Unexpected Complication of R-CHOP Chemotherapy: Rapidly Progressive Bronchiolitis Obliterans Syndrome

Background: Bronchiolitis obliterans syndrome (BOS) is the term used for the progressive obliteration of small airways before the patient has had a confirmatory lung biopsy. It is also recognized as a transplant-related complication. There have been no reports of BOS during initial standard chemotherapy. Case presentation: A 50-year-old woman with newly diagnosed follicular lymphoma grade 2, stage 3A, presented with hypoxia and progressive dyspnoea after the fifth cycle of R-CHOP. High-resolution computed tomography showed air trapping enhanced at the end-expiratory phase. Pulmonary function testing revealed severe obstructive and restrictive failure without bronchodilator response. We diagnosed BOS based on current criteria and treated the patient with glucocorticoids and cyclosporin. She was discharged home on oxygen therapy. However, soon after discharge, her respiratory symptoms deteriorated and she was hospitalized in a palliative care unit. She died of respiratory failure within a year of symptom onset. Conclusions: This is the first case report to describe rapidly progressive BOS in a patient undergoing R-CHOP treatment, which strongly suggests the condition was caused by the chemotherapy. Although a pathological diagnosis was not obtained, the clinical diagnosis of BOS was important so that the patient could receive appropriate treatment and palliative care based on the prognosis of this incurable condition

Spall fracture of metallic circular plates, vessel endplates and conical frustums driven by direct explosive loads

Dynamic fracture experiments are conducted for circular plates, vessel endplates andconical frustums of A2017-7075 aluminum alloys and 304 stainless steel, using a testing apparatus developed applying wire-row explosion technique to initiation, where tensile stress waves are generated producing spall in the specimens by the direct incidence of plane detonation waves of the explosive PETN. A VISAR system is adopted to observe the free-surface velocity histories of the specimens. The signals for basic circular plate specimens indicate the characteristics of the failure for tested materials, effects of explosive thickness variations and the configuration of specimens. Hydro codes are satisfactorily applied to simulate the experimental signal data and observed damage phenomena of recovered specimens. Next, an explosive-filled cylindrical vessel with an endplate at the one end is initiated at the other end surface and expanded by axially propagating explosive detonation to fracture. Both the VISAR signals and numerical simulation indicate a pullback signal of spallation atthe endplate. Finally conic frustums are also loaded by plane detonation, showing different type of spall failure due to the additional reflected waves from the slopping side surfaces

Flood Modeling and Simulation using iRIC: A Case Study of Kabul City

In Afghanistan, floods are common and measures must be taken to protect people and property from damage. There is, however, a lack of detailed observations and research on this subject in this area. Therefore, flood simulation models are needed to identify flood-prone areas. In this study, International River Interface Cooperative (iRIC) program that is river flow and riverbed variation analysis software with several solvers has been used. Nays2DFlood solver that simulates 2dimenstional plane flow has applied to a past flood in Kabul city. River discharge from two inflow points and averaged precipitation from three rain gauges at the time of flooding given as input to the model including DEM (Digital Elevation Model) data. The iRIC was confirmed as a 90-m grid digital elevation model to determine the position of streamlines correctly. However, the highest flood depth was overestimated because the 90-m grids were too coarse to detect the slight slope of the riverbed in some areas. Then the elevation of the riverbed modified using data acquired from Google Earth, and the simulation results improved. Moreover, it was found that river water rather than rainfall was the main cause of the flooding

Flood Modeling and Simulation using iRIC: A Case Study of Kabul City

In Afghanistan, floods are common and measures must be taken to protect people and property from damage. There is, however, a lack of detailed observations and research on this subject in this area. Therefore, flood simulation models are needed to identify flood-prone areas. In this study, International River Interface Cooperative (iRIC) program that is river flow and riverbed variation analysis software with several solvers has been used. Nays2DFlood solver that simulates 2dimenstional plane flow has applied to a past flood in Kabul city. River discharge from two inflow points and averaged precipitation from three rain gauges at the time of flooding given as input to the model including DEM (Digital Elevation Model) data. The iRIC was confirmed as a 90-m grid digital elevation model to determine the position of streamlines correctly. However, the highest flood depth was overestimated because the 90-m grids were too coarse to detect the slight slope of the riverbed in some areas. Then the elevation of the riverbed modified using data acquired from Google Earth, and the simulation results improved. Moreover, it was found that river water rather than rainfall was the main cause of the flooding

Photodynamic Diagnosis Using 5-Aminolevulinic Acid with a Novel Compact System and Chromaticity Analysis for the Detection of Oral Cancer and High-Risk Potentially Malignant Oral Disorders

Detecting early-stage oral cancer and precancerous lesions are critical to improving patient prognosis and quality of life after treatment. Photodynamic diagnosis using 5-aminolevulinic acid enables the detection of malignant lesions. This study aimed to improve the diagnostic accuracy of photodynamic diagnosis using an objective chromaticity analysis of fluorescence emitted from oral lesions. Sixty-seven patients with clinically suspicious oral cavity lesions underwent photodynamic diagnosis after topical application of 5-aminolevulinic acid solution, followed by imaging and histological evaluation of the lesions. Chromaticity red and green values were measured from the fluorescence images on the lesion, and the red-to-green ratio was calculated. The photodynamic diagnosis allowed for the visualization of oral cancer and high-risk dysplasia as red fluorescence. Compared to low-risk dysplasia and benign lesions, oral cancer and high-risk dysplasia areas had a significantly higher red value and red-to-green ratio. After setting the cutoff value, sensitivity and specificity were 83.3–88.7% and 83.3–83.9%, respectively, when discriminating between oral cancer or high-risk dysplasia and low-risk dysplasia or benign lesions. Photodynamic diagnosis combined with chromaticity analysis may be a valuable diagnostic tool for detecting oral lesions, with a high likelihood of malignant transformation

Grapefruit seed extract effectively inhibits the Candida albicans biofilms development on polymethyl methacrylate denture-base resin.

This study aimed to investigate the cleansing effects of grapefruit seed extract (GSE) on biofilms of Candida albicans (C. albicans) formed on denture-base resin and the influence of GSE on the mechanical and surface characteristics of the resin. GSE solution diluted with distilled water to 0.1% (0.1% GSE) and 1% (1% GSE) and solutions with Polident® denture cleansing tablet dissolved in distilled water (Polident) or in 0.1% GSE solution (0.1% G+P) were prepared as cleansing solutions. Discs of acrylic resin were prepared, and the biofilm of C. albicans was formed on the discs. The discs with the biofilm were treated with each solution for 5 min at 25°C. After the treatment, the biofilm on the discs was analyzed using a colony forming unit (CFU) assay, fluorescence microscopy, and scanning electron microscopy (SEM). In order to assess the persistent cleansing effect, the discs treated with each solution for 5 min were aerobically incubated in Yeast Nitrogen Base medium for another 24 h. After incubation, the persistent effect was assessed by CFU assay. Some specimens of acrylic resin were immersed in each solution for 7 days, and changes in surface roughness (Ra), Vickers hardness (VH), flexural strength (FS), and flexural modulus (FM) were evaluated. As a result, the treatment with 1% GSE for 5 min almost completely eliminated the biofilm formed on the resin; whereas, the treatment with 0.1% GSE, Polident, and 0.1% G+P for 5 min showed a statistically significant inhibitory effect on biofilms. In addition, 0.1% GSE and 0.1% G+P exerted a persistent inhibitory effect on biofilms. Fluorescence microscopy indicated that Polident mainly induced the death of yeast, while the cleansing solutions containing at least 0.1% GSE induced the death of hyphae as well as yeast. SEM also revealed that Polident caused wrinkles, shrinkage, and some deep craters predominantly on the cell surfaces of yeast, while the solutions containing at least 0.1% GSE induced wrinkles, shrinkage, and some damage on cell surfaces of not only yeasts but also hyphae. No significant changes in Ra, VH, FS, or FM were observed after immersion in any of the solutions. Taken together, GSE solution is capable of cleansing C. albicans biofilms on denture-base resin and has a persistent inhibitory effect on biofilm development, without any deteriorations of resin surface

Molecular Dynamics Study of the Core Structure of an Edge Dislocation in alpha-Fe at Finite Temperatures

Molecular dynamics study of the core structure of an edge dislocation in alpha-Fe at finite temperatures has been performed in order to obtain the basic information on the temperature dependence of the lattice resistance of the dislocation or the interaction between a dislocation and point defects. The edge dislocation of the Burgers vector a/2<111> on {110} atomic plane was inserted into the model iron lattice and was relaxed statically at 0 K first and then relaxed again at 300 K to obtain the stable core structure at this temperature. The Burgers vector distribution of the infinitesimal edge dislocations which constructs the inserted edge dislocation was obtained for 0 K and 300 K. The former shows a sharp distribution within about 8b, but the latter shows a rather wide distribution with a lower peak which extends over more than 10b, with a considerable atomic fluctuation. This suggests that the property of the edge dislocation at finite temperatures is significantly different from that at very Iow temperatures, especially in the mechanical behaviour or the interaction wlth point defects