Geotechnical Aspect of Damage In Adapazari City During the 1999 Kocaeli, Turkey, Earthquake

This report summerizes detailed investigation on the structural damage and its geotechnical condition in the Adapazaý City, Turkey, during the 1999 Kocaeli earthquake by the reconnaissance team of the Japanese Geotechnical Society. Damages to individual buildings were investigated along several streets in the downtown area. A little rough investigation was made almost all downtown area, in which damages were classified by its cause, i.e., inertia force or soil liquefaction. These investigations as well as hearing investigation and areal investigation by means of helicopters made clear the area where there was an island a few hundred years ago by which the name of Adapazarý i.e., ada (island) + pazarý (market), came from. In addition, the damage in the Adapazarý City is shown to be strongly affected by the ground condition because damage caused by liquefaciton was observed only outside the old island and areas where significant structural damage was observed were concentrated near the boundary between the old riverbed and island

Circulating lymphocyte is an important determinant of the effectiveness of preoperative radiotherapy in advanced rectal cancer

<p>Abstract</p> <p>Background</p> <p>Although preoperative radiotherapy (RT) is widely used as the initial treatment for locally advanced rectal cancer (RC) in the neoadjuvant setting, factors determining clinical response have not been adequately defined. In order to find other factors possibly related with radiosensitivity, we evaluated the relationships between circulating blood cell counts and RT effects.</p> <p>Methods</p> <p>In 179 cases with advanced RC, we retrospectively examined hemoglobin (Hb) levels and counts of white blood cells (WBC), platelets and WBC subsets before and after RT and investigated their associations with the complete response (CR) rate together with other clinicopathological factors.</p> <p>Results</p> <p>The ratio of lymphocytes in WBC taken before RT was significantly greater in 15 CR cases as compared with those in non-CR cases. Patients with high lymphocyte percentages (25.7%) showed better outcome than the counterparts. Conversely, the ratio of neutrophiles was reduced in CR cases. The lymphocyte ratio showed an independent association with CR with multivariate analysis, and tended to be maintained at relatively high levels in CR cases.</p> <p>Conclusions</p> <p>In RC patients, peripheral blood lymphocytes have a significant impact on the CR rate in response to RT. Lymphocyte-mediated immune reactions are supposed to have positive roles on clinical response in radiotherapy for RC.</p

Post-ERCP pancreatogastric fistula associated with an intraductal papillary-mucinous neoplasm of the pancreas – a case report and literature review

BACKGROUND: Fistula formation has been reported in intraductal papillary-mucinous neoplasms (IPMNs) with or without invasion of the adjacent organs. The presence or absence of invasion is mostly determined by postoperative histological examination rather than by preoperative work-up. CASE PRESENTATION: A 72 year-old Japanese woman showed remarkable dilatation of the main pancreatic duct (MPD) in the distal region of the pancreas. Subsequent ERCP also showed MPD dilatation, after which the patient suffered moderate pancreatitis. A subsequent gastroscopy revealed a small ulceration that had not been observed in a gastroscopy performed 3 months prior. Mucinous discharge from the ulceration suggested it might be the orifice of a fistula connected to the MPD. En bloc resection including the distal region of the pancreas, spleen, stomach and part of the transverse colon was performed under the pre- and intraoperative diagnosis of an invasive malignant IPMN. However, histopathology revealed the lesion to be of "borderline malignancy" without apparent invasion of the stomach. Light microscopy showed inflammatory cellular infiltrates (mainly neutrophils) around the pancreatogastric fistula, but there was no evidence of neoplastic epithelia lining the fistulous tract. CONCLUSION: This case highlights that a pancreatogastric fistula can develop after acute inflammation of the pancreas in the absence of cancer invasion. Further information regarding IPMN-associated fistulae is necessary to clarify the pathogenesis, diagnosis, appropriate surgical intervention and prognosis for this disorder

Environmental Disinfection by Hypochlorous Acid Solution

Weak Acid Hypochlorous Solution (WAHS) has been used for disinfection of foods (meats, vegetables etc.), and for environmental disinfection in the Retirement homes, Hospitals and Laboratory Animal facilities. We will introduce here some of environmental disinfection tests. 1) To study whether WAHS is available or not for blood blot inoculated by Acinetobacter baumannii on the plate comparing with Sodium Hypochlorite. 2) Comparison of Ethanol and WAHS on the floor and handrail. 3) To study efficacy of shallowly dipping by WAHS on wagon caster inoculated by Staphylococcus aureus. The results are: 1) It was observed that WAHS had an efficacy equal to Hypochlorite with lower concentration in the blood test, but in case that the adhesion amount of blood was larger, much higher concentration or adding physical removal was needed. 2) Ethanol and WAHS had Equivalent efficacy on the test of floor and handrail. 3) It was suggested that shallowly dipping by WAHS was available for disinfection of wagon caster. We hope to proceed to confirm how to use WAHS for environmental disinfection

Disseminated Mycobacterium genavense infection mimicking TAFRO syndrome

TAFRO syndrome is a rare variant of idiopathic multicentric Castleman's disease, for which disseminated non-tuberculous mycobacteria (NTM) infection must be excluded. However, due to the slow and fastidious growth of the organisms, identification of the pathogen is often challenging. We herein describe a case of disseminated Mycobacterium genavence infection, in which manifestations of the patient were confusingly similar to those of TAFRO syndrome. A 69-year-old Japanese man presented with prolonged fever accompanying pain in his back and ribs on the right side. Systemic investigations revealed thrombocytopenia, marked elevation of alkaline phosphatase, anasarca (pleural effusion and ascites), megakaryocytosis in the bone marrow, and hepatomegaly. Magnetic resonance imaging (MRI) showed diffuse, T1-and T2-low-intensity spotted lesions on his vertebral bodies, but biopsy showed inconclusive results. The patient met the diagnostic criteria of TAFRO syndrome and was started on prednisolone, which improved his general condition shortly thereafter. Blood culture after 42 days of incubation revealed the presence of Mycobacterium; however, we considered it a contamination at that time because no organisms grew on conventional agars, and the patient was discharged. Ten weeks after the isolation of Mycobacterium, he developed persistent fever and was readmitted. This time, vertebral bone mallow biopsy demonstrated a large amount of mycobacterium, which was later successfully identified as M. genavense by sequencing analysis. Under a final diagnosis of disseminated M. genavense infection, we treated the patient with clarithromycin, rifampicin, and ethambutol. This case highlighted that disseminated NTM infection may follow a similar clinical course as that of TAFRO syndrome