See-Saw Realization of the Texture Zeros in the Neutrino Mass Matrix

We study the see-saw realization of seven textures of the neutrino mass matrix, which were presented by Frampton, Glashow and Marfatia. Two of them B_1 and B_2 are not realized in the see-saw mechanism without fine-tuning of parameters. We present some specific textures of the Dirac neutrino mass matrix and the right-handed Majorana neutrino one. In order to test these textures, we discuss the effect on the branching ratio of mu --> e gamma. We also study the U(1)_X times U(1)_{X'} flavor symmetry, in which U(1)_X is anomalous and U(1)_{X'} is non-anomolous, to reproduce texture zeros. We present examples of U(1) charges for two textures A_1 and A_2$.Comment: Latex file, 15 pages, the sign of charge is revise

Energetics of lipid transport by the ABC transporter MsbA is lipid dependent.

Funder: China Scholarship Council (CSC); doi: https://doi.org/10.13039/501100004543Funder: Cambridge Commonwealth Trust; doi: https://doi.org/10.13039/501100003342The ABC multidrug exporter MsbA mediates the translocation of lipopolysaccharides and phospholipids across the plasma membrane in Gram-negative bacteria. Although MsbA is structurally well characterised, the energetic requirements of lipid transport remain unknown. Here, we report that, similar to the transport of small-molecule antibiotics and cytotoxic agents, the flopping of physiologically relevant long-acyl-chain 1,2-dioleoyl (C18)-phosphatidylethanolamine in proteoliposomes requires the simultaneous input of ATP binding and hydrolysis and the chemical proton gradient as sources of metabolic energy. In contrast, the flopping of the large hexa-acylated (C12-C14) Lipid-A anchor of lipopolysaccharides is only ATP dependent. This study demonstrates that the energetics of lipid transport by MsbA is lipid dependent. As our mutational analyses indicate lipid and drug transport via the central binding chamber in MsbA, the lipid availability in the membrane can affect the drug transport activity and vice versa.This research was funded by Biotechnology and Biological Sciences Research Council (BBSRC) grant BB/R00224X/1 (to H.W.V.V). D.G. and Y.T. were funded by China Scholarship Council – Cambridge Trust PhD Scholarships. C.G. was funded by a BBSRC Doctoral Training Partnership (DTP) Targeted PhD studentship (project 2114197). T.N. received a student grant from Christ’s College Cambridge

Vascular Patterns of Villous Tumors of the Colorectum

In order to more fully understand the morphological characteristics of villous tumors of the colorectum, the vascular patterns of six colorectal resection specimens were microangiographically studied. Grossly, villous adenomas were of two main types: pedunculated polyps and carpet-like lesions. Pedunculated villous adenomas had many large stalk vessels in a broad short pedicle, representing a large blood supply to the tumor. The carpet-like lesions were composed of continuous clusters of polyps with stalk vessels and the flat elevated lesions among polyps and at the periphery showed similar vascular patterns to the mucosa of normal colon. In lesions with cancer invasive to the proper muscle layer, scattered ulcerations due to the destruction of polyps were also observed, corresponding to at least a Dukes B lesion. The above findings could represent very important additional information for endoscopic treatment or local excision for the prevention of hemorrhagic complicatios or incomplete removal of tumor

Clinical Aspect of Peripheral Cholangiocarcinoma: A Study of 7 Hepatectomy Cases

To clarify the features and problems presented by a peripheral cholangiocarcinoma (CCC), seven patients with hepatectomy from the First Department of Surgery, Nagasaki University School of Medicine (6 patients), and from Department of Surgery, National Ureshino Hospital (one patient) were reviewed. Men predominate with ratio of 5:2, and an average age was 65.4 years. Tumor location was left lateral segment in 4 patients, right lobe, middle lobe and posterior segment in one, respectively. Three patients were associated with hepatolithiasis. Underlying liver disease was found in 4 patients (57%); cirrhosis in 3 patients, and chronic hepatitis in one. Initial symptoms were abdominal pain, fever and palpable abdominal mass. In imaging modalities available, the detection rates of tumor were 100% in CT and 67% in US and angiography, respectively. Combination of MRI and CT clearly showed tumor characteristics. The serum CEA was slightly elevated in 5 patients (83%), but serum CA19-9 rose strikingly in 3 patients. Most tumors showed an infiltrating growth along intrahepatic bile duct, with a portal vein thrombus and/or satellite tumors frequently. In 3 patients, early recurrence with intrahepatic metastasis occured within the first 6 months. The patient of poorly differentiated adenocarcinoma containing a squamous or signet ring cell carinoma showed an extremely poor prognosis. This study suggests that early detection of small CCC and an extended resection are the most important factors for the survival of patient

Lepton Flavor Violating Process in Bi-maximal texture of Neutrino Mixings

We investigate the lepton flavor violation in the framework of the MSSM with right-handed neutrinos taking the large mixing angle MSW solution in the quasi-degenerate and the inverse-hierarchical neutrino masses. We predict the branching ratio of $\mu \to e+\gamma$ and $\tau \to \mu+\gamma$ processes assuming the degenerate right-handed Majorana neutrino masses. We find that the branching ratio in the quasi-degenerate neutrino mass spectrum is 100 times smaller than the ones in the inverse-hierarchical and the hierarchical neutrino spectra. We emphasize that the magnitude of $U_{e3}$ is one of important ingredients to predict BR($\mu \to e +\gamma$). The effect of the deviation from the complete-degenerate right-handed Majorana neutrino masses are also estimated. Furtheremore, we examine the S_{3\sL}\times S_{3\sR} model, which gives the quasi-degenerate neutrino masses, and the Shafi-Tavartkiladze model, which gives the inverse-hierarchical neutrino masses. Both predicted branching ratios of $\mu\to e+\gamma$ are smaller than the experimantal bound.Comment: Latex file, 38 pages, 10 figures, revised versio

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020)

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high-quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J-SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU-acquired weakness [ICU-AW], post-intensive care syndrome [PICS], and body temperature management). The J-SSCG 2020 covered a total of 22 areas with four additional new areas (patient- and family-centered care, sepsis treatment system, neuro-intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large-scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members.As a result, 79 GRADE-based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J-SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.other authors: Satoru Hashimoto,Daisuke Hasegawa,Junji Hatakeyama,Naoki Hara,Naoki Higashibeppu,Nana Furushima,Hirotaka Furusono,Yujiro Matsuishi,Tasuku Matsuyama,Yusuke Minematsu,Ryoichi Miyashita,Yuji Miyatake,Megumi Moriyasu,Toru Yamada,Hiroyuki Yamada,Ryo Yamamoto,Takeshi Yoshida,Yuhei Yoshida,Jumpei Yoshimura,Ryuichi Yotsumoto,Hiroshi Yonekura,Takeshi Wada,Eizo Watanabe,Makoto Aoki,Hideki Asai,Takakuni Abe,Yutaka Igarashi,Naoya Iguchi,Masami Ishikawa,Go Ishimaru,Shutaro Isokawa,Ryuta Itakura,Hisashi Imahase,Haruki Imura,Takashi Irinoda,Kenji Uehara,Noritaka Ushio,Takeshi Umegaki,Yuko Egawa,Yuki Enomoto,Kohei Ota,Yoshifumi Ohchi,Takanori Ohno,Hiroyuki Ohbe,Kazuyuki Oka,Nobunaga Okada,Yohei Okada,Hiromu Okano,Jun Okamoto,Hiroshi Okuda,Takayuki Ogura,Yu Onodera,Yuhta Oyama,Motoshi Kainuma,Eisuke Kako,Masahiro Kashiura,Hiromi Kato,Akihiro Kanaya,Tadashi Kaneko,Keita Kanehata,Ken-ichi Kano,Hiroyuki Kawano,Kazuya Kikutani,Hitoshi Kikuchi,Takahiro Kido,Sho Kimura,Hiroyuki Koami,Daisuke Kobashi,Iwao Saiki,Masahito Sakai,Ayaka Sakamoto,Tetsuya Sato,Yasuhiro Shiga,Manabu Shimoto,Shinya Shimoyama,Tomohisa Shoko,Yoh Sugawara,Atsunori Sugita,Satoshi Suzuki,Yuji Suzuki,Tomohiro Suhara,Kenji Sonota,Shuhei Takauji,Kohei Takashima,Sho Takahashi,Yoko Takahashi,Jun Takeshita,Yuuki Tanaka,Akihito Tampo,Taichiro Tsunoyama,Kenichi Tetsuhara,Kentaro Tokunaga,Yoshihiro Tomioka,Kentaro Tomita,Naoki Tominaga,Mitsunobu Toyosaki,Yukitoshi Toyoda,Hiromichi Naito,Isao Nagata,Tadashi Nagato,Yoshimi Nakamura,Yuki Nakamori,Isao Nahara,Hiromu Naraba,Chihiro Narita,Norihiro Nishioka,Tomoya Nishimura,Kei Nishiyama,Tomohisa Nomura,Taiki Haga,Yoshihiro Hagiwara,Katsuhiko Hashimoto,Takeshi Hatachi,Toshiaki Hamasaki,Takuya Hayashi,Minoru Hayashi,Atsuki Hayamizu,Go Haraguchi,Yohei Hirano,Ryo Fujii,Motoki Fujita,Naoyuki Fujimura,Hiraku Funakoshi,Masahito Horiguchi,Jun Maki,Naohisa Masunaga,Yosuke Matsumura,Takuya Mayumi,Keisuke Minami,Yuya Miyazaki,Kazuyuki Miyamoto,Teppei Murata,Machi Yanai,Takao Yano,Kohei Yamada,Naoki Yamada,Tomonori Yamamoto,Shodai Yoshihiro,Hiroshi Tanaka,Osamu NishidaGuideline

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020)

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high-quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J-SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU-acquired weakness [ICU-AW], post-intensive care syndrome [PICS], and body temperature management). The J-SSCG 2020 covered a total of 22 areas with four additional new areas (patient- and family-centered care, sepsis treatment system, neuro-intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large-scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members.other authors: Yasuhiro Norisue, Satoru Hashimoto, Daisuke Hasegawa, Junji Hatakeyama, Naoki Hara, Naoki Higashibeppu, Nana Furushima, Hirotaka Furusono, Yujiro Matsuishi, Tasuku Matsuyama, Yusuke Minematsu, Ryoichi Miyashita, Yuji Miyatake, Megumi Moriyasu, Toru Yamada, Hiroyuki Yamada, Ryo Yamamoto, Takeshi Yoshida, Yuhei Yoshida, Jumpei Yoshimura, Ryuichi Yotsumoto, Hiroshi Yonekura, Takeshi Wada, Eizo Watanabe, Makoto Aoki, Hideki Asai, Takakuni Abe, Yutaka Igarashi, Naoya Iguchi, Masami Ishikawa, Go Ishimaru, Shutaro Isokawa, Ryuta Itakura, Hisashi Imahase, Haruki Imura, Takashi Irinoda, Kenji Uehara, Noritaka Ushio, Takeshi Umegaki, Yuko Egawa, Yuki Enomoto, Kohei Ota, Yoshifumi Ohchi, Takanori Ohno, Hiroyuki Ohbe, Kazuyuki Oka, Nobunaga Okada, Yohei Okada, Hiromu Okano, Jun Okamoto, Hiroshi Okuda, Takayuki Ogura, Yu Onodera, Yuhta Oyama, Motoshi Kainuma, Eisuke Kako, Masahiro Kashiura, Hiromi Kato, Akihiro Kanaya, Tadashi Kaneko, Keita Kanehata, Ken-ichi Kano, Hiroyuki Kawano, Kazuya Kikutani, Hitoshi Kikuchi, Takahiro Kido, Sho Kimura, Hiroyuki Koami, Daisuke Kobashi, Iwao Saiki, Masahito Sakai, Ayaka Sakamoto, Tetsuya Sato, Yasuhiro Shiga, Manabu Shimoto, Shinya Shimoyama, Tomohisa Shoko, Yoh Sugawara, Atsunori Sugita, Satoshi Suzuki, Yuji Suzuki, Tomohiro Suhara, Kenji Sonota, Shuhei Takauji, Kohei Takashima, Sho Takahashi, Yoko Takahashi, Jun Takeshita, Yuuki Tanaka, Akihito Tampo, Taichiro Tsunoyama, Kenichi Tetsuhara, Kentaro Tokunaga, Yoshihiro Tomioka, Kentaro Tomita, Naoki Tominaga, Mitsunobu Toyosaki, Yukitoshi Toyoda, Hiromichi Naito, Isao Nagata, Tadashi Nagato, Yoshimi Nakamura, Yuki Nakamori, Isao Nahara, Hiromu Naraba, Chihiro Narita, Norihiro Nishioka, Tomoya Nishimura, Kei Nishiyama, Tomohisa Nomura, Taiki Haga, Yoshihiro Hagiwara, Katsuhiko Hashimoto, Takeshi Hatachi, Toshiaki Hamasaki, Takuya Hayashi, Minoru Hayashi, Atsuki Hayamizu, Go Haraguchi, Yohei Hirano, Ryo Fujii, Motoki Fujita, Naoyuki Fujimura, Hiraku Funakoshi, Masahito Horiguchi, Jun Maki, Naohisa Masunaga, Yosuke Matsumura, Takuya Mayumi, Keisuke Minami, Yuya Miyazaki, Kazuyuki Miyamoto, Teppei Murata, Machi Yanai, Takao Yano, Kohei Yamada, Naoki Yamada, Tomonori Yamamoto, Shodai Yoshihiro, Hiroshi Tanaka & Osamu Nishid

Clinical and follow-up study of cenesthopathic patients

In order to clarify the confused conception about so-called cenesthopathy, a pricise clinical and follow-up study was made on 22 patients who presented peculiar cenesthopathic complpints during long terms. Such cases as organic diseases, apparent schizophrenia and depression were excluded. The author could classify them into 5 groups. The 1st group is neurotic cases. The 2nd group is schizophrenic cases shifted from so-called borderline cases. The 3rd group is the cases of paranoid reaction. The 4th group is borderline cases in adolescence. The last 5th group is the cases unable to be classified into any groups above mentioned, and shows most characteristic symptoms. The distinguishing traits of 5th group were as follows. They developed symptoms in middle ages after being affected psychologically or physically. The persistent abnormal cenesthesia full of agony was rather tinged with hallucination, and it was some experience of moving, tense or pulling sensations, or of utterly new strange foreign sensations. Despite the peculiar strange complaints, they did not make pathological interpretations and their insight into their morbid states was preserved to some extent. But, pathological obsessive attitudes (such as skin-rubbing) and temporary abulic states often appeared, so that in their course they wore temporarily psychotic feature. Despite the chronic course, schizophrenic tendency did not appear. The author discussed the psychopathology of cenesthopathy and concluded that the 5th group should be diagnosed as typical cenesthopathia