Paecilomyces lilacinus-induced Scleritis Following Bleb-associated Endophthalmitis after Trabeculectomy

Paecilomyces lilacinus (P. lilacinus) is a rare cause of fungal scleritis. We herein report a case of P. lilacinus-induced scleritis following bleb-associated endophthalmitis after trabeculectomy that was successfully treated with surgical excision of the affected sclera in combination with antifungal medication. An 85-year-old female underwent trabeculectomy of the left eye. A dellen formed in the corneal periphery due to limbal elevation of the filtering bleb and progressed to an infectious corneal ulcer, leading to blebitis. Eight days after the onset of blebitis, the patient was diagnosed with endophthalmitis, which resolved after vitrectomy. The growth of P. lilacinus was identified on swabs of the conjunctiva and the corneal specimen. Scleritis developed after the resolution of the endophthalmitis, and an early excision of the affected sclera, in addition to antifungal medication, resolved it completely. However, the scleritis recurred in a different region of the left eye. After 7 months of antifungal medication, the left eye showed no residual infection. When treating P. lilacinus-induced scleritis, surgical excision of the affected sclera has been shown to be an effective treatment strategy. Nevertheless, it is possible that the infection may recur in another part of the eyeball after the complete resolution of the primary lesion

Body sway increases immediately after strabismus surgery.

The purposes of this study were to examine whether body sway is altered immediately after strabismus surgery in children and to find preoperative clinical factors associated with body sway. In a prospective study, body sway was measured on 1-3 days before surgery and on the third day after surgery; for the measurements, computerized static stabilometry was carried out on 28 consecutive patients with strabismus (age range: 3 to 12 years old; mean: 7.4) who underwent strabismus surgery under general anesthesia. The linear length of the sway path (cm), the linear length of the sway path in a particular unit of time (cm/second), and the area of the sway path (cm2), indicative of the extent of body sway, all increased significantly among a total of 28 patients in both conditions of the patient's eyes open and closed, as well as among those in a subgroup of 16 patients with exotropia, after they had undergone strabismus surgery (p &#60; 0.05, Wilcoxon signed ranks test). The center of pressure along the Y axis of orientation from the toe to the heel was found to deviate significantly toward the heel postoperatively, as compared with the preoperative center in the subgroup of 16 patients with exotropia (p &#60; 0.05). Before surgery, 15 patients with no stereoacuity exhibited a greater amount of body sway when their eyes were open than did 13 patients with measurable stereoacuity (p &#60; 0.05, Mann-Whitney U-test). In the subgroup of 16 patients with exotropia when their eyes open, 3 patients with abnormal head posture exhibited more extensive body sway than did 13 patients without abnormal head posture (p &#60; 0.05). Body sway was found to significantly increase immediately after strabismus surgery in children with strabismus. Stereoacuity and abnormal head posture are 2 clinical factors associated with preoperative postural instability.</p

Orbital Emphysema Causing Syncope

Orbital emphysema is an abnormal condition in which air is present within the orbit. We report a rare case of a 19-year-old man who suffered syncopic attacks caused by sniffles following orbital emphysema as a result of trauma. Treating rhinitis is important in patients with orbital emphysema, and patients with cardiac disorders in addition to those with this condition must be warned about the risks of sniffles, sneezing, or nose blowing

進行大腸癌における大腸ステント留置術と集学的治療の検討

学位の種別: 課程博士審査委員会委員 : (主査)東京大学教授 渡邉 聡明, 東京大学教授 大友 邦, 東京大学准教授 藤城 光弘, 東京大学講師 鈴木 亮, 東京大学講師 伊地知 秀明University of Tokyo(東京大学

Concise Review: Are Stimulated Somatic Cells Truly Reprogrammed into an ES/iPS-Like Pluripotent State? Better Understanding by Ischemia-Induced Multipotent Stem Cells in a Mouse Model of Cerebral Infarction

Following the discovery of pluripotent stem (PS) cells such as embryonic stem (ES) and induced pluripotent stem (iPS) cells, there has been a great hope that injured tissues can be repaired by transplantation of ES/iPS-derived various specific types of cells such as neural stem cells (NSCs). Although PS cells can be induced by ectopic expression of Yamanaka’s factors, it is known that several stimuli such as ischemia/hypoxia can increase the stemness of somatic cells via reprogramming. This suggests that endogenous somatic cells acquire stemness during natural regenerative processes following injury. In this study, we describe whether somatic cells are converted into pluripotent stem cells by pathological stimuli without ectopic expression of reprogramming factors based on the findings of ischemia-induced multipotent stem cells in a mouse model of cerebral infarction

Effects of Extracellular Acidification on Intracellular pH and ATP-Induced Calcium Mobilization in Rabbit Lens Epithelial Cells

Effects of extracellular acidification on intracellular pH (pHi) and ATP-induced calcium mobilization were investigated in rabbit lens epithelial cells. Primary-cultured lens epithelial cells of Japanese white rabbits were used. Intracellular calcium ([Ca2+]i) and pHi were measured by using fluorescent dyes, fura-2 acetoxymethylester (fura-2 AM) and 2',7'-bis (carboxyethyl)-5,6-carboxyfluorescein acetoxymethylester (BCECF AM), respectively. The addition of 10 ?mol/L ATP produced an initial peak followed by a sustained increase in [Ca2+]i in a standard artificial aqueous humor at extracellular pH (pH0) 7.40. The initial peak was abolished by pretreatment with 1 ?mol/L thapsigargin, whereas the sustained increase was attenuated in a Ca2+-free solution or by pretreatment with 100 ?mol/L verapamil. Acidification of the pH0 from 7.40 to 6.80 decreased the pHi from 7.21 to 7.03, and enhanced both the initial peak and sustained increase in [Ca2+]i. These results suggest that acidification of pH0 significantly affects the pHi and modifies the ATP-induced [Ca2+]i transient in rabbit lens epithelial cells

Super responder of critical COVID-19 case

This report presents a case of a 74-year-old man who showed dramatic therapeutic response to treatment of coronavirus infectious disease-19 (COVID-19) pneumonia. He reported four-day history of sustained fever and acute progressive dyspnea. He developed severe respiratory failure, underwent urgent endotracheal intubation and showed marked elevation of inflammatory and coagulation markers such as c-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH) and D-dimer. Chest computed tomography (CT) demonstrated diffuse consolidation and ground glass opacity (GGO). We diagnosed critical COVID-19 pneumonia with detailed sick contact history and naso-pharyngeal swab of a reverse-transcriptase-polymerase-chain reaction (RT-PCR) assay testing. He received anti-viral drug, anti-interleukin (IL-6) receptor antagonist and intravenous methylprednisolone. After commencing combined intensive therapy, he showed dramatic improvement of clinical condition, serum biomarkers and radiological findings. Early diagnosis and rapid critical care management may provide meaningful clinical benefit even if severe case

A Randomized Phase 2 Trial of Antibiotic Prophylaxis Versus No Intervention for Muscle Biopsy in A Neurology Department

Muscle biopsy can be used to confirm the diagnosis of neuromuscular diseases. However, it is unclear whether antibiotic prophylaxis prior to muscle biopsy is needed to prevent surgical site infection (SSI). We are conducting a phase 2, single-center, open-labeled, prospective randomized trial to clarify the need for antibiotic prophylaxis in patients at low risk for SSI undergoing muscle biopsy. Patients will be randomized to an antibiotic prophylaxis group or a control group, and the incidence of SSI will be compared between the groups. Our findings will clarify the need for antibiotic prophylaxis in this patient population

豆類中のビタミンE含有量におよぼす加熱の影響(自然科学)

ビタミンEは食品中に広く分布しているが,調理中に酸化をうけて含有量に変化が起こることが知られている。これらの変化に関する報告の大部分は食用油中のビタミンEについてであり,その他の食品中のビタミンEの変化についての報告は少ない。特に豆類は組織が堅いため加熱時間が長いので,ビタミンE量の変化は大きいと考えられる。大豆,黒大豆,小豆中のビタミンE含有量が加熱によってどのように変化するかを高速液体クロマトグラフィー法によって定量したところ,大豆では生の49%,黒大豆では15%,小豆は27%まで減少した。また大豆に食塩や重曹を添加して加熱した場合,あるいは黒大豆に鉄ミョウバンを添加した場合は,いずれも無添加にくらべて高い残存率を示し,これらの添加はビタミンB含有量の減少を抑制した