AA and male gender were associated with a higher risk of airway obstruction (odds ratio, 2.928; 95% CI, 1.722 to 4.979; and odds ratio, 1.622; 95% CI, 1.055 to 2.493, respectively). Conclusion: These data suggest that AA may be a risk factor indicative of the presence of chronic obstructive pulmonary disease. A higher prevalence of depressed pulmonary function should be suspected as a preoperative risk in presence of thoracic or abdominal AA as compared with other types of cardiovascular disorders. (J Vasc Surg 2002;36:35-40.