Spontaneous Bilateral Pneumothorax in a Patient with Anorexia Nervosa: The Management of Prolonged Postoperative Air Leakage

A 24-year-old Japanese female with anorexia nervosa presented to our hospital for bilateral pneumothorax, and 12-Fr thoracostomy catheters were inserted into the bilateral pleural cavities. On hospital day 9, a thoracoscopic bullectomy was performed. However, air leakage relapsed on both sides on postoperative day 1. The air leakage on the right side was particularly persistent, and we switched the drainage to a Heimlich valve. Both lungs expanded gradually and the chest tube was removed on postoperative day 19. Passive pleural drainage might be an option for prolonged air leakage after a bullectomy in patients with anorexia nervosa

Gastrointestinal Stromal Tumor in a Patient with Neurofibromatosis: Abscess Formation in the Tumor Leading to Bacteremia and Seizure

A 66-year-old woman with neurofibromatosis type 1 (NF1) was brought to the emergency room with seizures and high-grade fever. Seizure in adult NF1 patients raises concern for intracranial lesions. However, neurological examination and central nervous system imaging failed to detect any causative intracranial lesions for her seizure. Gram-positive cocci, Streptococcus anginosus, were detected by blood cultures. Abdominal computed tomography revealed a well-defined round mass 7 cm in diameter, which was found to be a small intestinal gastrointestinal stromal tumor (GIST) containing an abscess. There was fistula formation between the intestinal lumen and the abscess, in which there were numerous Gram-positive cocci. The seizure may have been caused by hypoosmolality (hyponatremia and hypoproteinemia), which may result from decreased food intake associated with high-grade fever and general malaise. In this case GIST originating from the small intestine was invaded by S. anginosus through a fistula, leading to abscess formation, bacteremia, high-grade fever, and seizure, which was the first clinical manifestation

Stable isotopic and geochemical characteristics of groundwater in Kherlen River basin, a semi-arid region in eastern Mongolia

Inorganic solute ion concentrations and stable isotopes of oxygen and hydrogen ingroundwater, river water and precipitation were investigated to gain insight into thegroundwater recharge process in the Kherlen River basin, a semi-arid region in easternMongolia. The solute constituents in the river water (main stream) were of Ca-HCO3 type,spatially invariant and low in concentration. Groundwater in the upstream region was alsocharacterized by a Ca-HCO3 type, though all ion concentrations were higher than in the riverwater. On the other hand, the chemical composition of the groundwater in the midstreamregion (southern and eastern) was spatially variable and the Na+, Mg2+, Cl- and HCO3-concentrations were considerably higher than in the river water and upstream groundwater.The stable isotopic compositions showed an evaporation effect on the groundwater and river water, as well as an altitude effect in the precipitation and river water. Preferential rechargeby relatively large rainfall events is thought to have caused the depleted isotopic ratio in thegroundwater in the dry regions. The stable isotope, chemical and hydrological data suggestthat the main stream water of the Kherlen River is recharged by precipitation that falls in aheadwater region at an altitude of more than 1650 m, and that the interaction between thegroundwater and river water is not dominant in the midstream and downstream regions ofthe river basin

Subaru Deep Survey V. A Census of Lyman Break Galaxies at z=4 and 5 in the Subaru Deep Fields: Photometric Properties

(abridged) We investigate photometric properties of Lyman Break Galaxies (LBGs) at z=3.5-5.2 based on large samples of 2,600 LBGs detected in deep (i'~27) and wide-field (1,200 arcmin^2) images taken in the Subaru Deep Field (SDF) and the Subaru/XMM Deep Field (SXDF). The selection criteria for the LBG samples are examined with 85 spectroscopically identified objects and by Monte Carlo simulations. We find in the luminosity functions of LBGs (i) that the number density of bright galaxies (M_{1700}<-22; corresponding to SFR_{corr}>100 Msolar yr^{-1}) decreases significantly from z=4 to 5 and (ii) that the faint-end slope of the luminosity function may become steeper towards higher redshifts. We estimate dust extinction of z=4 LBGs with M<M^* from UV slopes, and obtain E(B-V)=0.15+/-0.03 as the mean value. The dust extinction remains constant with apparent luminosity, but increases with intrinsic luminosity. We find no evolution in dust extinction between LBGs at z=3 and 4. We investigate the evolution of UV-luminosity density at 1700A, rho, and find that rho does not significantly change from z=3 to z=5, i.e., rho(z=4)/rho(z=3)=1.0+/-0.2 and rho(z=5)/rho(z=3)=0.8+/-0.4, thus the cosmic star-formation rate (SFR) density remains constant. We find that the stellar mass density estimated from the cosmic SFR is consistent with those derived directly from the stellar mass function at z=0-1, but exceeds those at z~3 by a factor of 3. We find that the ratio of the UV-luminosity density of Ly-a emitters (LAEs) to that of LBGs is ~60% at z=5, and thus about a half of the star formation at z=5 probably occurs in LAEs. We obtain a constraint on the escape fraction of UV-ionizing photons produced by LBGs, f_{esc}>~0.13.Comment: 41 pages, 22 figures, ApJ in press. Paper with high resolution figures is available at http://hikari.astron.s.u-tokyo.ac.jp/~ouchi/work/astroph/SDS_V_VI/SDS_V.pdf (PDF