Progressing subglottic and tracheobronchial stenosis in a patient with CHARGE syndrome diagnosed in adulthood

AbstractA 33-year-old woman was admitted for a pseudocroup-like cough and wheezing after general anesthesia. Several months ago, she had undergone cardiac re-operation and turbinectomy, both of which had involved difficult intubations. Bronchoscopy indicated a pin-hall-like subglottic stenosis; therefore, emergency tracheotomy was performed. Six years later, a computed tomography scan demonstrated progressive stenosis of the entire circumference of the trachea and main bronchi. She died at 40 years. Her autopsy revealed marked tracheobronchial stenosis. She had many medical histories that had gone undiagnosed and had been clinically ill with only heart defects. She did not have coloboma but had microphthalmos, atresia choanae, retarded growth development, and deafness; thus, we diagnosed CHARGE syndrome that refers to multiple congenital anomalies, including airway abnormalities, which can lead to secondary complications such as traumatic stenosis after intubation. Physicians should have knowledge of this rare disease and should pay special attention to potential airway problems

Fluorescence and chemiluminescence behavior of distyrylbenzene bearing two arms of dipicolylaminomethyl groups: Interactions with zinc ion and ATP

Available online 31 January 2018.The absorption and fluorescence spectral study of the distyrylbenzene bearing two arms of the dipicolylaminomethyl groups, the effective ligands for Zn2+, was studied in the presence of Zn2+ and ATP. Upon complexation of the distyrylbenzene with zinc ions in acetonitrile, enhancement of the fluorescence intensity was observed due to inhibition of intramolecular PET (photo-induced electron transfer) quenching, but no effect was found in aqueous media because the equilibrium laid to the free form of the ligands. In contrast, the addition of ATP disodium salt was effective to enhance the fluorescence intensity of the combination of the distyrylbenzne and Zn2+ in aqueous media. This assembly was applied to the peroxyoxalate chemiluminescence system and a significant increase in the intensity was observed, which provides a potential detection for ATP by chemiluminescence. (C) 2018 Elsevier B.V. All rights reserved.ArticleSPECTROCHIMICA ACTA PART A-MOLECULAR AND BIOMOLECULAR SPECTROSCOPY. 195:223-229 (2018)journal articl

Development of a multi-pixel photon sensor with single-photon sensitivity

A multi-pixel photon sensor with single-photon sensitivity has been developed, based on a technology of a hybrid photo-detector (HPD) consisting of a photocathode and a multi-pixel avalanche diode (MP-AD). The developed HPD has a proximity focused structure, where a photocathode and an MP-AD are facing each other with a small gap of 2.5 mm. The MP-AD, which has an effective area of 16x16 mm2 composed of 8x8 pixels, has been specially designed for the HPD. The gain of the HPD reaches 5x10^4, sufficiently high to detect single photons with a timing resolution better than 100 ps. Number of photoelectrons up to four can be clearly identified in a pulse-height spectrum as distinct peaks, thanks to the low noise characteristics of the HPD. It is also demonstrated that the HPD can be operated with good performance in a magnetic field as high as 1.5 TComment: 39 pages, 22 figures, submitted to Nucl. Intr. and Meth.

Diagnostic reliability of magnetic resonance imaging for central nervous system syndromes in systemic lupus erythematosus: a prospective cohort study

<p>Abstract</p> <p>Background</p> <p>Previous studies of magnetic resonance imaging (MRI) as a diagnostic tool for central nervous system (CNS) syndromes in systemic lupus erythematosus (SLE) contained several limitations such as study design, number of enrolled patients, and definition of CNS syndromes. We overcame these problems and statistically evaluated the diagnostic values of abnormal MRI signals and their chronological changes in CNS syndromes of SLE.</p> <p>Methods</p> <p>We prospectively studied 191 patients with SLE, comparing those with (n = 57) and without (n = 134) CNS syndrome. CNS syndromes were characterized using the American College of Rheumatology case definitions.</p> <p>Results</p> <p>Any abnormal MRI signals were more frequently observed in subjects in the CNS group (n = 25) than in the non-CNS group (n = 32) [relative risk (RR), 1.7; 95% confidence interval (CI), 1.1-2.7; <it>p </it>= 0.016] and the positive and negative predictive values for the diagnosis of CNS syndrome were 42% and 76%, respectively. Large abnormal MRI signals (ø ≥ 10 mm) were seen only in the CNS group (n = 7; RR, 3.7; CI, 2.9-4.7; <it>p </it>= 0.0002), whereas small abnormal MRI signals (ø < 10 mm) were seen in both groups with no statistical difference. Large signals always paralleled clinical outcome (<it>p </it>= 0.029), whereas small signals did not (<it>p </it>= 1.000).</p> <p>Conclusions</p> <p>Abnormal MRI signals, which showed statistical associations with CNS syndrome, had insufficient diagnostic values. A large MRI signal was, however, useful as a diagnostic and surrogate marker for CNS syndrome of SLE, although it was less common.</p

HPV カンセン ジョウキョウ ト シキュウ ケイガン ケンシン ニオケル サイボウ シン ト HPV ケンサ ヘイヨウ ノ イギ

Human papillomavirus (HPV) 中高リスク型の感染が,子宮頸部の前癌病変や子宮頸癌の発症に関与していることが明らかにされた.HPV 感染の一部は持続感染し,子宮頸癌のリスクとなる.そこでHPV 感染状況と子宮頸癌検診における細胞診とHPV 検査併用の意義について検討した.対象は3 年以上経過観察可能であった細胞診正常81 例と細胞診異常で組織診を施行した80 例である.HPV 検出にはHybrid Capture AssayII&reg;( HC-II&reg;) 法を用いた.細胞診正常11 例,細胞診異常61 例でHPV が検出され,細胞診異常の程度が進むほどHPV 検出率は上昇した.組織診でも病変が進行するほどHPV 検出率は高くなった.細胞診正常ではHPV陽性持続で病変の進行を認めた.組織診別では,慢性子宮頸管炎(Chronic Cervicitis:CC) ではHPV 陽性持続1 例と陽性化1 例に,子宮頸部上皮内病変(Cervical Intraepithelial Neoplasia:CIN) IではHPV 陽性持続2 例に,CIN IIでは陽性持続3 例と陽性化した1 例に,CIN IIIでは陽性持続2 例に病変の進行が認められた.HPV 感染が認められなかった例では病変の進行を認めない結果から,細胞診とHPV 検査を併用することにより,細胞診正常でHPV 検査陰性であれば検診間隔を3 年に延ばすことが可能であると示唆された.またHPV持続感染が病変進行の原因となると考えられ,HPV 検査の導入は子宮頸癌の早期発見,早期治療に有用である.Persistent infection with intermediate or high risk subtypesof human papillomavirus (HPV) is associated withuterine cervical neoplasia and cervical cancer. Over a3-year period, we followed up 161 patients with normal( 81cases) and abnormal (80 cases) results of cytologicalscreening tests to determine the status of persistent HPVinfection and the significance of combined uterine cervicalcancer cytological screenings and HPV tests. The hybridcapture assay II&reg; method was used to test for intermediateor high risk of HPV infection. HPV infection was detectedin 11 patients with normal results and 61 patients with abnormalresults of cytological screening tests. The positiverate of HPV infection was associated with the status of cytologicaland pathological lesion progression. Lesions of 2patients with persistent HPV infection who had normal resultsin cytological screening tests had been diagnosed withprogressive lesions. Lesions of patients in whom HPV infectionwas negative or negative conversion were determinedto be non-progressive. Disease progression was seen in theform of chronic cervicitis in 1 patient with persistent HPVinfection and 1 patient with HPV positive conversion;inthe form of cervical intraepithelial neoplasia (CIN) I in 2patients with persistent HPV infection;in the form of CINII in 3 patients with persistent HPV infection and 1 patientwith HPV positive conversion;and in the form of CIN IIIin 2 patients with persistent HPV infection. In conclusion,combined cytological screening and HPV tests will increasethe precision of uterine cervical cancer screening and willbe valuable for the early detection and a rapid treatment ofuterine cervical cancer. Moreover, the interval between 2consecutive uterine cervical cancer screenings can be extendedto at least 3 years in patients who have normal resultsof cytology and no HPV infection