Traumatic renal artery occlusion associated with a grade III hepatic injury in an 11-year-old boy: A case report

AbstractBlunt trauma represents a major cause of death in children. Multi-trauma is defined as life-threatening injury of two or more body regions and remains a challenge for diagnosis and therapy. Here, we present a case of an 11-year-old boy with a traumatic renal artery occlusion associated with a hepatic injury, which was treated with conservative non-operative treatment. Prompt diagnosis and conservative treatment of a traumatic renal artery occlusion in a pediatric patient may lead to a successful outcome, avoiding unnecessary laparotomy

Potential application of measuring serum infliximab levels in rheumatoid arthritis management: A retrospective study based on KURAMA cohort data

Infliximab (IFX) therapy has considerably improved the treatment of rheumatoid arthritis (RA). However, some patients still do not respond adequately to IFX therapy, or the efficacy of the treatment diminishes over time. Although previous studies have reported a relationship between serum IFX levels and therapeutic efficacy, the potential applications of IFX therapeutic drug monitoring (TDM) in clinical practice remain unclear. The purpose of this study was to investigate the potential applications of IFX TDM by analyzing a Japanese cohort database. Data were collected retrospectively from the Kyoto University Rheumatoid Arthritis Management Alliance cohort between January 1, 2011, and December 31, 2018. Serum IFX levels were measured using a liquid chromatography-tandem mass spectrometer. Out of the 311 RA patients that used IFX, 41 were eligible for the analysis. Serum IFX levels were significantly higher in responders than in non-responders. An optimal cut-off value was determined to be 0.32 μg/mL based on a receiver operating characteristic curve. At the IFX measurement point, a better therapeutic response was observed in the high IFX group (n = 32) than in the low IFX group (n = 9). Conversely, at the maximum effect point, when DAS28-ESR was the lowest between IFX introduction and measurement points, there were no differences in responder proportions between the low and high IFX groups. IFX primary ineffectiveness could be avoided with appropriate dose escalation without blood concentration measurement in clinical practice. In conclusion, IFX TDM could facilitate the identification of secondary non-responders and in turn, proper IFX use

極地での曝露による繊維表面形態と物性（第一報） ―南極大陸及び西宮市におけるナイロン6 繊維の表面形態について―

Some of the flags set on the traverse route between Syowa Station and Dome Fuji in the Antarctic, which were carried back to our group by the staffs of Wintering Party of the 35th Japanese Antarctic Research Expedition in 1993-95, were examined as specimens exposed in the polar regions. The fibers of original flag with a circular cross section showed flat and smooth surface, though the fiber of the exposed flags showed a weave-like shape by the disappearance of the skin parts. Such violent disruption was not observed for the flags exposed under mild weather in Nishinomiya Japan. The degradation of the flags exposed in the Antarctic was estimated in relation to the depletion of the ozone layer as well as multiplex reflection of sunshine and a strong wind from the characteristic circumstance of the Antarctic. In addition, the oligomerization on the surface of the fibers exposed in the Antarctic was observed by scanning electron microscopy. This was suggested to the recrystallization formed under the influence of intensely ultraviolet irradiation, multiplex reflection of sunshine and water