We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
We describe a newborn with a congenital left atrial appendage aneurysm. The aneurysm size did not change prenatally. However, it rapidly enlarged after birth. MRI was useful for assessing the aneurysm extent and exact size, and for diagnosis. Respiratory distress and feeding difficulties appeared, and surgery was performed. These symptoms disappeared post-operatively. The patient is alive without complications or recurrence.
To assess the effectiveness of a targeted intervention using a collaborative approach, added to a comprehensive educational intervention, to facilitate the appropriate use of oral third-generation cephalosporins (3GCs).
Design:
Quasi-experimental study.
Setting:
The University of Tokyo Hospital, a tertiary-care teaching hospital.
Participants:
Approximately 2,000,000 outpatients and 80,000 inpatients at the hospital between April 2017 and March 2020.
Intervention:
The targeted intervention using the collaborative approach was implemented in the departments with the highest use of oral 3GCs (ophthalmology and dermatology departments). Interrupted time-series analysis was applied to assess the change in days of therapy (DOT) of oral 3GCs between the preintervention period (April 2017–April 2019) and the postintervention period (May 2019–March 2020) for both inpatients and outpatients.
Results:
After the introduction of the targeted intervention with oral 3GCs, a significant immediate reduction of 13.48 DOT per 1,000 patient days was detected in inpatients (P < .001). However, no significant change in slope was observed before and after the intervention (−0.02 DOT per 1,000 patient days per month; P = .94). Although a temporary increase was observed after the targeted intervention in outpatients, the slope significantly decreased (−0.69 DOT per 1,000 outpatient visits per month; P = .044). No differences were observed in the use of other oral antibiotics after the intervention.
Conclusions:
The targeted intervention contributed to a reduction in DOT of oral 3GCs in both inpatients and outpatients. Targeted interventions using a collaborative approach might be helpful in further decreasing the inappropriate use of antibiotics.
CyberKnife is the most advanced form of stereotactic body radiotherapy (SBRT) system that uses a robotic arm to deliver highly focused beams of radiation; however, a limitation is that it only irradiates from ceiling to floor direction. In patients with posterior lungs tumour who are positioned supine, normal lung tissue may suffer undesirable radiation injuries. This study compares the treatment planning between the prone set-up and the supine set-up for lung cancer in CyberKnife SBRT to decrease normal lung dose to avoid radiation side effects.
Materials and methods:
A human phantom was used to generate 108 plans (54 for prone and 54 for supine) using the CyberKnife planning platform. The supine and prone plans were compared in terms of the dosimetric characteristics, delivery efficiency and plan efficiency.
Results:
For posterior targets, the area of low-dose exposure to normal lungs was smaller in the prone set-up than in the supine set-up. V10 of the lungs was 7·53% and 10·47% (p < 0·001) in the anterior region, and 10·78% and 8·03% (p < 0·001) in the posterior region in the supine and prone set-up plans, respectively.
Conclusions:
The comparison between the prone set-up and the supine set-up was investigated with regard to target coverage and dose to organs at risk. Our results may be deployed in CyberKnife treatment planning to monitor normal tissue dose by considering patient positioning. This may assist in the design of better treatment plans and prevention of symptomatic radiation pneumonitis in lung cancer patients.
To modify the final dose delivered to superficial tissues and to modulate dose distribution near irradiated surface, different boluses are used. Air gaps often form under the bolus affecting dose distribution. This study aimed to evaluate the effect of an air gap under the bolus radiation on dose delivery.
Materials and methods:
To evaluate the impact of the air gap, both helical tomotherapy (HT) and direct tomotherapy (DT) were performed in a simulation study.
Results:
The maximum dose to bolus in DT plans was bigger than that used in HT plans. The maximum dose delivered to the bolus depended on the air gap size. However, the maximum dose to bolus in all HT plans was within the acceptable value range. Acceptable value was set to up to 107% of the prescription dose. In the simulation performed in this study, the acceptable air gap under bolus was up to 15 mm and below 5 mm in HT and DT plans, respectively.
Conclusions:
HT technique is a good choice, but DT technique can be also used if the bolus position can be reproduced accurately. Thus, the reproducibility of the bolus position between planning and treatment is very important.
Fungi are one of the most diverse carbon source-assimilating organisms, living as saprobes, parasites and symbionts; they play an important role in carbon cycling in the ecosystem. A lichen thallus provides habitats for many non-lichenized fungi and usually contains large quantities of polyols. However, research has not been undertaken to identify carbon sources of lichen-inhabiting fungi. In this study, we isolated various lichen-inhabiting fungi from surface-sterilized Ramalina spp., Flavoparmelia caperata and Peltigera degenii, and demonstrated their ability to assimilate carbon sources, namely glucose, ribitol and mannitol. Several isolates efficiently assimilated mannitol and ribitol; however, most isolates could assimilate only mannitol or both ribitol and mannitol at low levels. It is suggested that there are different preferences and niche segregation of carbon sources among lichen-inhabiting fungi, and that this assemblage includes fungi with different lifestyles such as saprobes, endophytes and transient visitors.
An array of nano-scale protrusions, called the nipple array, is found on the body surface of various invertebrates, and this structure is believed to decrease light reflectance and water wettability on the surface in the terrestrial environment. However, its potential functions have not been well studied in aquatic environments. Clavelina spp. are colonial ascidians that have the nipple array on their integumentary matrix (i.e. tunic). We examined the physical properties on the surface of the tunic of C. cyclus and C. obesa, such as hardness, wettability and refractive indices, to evaluate the functional importance of this structure. The tunic cuticle of both species was covered with the nipple array, and the cuticle of C. cyclus was bent into folds forming parallel plications. The Clavelina tunic was very soft and had high bubble- and oil-repellency. The refractive-index deviation between the tunic and seawater was 0.07–0.095 for 589-nm light (D-line). Rigorous coupled wave analysis (RCWA) showed that the nipple array slightly reduced reflectance on the surface and the parallel plications reduced the reflectance still more. The nanoimprinted plates imitating the parallel plications have higher bubble repellency and lower reflectance than the flat plates. These findings support the functional importance of the plications as well as the nipple array.
We compute the weight of the snow cover as a function of the daily quantity of precipitation and daily melting using only data from the Automated Meteorological Data Acquisition System (AMeDAS), which is used widely in Japan. The correlation between long-term measurements and meteorological data in AMeDAS factors was computed by statistical methods from the Forestry and Forest Product Research Institute, Tokamachi Experiment Station, in Niigata Prefecture, using data for 11 winter seasons (1977–87).
The daily quantity of melting is expressed with a three-day moving average of degree days. The coefficient of correlation between the daily groups of each value of the 1323 days during the 11 winter seasons was 0.986 with a standard deviation of ±590 Ν m−2. Thus, if air temperature and precipitation can be obtained for an area, the weight of the snow cover can be estimated with confidence.
Thermomechanical fatigue (TMF) tests have been carried out in a nickel-based single crystal TMS-82 superalloy, and the dynamic evolutions of dislocations and stacking faults have been studied in detail. It is found that the reversible formation of stacking faults is always associated with the loading orientation. Specifically, stacking faults expand under compression and shrink under tension due to the disappearance and appearance of dislocations during the TMF process. Stacking faults result from shear of γ′ precipitates by 1/3<112> dislocations, which arise from the decomposition of 1/2<110> matrix dislocations. The calculations of critically resolved shear stress to push dislocations that glide in the γ′ particles confirm the expansion of stacking faults under compression. However, under tension, dislocations in γ channel prevent 1/2<110> dislocations to enter γ′ cuboids and consequently, stacking faults shrink. Appearance and disappearance of dislocations during TMF cycling are associated with plastic deformation and annealing process, respectively.
High integrity SiO2/Al2O3 gate stack has been demonstrated for GaN metal-oxide-semiconductor (MOS) transistors. The SiO2 film formed on GaN by the microwave-excited plasma enhanced chemical vapor deposition (MW-PECVD) exhibits good properties compared that by the LP (Low Pressure)-CVD. Then, by incorporating the advantages of both of SiO2 with a high insulating and Al2O3 with good interface characteristics, the SiO2/Al2O3 gate stack structure has been employed in GaN MOS devices. The structure shows a low interface state density between gate insulator and GaN, a high breakdown field, and a large charge-to-breakdown by applying 3-nm Al2O3. The SiO2/Al2O3 gate stack has also been applied to AlGaN/GaN hybrid MOS heterojunction field-effect transistor (HFET) and the HFET shows excellent properties with the threshold voltage of 4.2 V and the maximum field-effect mobility of 192 cm2/Vs.
Muscle atrophy increases the production of reactive oxygen species and the expression of atrophy-related genes, which are involved in the ubiquitin–proteasome system. In the present study, we investigated the effects of β-carotene on oxidative stress (100 μm-H2O2)-induced muscle atrophy in murine C2C12 myotubes. β-Carotene (10 μm) restored the H2O2-induced decreased levels of myosin heavy chain and tropomyosin (P< 0·05, n 3) and decreased the H2O2-induced increased levels of ubiquitin conjugates. β-Carotene reduced the H2O2-induced increased expression levels of E3 ubiquitin ligases (Atrogin-1 and MuRF1) and deubiquitinating enzymes (USP14 and USP19) (P< 0·05, n 3) and attenuated the H2O2-induced nuclear localisation of FOXO3a. Furthermore, we determined the effects of β-carotene on denervation-induced muscle atrophy. Male ddY mice (8 weeks old, n 30) were divided into two groups and orally pre-administered micelle with or without β-carotene (0·5 mg once daily) for 2 weeks, followed by denervation in the right hindlimb. β-Carotene was further administered once daily until the end of the experiment. At day 3 after denervation, the ratio of soleus muscle mass in the denervated leg to that in the sham leg was significantly higher in β-carotene-administered mice than in control vehicle-administered ones (P< 0·05, n 5). In the denervated soleus muscle, β-carotene administration significantly decreased the expression levels of Atrogin-1, MuRF1, USP14 and USP19 (P< 0·05, n 5) and the levels of ubiquitin conjugates. These results indicate that β-carotene attenuates soleus muscle loss, perhaps by repressing the expressions of Atrogin-1, MuRF1, USP14 and USP19, at the early stage of soleus muscle atrophy.
The influence of Co content on stacking fault energy (SFE) of the γ matrix in four Ni–Co base superalloys, including newly developed alloys, has been studied by utilizing high-resolution transmission electron microscopy. The results indicated the SFE was not linear with Co content of the γ matrix. The lowest SFE could be attained at around 34.0 at.% Co. This effect was attributed to variation of electron holes, saturated Co content in the matrix, and the effect of Co on the partition coefficient of other alloying elements. A high density of twins was related to low SFE and could improve the mechanical properties.
A chemotaxonomic study was carried out on the Lethariella cladonioides complex, including L. sernanderi and L. cashmeriana of the subgenus Chlorea, based on extensive field surveys and a detailed morphological and chemical analysis. Only one species, L. cladonioides made up of five chemical races, is recognized. Lethariella sernanderi and L. cashmeriana are reduced to synonyms under L. cladonioides. The presence of a remarkable chemical polymorphism within the population of L. cladonioides is demonstrated. New data on the chemistry and the distribution of the species are presented.
The aim of the present study was to examine the effects of cobalamin (Cbl) on the activity and expression of l-methylmalonyl-CoA mutase (MCM) in rat liver and cultured COS-7 cells. The MCM holoenzyme activity was less than 5 % of the total (holoenzyme+apoenzyme) activity in the liver although rats were fed a diet containing sufficient Cbl. When weanling rats were maintained on a Cbl-deficient diet, the holo-MCM activity became almost undetectable at the age of 10 weeks. In contrast, a marked increase in the total-MCM activity occurred under the Cbl-deficient conditions, and at the age of 20 weeks it was about 3-fold higher in the deficient rats than in the controls (108 (sd 14·5) v. 35 (sd 8·5) nmol/mg protein per min (n 5); P < 0·05). Western blot analysis confirmed that the MCM protein level increased significantly in the Cbl-deficient rats. However, the MCM mRNA level, determined by real-time PCR, was rather decreased. When COS-7 cells were cultured in a medium in which 10 % fetal bovine serum was the sole source of Cbl, holo-MCM activity was barely detected. The supplementation of Cbl resulted in a large increase in the holo-MCM activity in the cells, but the activity did not exceed 30 % of the total-MCM activity even in the presence of Cbl at 10 μmol/l. In contrast, the total-MCM activity was significantly decreased by the Cbl supplementation, indicating that Cbl deficiency results in an increase in the MCM protein level in COS-7 cells as well as in rat liver.
The difference between vitamin K metabolism in the liver and that in the bone of vitamin K-deficient rats was examined. After 17 d administration of vitamin K-deficient food, vitamin K in the liver was almost depleted, and prothrombin time (PT) was prolonged. Serum total osteocalcin level was slightly decreased by vitamin K deficiency, whereas serum undercarboxylated osteocalcin level did not change. The level of menaquinone (MK)-4 as well as that of phylloquinone was decreased, but approximately 40 % of the initial level still existed in the femur after the 17 d period. A single-dose administration of vitamin K (250 nmol/kg body weight) markedly increased vitamin K level in the liver but not in the femur. These results suggest that the turnover of vitamin K in the bone is slower than that in the liver, and bone metabolism may be little affected by the short period of intake of vitamin K-deficient food. However, intake of a larger amount of vitamin K is required for its accumulation in the bone than in the liver. Furthermore, the counteracting effect of MK-7 on prolonged PT in vitamin K-deficient rats was found to be higher than phylloquinone or MK-4.
Whole-genome scans have identified Dmo1 as a major quantitative trait locus (QTL) for obesity
and dyslipidaemia in the Otsuka Long Evans Tokushima Fatty (OLETF) rat. We have produced
congenic rats for the Dmo1 locus, using marker-assisted speed congenic protocols, enforced by
selective removal of other QTL regions (QTL-marker-assisted counterselection), to efficiently
transfer chromosomal segments from non-diabetic Fischer 344 (F344) rats into the OLETF
background. In the third generation of congenic animals, we observed a substantial therapeutic
effect of the Dmo1 locus on lipid metabolism, obesity control and plasma glucose homeostasis. We
conclude that single-allele correction of an impaired genetic pathway can generate a substantial
therapeutic effect, despite the complex polygenic nature of type II diabetic syndromes.
Texture control of Al and Cu by underlying refractory metal is discussed. Al texture can be controlled with underlayer metals like as Ti and TiN which have the same atomic arrangement within 3% misfits to Al. Cu texture can be also controlled by underlayer TiN in spite of a large difference in inter-atomic distance of Cu and TiN. Since the epitaxial growth of TiN on Cu is observed, it is suggested that epitaxial growth may occur at the early stage of Cu deposition on TiN.
The electromigration performance was evaluated in double level interconnects with W-stud via. It is confirmed that highly <111> textured Al and Cu have high electromigration resistance. Both the diffusion of Cu in Al-Cu and Al drift are suppressed in <111> textured Al-alloy interconnects, and Cu drift is also suppressed in Cu damascene lines formed on <111> textured TiN. Grain boundary diffusion and the interfacial diffusion would be suppressed in highly textured metals with underlayer and it is speculated that interfacial diffusion is more important in Cu damascene lines.
We present an extremely rare case of epithelial-myoepithelial carcinoma (EMC) arising in the nasal cavity. The patient was a 56-year-old Japanese male with a polypoid tumour arising from the nasal septum. Histopathological examination revealed the tumour to consist of a solid proliferation of clear-cells and, in some areas, small or elongated duct structures with a double-layered arrangement of inner cuboidal cells and outer clear-cells. Dual differentiation toward myoepithelial and ductal cells were confirmed immunohistochemically. The occurrence of EMC in the nasal cavity is possible and this entity should be generally recognized by surgical pathologists, not only those engaged in head and neck surgery.
Benign tumours of the tonsils are rare. Only a few cases of tonsillar lipoma have been previously reported. The case of a pedunculated polypoid lipoma of the palatine tonsil in a 44-year-old Japanese woman is presented. The ‘polyp’ was excised and an histopathological examination was carried out. The ‘polyp’ contained dilated lymphatics in the dense fibrous connective tissue beneath the overlying mucosal epithelium and below the mature fat tissue with intervening strands of fibrous tissue.