Cerebral amyloid angiopathy-related inflammation presenting with steroid-responsive higher brain dysfunction: case report and review of the literature

A 56-year-old man noticed discomfort in his left lower limb, followed by convulsion and numbness in the same area. Magnetic resonance imaging (MRI) showed white matter lesions in the right parietal lobe accompanied by leptomeningeal or leptomeningeal and cortical post-contrast enhancement along the parietal sulci. The patient also exhibited higher brain dysfunction corresponding with the lesions on MRI. Histological pathology disclosed β-amyloid in the blood vessels and perivascular inflammation, which highlights the diagnosis of cerebral amyloid angiopathy (CAA)-related inflammation. Pulse steroid therapy was so effective that clinical and radiological findings immediately improved

Characteristics of the Changes in the Compressive and Tensile Stress of the Construction Sealant under Cyclic Movement

A compact fatigue testing machine to quantitatively evaluate the effects of this complex degradation of sealants and the load change of the sealant under dynamic fatigue has been developed. The developed fatigue testing machine is compact with dimensions of (width) 100 × (length) 135 × (height) 110 mm. It can be installed in an outdoor exposure test site or in a chamber. Thus, this machine can be used for performing various compounded accelerated degradation tests. We report the use of this testing machine to examine the effects of this complex degradation of sealants and the load change of the sealant under dynamic fatigue

Perinatal Management for a Pregnant Woman with an MYH9

We diagnosed a primipara woman with an MYH9 disorder during her pregnancy. A peripheral blood smear with an immunofluorescence analysis is the established method of diagnosing MYH9 disorders. We provided genetic counseling, as required, which included apprising the woman of the inheritance pattern, the importance of a genetic analysis, and the potential delivery risks for the patient and her offspring. Given that the potential delivery risks are reportedly low, special perinatal management is not necessary for patients with an MYH9 disorder whose platelet count is above 5.0 × 104/μL, except for rapid blood access

Innovative Treatment of a Fetal Lung Mass Model Using High-intensity Focused Ultrasound (HIFU)

Current therapy for space-occupying fetal lung mass lesions (fetal pulmonary lobectomy) is invasive and technically demanding. Accordingly, new therapeutic procedures are required which are much less invasive and more efficient. The purpose of this study was to investigate the feasibility of high-intensity focused ultrasound (HIFU) as a new therapeutic modality for fetal lung mass lesions, using an experimental animal model. We created a solid fetal lung model by differential lung ventilation using anesthetized adult rabbits. In this model, experimental animals with a unilateral independent (fluid-filled) lung were maintained by single lung ventilation of the other dependent lung. Within the independent lung, target blood vessels depicted by color flow Doppler were repeatedly irradiated with HIFU energy beams (n=19). Occlusion of these blood vessels in vivo was confirmed by evaluation of the flow using color flow Doppler. After the procedure, the animals were sacrificed and their harvested lungs were assessed grossly and microscopically. Pulmonary blood vessels (artery and/or vein) were effectively occluded with 2 to 5 cycles of HIFU energy delivery (10.5 seconds each) with a success rate of 62.5% (arteries) and 72.7% (veins). No clear changes including tissue perforations were observed grossly on the surface of the lungs. Ultrasound-guided HIFU energy delivery seems promising for occlusion of the pulmonary blood vessels within a fluid-filled independent lung (fetal lung model). Thus in the future, HIFU irradiation could be used as a less invasive technique to occlude the feeding vessels of fetal lung mass lesions in utero

Evaluation of Financial and Non-financial Conflicts of Interest and Quality of Evidence underlying Psoriatic Arthritis Clinical Practice Guidelines-Analysis of Personal Payments from Pharmaceutical Companies and Authors' Self-citation Rate in Japan and the United States

OBJECTIVE: To assess financial conflict of interest (FCOI) and non-financial conflicts of interest (NFCOI) among psoriatic arthritis clinical practice guideline (PsACPG) authors in Japan and US, and to evaluate the quality of evidence and strength of recommendations of PsACPG.METHODS: We performed a retrospective analysis using payment data from major Japanese pharmaceutical companies and the US Open Payments Database from 2016 to 2018. All authors of PsACPG issued by Japanese Dermatological Association (JDAPsACPG) and American College of Rheumatology (ACRPsACPG) were included.RESULTS: Of 23 CPG authors in Japan, 21 (91.3%) received at least one payment, with the combined total of $3,335,413 between 2016 and 2018. Regarding 25 US authors, 21 (84.0$4,081,629 during the same period. The 3-year combined average payment per author was $145,018 (standard division [SD]:$114,302) in Japan and $162,825 (SD:$259,670) in US. 18 (78.3%) JDAPsACPG and 12 (48.0%) ACRPsACPG authors had undisclosed FCOI worth $474,663 and$218,501, respectively. The percentage of citations with at least one CPG author relative to total citations were 3.4% in Japan and 33.6% in US. 71.4% and 88.8% of recommendations for psoriatic arthritis in JDA and ACR were supported by low or very low quality of evidence.CONCLUSION: More rigorous cross-checking of information disclosed by pharmaceutical companies and self-reported by physicians, and more stringent and transparent COI policies are necessary.</p

Debridement in Patients with Pressure Ulcers

Debridement is a topical treatment for pressure ulcers based on wound bed preparation. and wound healing is triggered only after removal of the necrotic tissue. There are three types of debridement: surgical, mechanical. and autolytic. Surgical debridement is invasive; however, it promotes the wound healing process. It is mainly performed in hospitals. Autolytic debridement is performed in situations wherein it is not possible to cope with bleeding, such as in homecare settings. Although less invasive, removal of necrotic tissue by autolytic debridement takes a substantial amount of time. Mechanical debridement is performed by physically removing small areas of necrotic tissue from the granulation surface using negative-pressure wound therapy, curettes, or the wet-to-dry technique

Safety of SARS-CoV-2 BNT162b2 Vaccine in Elderly Patients from Japan - A Preliminary Assessment and A Call on Careful Pharmacovigilance

Vaccines are efficacious, effective and safe measures to control COVID-19. Despite phase 3 and 4 studies, some concerns should be addressed in certain populations regarding its specific vaccine safety. One of them is the safety of the elderly. The majority of enrollees in clinical studies on COVID-19 vaccines have been young to middle-aged individuals, with few exceptions

Safety of SARS-CoV-2 BNT162b2 Vaccine in Elderly Patients from Japan - A Preliminary Assessment and A Call on Careful Pharmacovigilance

Vaccines are efficacious, effective and safe measures to control COVID-19. Despite phase 3 and 4 studies, some concerns should be addressed in certain populations regarding its specific vaccine safety. One of them is the safety of the elderly. The majority of enrollees in clinical studies on COVID-19 vaccines have been young to middle-aged individuals, with few exceptions

Current Performance and On-Going Improvements of the 8.2 m Subaru Telescope

An overview of the current status of the 8.2 m Subaru Telescope constructed and operated at Mauna Kea, Hawaii, by the National Astronomical Observatory of Japan is presented. The basic design concept and the verified performance of the telescope system are described. Also given are the status of the instrument package offered to the astronomical community, the status of operation, and some of the future plans. The status of the telescope reported in a number of SPIE papers as of the summer of 2002 are incorporated with some updates included as of 2004 February. However, readers are encouraged to check the most updated status of the telescope through the home page, http://subarutelescope.org/index.html, and/or the direct contact with the observatory staff.Comment: 18 pages (17 pages in published version), 29 figures (GIF format), This is the version before the galley proo