New model of plasma convection during transpolar arc events

A transpolar arc (TPA) event occurred on December 10, 1996, is examined using auroral images from the Polar UVI. Before the appearance of the TPA, the total pressure of the magnetotail observed at X～-24 R_E had been increasing for about three hours. Since the IMF Bz was strongly positive during this period, the viscous-like interaction probably contributed to the increase in the total pressure of the magnetotail. A clear TPA appeared in association with fluctuations in the IMF By component. A subsequent decrease in the IMF Bz component caused a significant equatorward shift of the dawnside auroral oval, probably resulting in the duskward movement of the TPA. The nightside termination of the TPA, however, was fixed at around local midnight of the auroral oval. This observation indicates that a quasi-stable structure existed in the magnetospheric convection pattern. To account for the present observations, a new model for the formation of TPAs is proposed. The model assumes that the interactions between the viscous convection cells and the merging cell occur in the magnetotail, and predicts that the TPA is mapped along magnetic field lines onto a plasma flow channel that branches off from the earthward plasma convection toward the flank of the magnetotail

Prevalence of asthma symptoms based on the European Community Respiratory Health Survey questionnaire and FENO in university students: gender differences in symptoms and FENO

<p>Abstract</p> <p>Background</p> <p>The fractional concentration of nitric oxide in exhaled air (F<smcaps>E</smcaps>NO) is used as a biomarker of eosinophilic airway inflammation. F<smcaps>E</smcaps>NO is increased in patients with asthma. The relationship between subjective asthma symptoms and airway inflammation is an important issue. We expected that the subjective asthma symptoms in women might be different from those in men. Therefore, we investigated the gender differences of asthma symptoms and F<smcaps>E</smcaps>NO in a survey of asthma prevalence in university students.</p> <p>Methods</p> <p>The information about asthma symptoms was obtained from answers to the European Community Respiratory Health Survey (ECRHS) questionnaire, and F<smcaps>E</smcaps>NO was measured by an offline method in 640 students who were informed of this study and consented to participate.</p> <p>Results</p> <p>The prevalence of asthma symptoms on the basis of data obtained from 584 students (266 men and 318 women), ranging in age from 18 to 24 years, was analyzed. Wheeze, chest tightness, an attack of shortness of breath, or an attack of cough within the last year was observed in 13.2% of 584 students. When 38.0 ppb was used as the cut-off value of F<smcaps>E</smcaps>NO to make the diagnosis of asthma, the sensitivity was 86.8% and the specificity was 74.0%. F<smcaps>E</smcaps>NO was ≥ 38.0 ppb in 32.7% of students. F<smcaps>E</smcaps>NO was higher in men than in women. The prevalence of asthma symptoms estimated by considering F<smcaps>E</smcaps>NO was 7.2%; the prevalence was greater in men (9.4%) than women (5.3%). A F<smcaps>E</smcaps>NO ≥ 38.0 ppb was common in students who reported wheeze, but not in students, especially women, who reported cough attacks.</p> <p>Conclusions</p> <p>The prevalence of asthma symptoms in university students age 18 to 24 years in Japan was estimated to be 7.2% on the basis of F<smcaps>E</smcaps>NO levels as well as subjective symptoms. Gender differences were observed in both F<smcaps>E</smcaps>NO levels and asthma symptoms reflecting the presence of eosinophilic airway inflammation.</p> <p>Trial registration number</p> <p>UMIN000003244</p

Evaluation of a Rapid Immunochromatographic ODK-0901 Test for Detection of Pneumococcal Antigen in Middle Ear Fluids and Nasopharyngeal Secretions

Since the incidence of penicillin-resistant Streptococcus pneumoniae has been increasing at an astonishing rate throughout the world, the need for accurate and rapid identification of pneumococci has become increasingly important to determine the appropriate antimicrobial treatment. We have evaluated an immunochromatographic test (ODK-0901) that detects pneumococcal antigens using 264 middle ear fluids (MEFs) and 268 nasopharyngeal secretions (NPSs). A sample was defined to contain S. pneumoniae when optochin and bile sensitive alpha hemolytic streptococcal colonies were isolated by culture. The sensitivity and specificity of the ODK-0901 test were 81.4% and 80.5%, respectively, for MEFs from patients with acute otitis media (AOM). In addition, the sensitivity and specificity were 75.2% and 88.8%, respectively, for NPSs from patients with acute rhinosinusitis. The ODK-0901 test may provide a rapid and highly sensitive evaluation of the presence of S. pneumoniae and thus may be a promising method of identifying pneumococci in MEFs and NPSs

Treatments of refractory eosinophilic lung diseases with biologics

Biologics targeting the molecules associated with type 2 inflammation have significantly improved the outcomes of patients with severe eosinophilic asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). Chronic eosinophilic airway/lung diseases including chronic eosinophilic pneumonia, allergic bronchopulmonary aspergillosis/mycosis, eosinophilic bronchitis, and eosinophilic granulomatosis with polyangiitis share clinical features with eosinophilic asthma and CRPwNP, which are mostly adult-onset and may develop simultaneously or consecutively. These eosinophilic airway/lung diseases respond well to initial treatment with systemic corticosteroids, but often recur when the corticosteroids are tapered. The management of these “refractory” cases is an unmet need for clinicians. We first reviewed the standard treatments for these chronic eosinophilic airway/lung diseases, followed by the definition and prevalence of refractory diseases and the role of biologics in their management. The available evidence varies from case reports and case series to randomized control trials, depending on the type of disease; however, these studies provide not only a direction for clinical practice, but also insights into the pathophysiology of each disease. Physicians should discuss the efficacy and costs of biologics in patients with refractory eosinophilic airway/lung diseases to minimize not only the current symptoms, but future risks as well

Computed tomography findings of paranasal sinuses in patients with eosinophilic granulomatosis with polyangiitis: Comparison with other eosinophilic sinus diseases and clinical relevance of their severity

Background: Although paranasal sinuses are one of the most representative organs affected by eosinophilic granulomatosis with polyangiitis (EGPA), they have not been studied sufficiently. The aim of this study was to compare computed tomography (CT) findings in paranasal sinuses of EGPA with those of other eosinophilic sinus diseases and elucidate the clinical relevance of their severity. Methods: CT findings of paranasal sinuses in EGPA patients prior to therapeutic intervention (n = 30) were evaluated using the Lund–Mackay staging (LMS) system and compared with those of three control diseases [(NSAID-exacerbated respiratory disease (N-ERD), aspirin-tolerant asthma, and eosinophilic chronic rhinosinusitis without asthma (ECRS)]. We divided EGPA patients into three groups based on their LMS scores and examined their association with disease manifestation. Results: Total scores of the LMS system in EGPA were significantly lower than those of N-ERD and ECRS without asthma. There was a large variation in total LMS scores in EGPA, suggesting considerable heterogeneity of their sinus lesions. Although EGPA with low LMS system scores showed only minor findings in maxillary and anterior ethmoid regions, those with high LMS system scores were characterized by high scores in the ostiomeatal complex. However, the frequencies of patients with a Five-Factor Score ≥2 and with cardiac involvement were significantly higher for EGPA with low LMS system scores. Conclusions: Although paranasal sinus lesions in EGPA were less severe than those of other eosinophilic sinus diseases, their milder CT findings may be associated with a higher frequency of extra-respiratory organ involvement