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Development of pulmonary arteriovenous fistulas in patients with cavopulmonary anastomosis may result in a significant morbidity. Although the use of bubble contrast echocardiography with selective injection into both the branch pulmonary arteries in identifying pulmonary arteriovenous fistulas has been increasing, the actual efficacy of this diagnostic modality has not been properly evaluated. Thus, this study aimed to assess the efficacy of bubble contrast echocardiography in detecting pulmonary arteriovenous fistulas in children with total cavopulmonary connection.
A total of 140 patients were included. All patients underwent cardiac catheterisation. Bubble contrast echocardiographic studies were performed by injecting agitated saline solution into the branch pulmonary arteries. Transthoracic echocardiograms that use an apical view were conducted to assess the appearance of bubble contrast in the systemic ventricles. Then, the contrast echocardiogram results and other cardiac parameters were compared.
No correlation was found between contrast echocardiogram grade and other cardiac parameters, such as pulmonary capillary wedge saturation and pulmonary artery resistance. Moreover, only 13 patients had negative results on both the right and left contrast echocardiograms, and 127 of the 140 patients had positive results on contrast echocardiograms even though they had normal pulmonary capillary wedge saturation. Results showed that bubble contrast echocardiography was a highly sensitive method and was likely to obtain false-positive results.
Bubble contrast echocardiography might be highly false positive in detecting pulmonary arteriovenous fistulas in patients with cavopulmonary anastomosis. We have to consider how we make use of this method. Further standardisation of techniques is required.
We investigated whether non-digestible saccharide fermentation-derived hydrogen molecules (H2) in rat colon could improve the in vivo reduction–oxidation (redox) balance via regeneration of α-tocopherol, by assessing their effect on hydroxyl radicals, the α-tocopherol concentration and the redox balance. In Expt 1, a Fenton reaction with phenylalanine (0 or 1·37 mmol/l of H2) was conducted. In Expt 2, rats received intraperitoneally maize oil containing phorone (400 mg/kg) 7 d after drinking ad libitum water containing 0 or 4 % fructo-oligosaccharides (FOS) (groups CP and FP, respectively). In Expt 3, rats unable to synthesise ascorbic acid drank ad libitum for 14 d water with 240 mg ascorbic acid/l (group AC), 20 mg of ascorbic acid/l (group DC) or 20 mg of ascorbic acid/l and 4 % FOS (group DCF). In the Fenton reaction, H2 reduced tyrosine produced from phenylalanine to 72 % when platinum was added and to 92 % when platinum was excluded. In Expt 2, liver glutathione was depleted by administration of phorone to rats. However, compared with CP, no change in the m-tyrosine concentration in the liver of FP was detected. In Expt 3, net H2 excretion was higher in DCF than in the other rats after 3 d of the experiment. Furthermore, the concentrations of H2 and α-tocopherol and the redox glutathione ratio in perirenal adipose tissue of rats were significantly higher in DCF than in DC. To summarise, in rat colon, fermentation-derived H2 further shifted the redox balance towards a more reducing status in perirenal adipose tissue through increased regeneration of α-tocopherol.
To identify chronological changes in the marine reservoir effect in southwest Japan, the radiocarbon ages of eight pairs of marine shells and terrestrial plants were measured from the same horizons of one core of Holocene sediments. This core was obtained from the northern part of the Sukumo Plain in southwestern Shikoku Island, which faces the warm Kuroshio Current. The drilling site is located in an area of subsidence associated with the convergence of the Philippine Sea Plate and the Eurasian Plate. On analyses of lithology, molluscan assemblages, and radiocarbon dating, we interpreted, from oldest to youngest, nine units: basement rock, a braided river channel, a meandering river channel, an estuary, a transgressive inner bay, Kikai-Akahoya volcanic ash, a deltaic inner bay, a tidal flat, and artificial soil. Changes in the depositional environment were mainly associated with sea-level rise after the end of the last glaciation. The reservoir ages of the eight pairs, 330 ± 70 yr, were obtained from a transgressive inner bay to deltaic inner bay sediments, formed during 4100–9200 cal BP. The chronological change in the reservoir effect allows us to correlate the Sukumo Core sediments with previous results from southwestern Japan, the Korean Peninsula, and Taiwan Island.
Little is known about physical constitution outcomes for very preterm infants. Here, we compare z-scores of anthropometric parameters up to 6 years of age in children born with very low birth weight (VLBW) at less than 30 weeks of gestation, with or without intrauterine growth restriction (IUGR).
Participants were divided into four subgroups: male (M), small for gestational age (SGA) (n = 30); M, appropriate for gestational age (AGA) (n = 59); female (F), SGA (n = 24); and F, AGA (n = 61). z-Scores of body weight (BW), body length (BL), and body mass index (BMI) were assessed at birth, 1 year corrected age, 3 years of age, and 6 years of age.
For boys, BW and BMI were significantly lower among SGA children than among AGA children at all assessments, but there was no difference in BL at 3 or 6 years. For girls, BW and BL were significantly lower among SGA children than among AGA children at all assessments, but no difference was detected in BMI after 1.5 years. No significant variation in the z-score of BW or BMI in either SGA group was observed after 1 year. BL z-score in all groups gradually increased until 6 years of age.
IUGR affects BW and BMI in boys and BW and BL in girls during the first 6 years in VLBW children born at less than 30 weeks of gestation. SGA children did not catch up in BW or BMI from 1 to 6 years of age.
Interest groups and other organizations are crucial vehicles for voter mobilization, but variations in their capacities are not well understood. To clarify the ways in which vote mobilization capacities vary, I analyze vote mobilization in two private-sector industrial unions supporting the Democratic Party of Japan (DPJ). The Japanese Federation of Textile, Chemical, Food, Commercial Service and General Workers’ Union (UA Zensen), has a very large membership but mobilizes few votes. The Confederation of Japan Automobile Worker's Unions (JAW), on the other hand, has fewer members but mobilizes more votes. In this article, I argue that unions whose constituent units operate company towns are most successful in mobilizing votes. Organizational capacity –independent of membership size – matters in the electoral arena. Using data from House of Councillors elections, I show that those industrial unions that include many enterprises with company towns have advantage in voter mobilization.
A new class of high-temperature materials based on refractory elements was investigated with an aim to improve the energy efficiency of thermal power plants. Alloys based on Nb and Mo composed of BCC solid solution (BCCss) (Nb-Mo) and T2-silicide (Nb,Mo)5(Si,B)3 are promising candidates as high-temperature materials. Further investigation on the alloy phase equilibria of this system is required to improve the mechanical properties and oxidation resistance through optimization of the phase compositions. Cr is one candidate to modify the properties of the alloy because Cr is expected to stabilize the T2 compound phase along with B. Here, the phase equilibria among BCCss and the T2 compound are widely investigated in the Cr-Mo-Nb-Si-B system, and a BCCss-T2 two-phase microstructure is found in Mo-rich alloys. The B/Si ratio in the T2 phase increases with the Cr content, while almost no B solubility was found in BCCss. As the Si content increases in alloys, the A15 silicide phase ((Cr, Mo, Nb)3Si) and/or Laves phase appear.
Nanoindentation tests were conducted to investigate the mechanical properties of the BCCss phase of the alloys in the Cr-Mo-Nb-Si-B system. The nanohardness and reduced elastic modulus of these alloys tended to be higher with an increase in Cr.
It is well known that various elements substitute for a certain sub-lattice of intermetallic compounds. There have been various experimental investigations of the effects of substituted elements on mechanical properties, however, there are few reports describing the effects of multi-element substitution. In the present study, L12-type compounds A3B (Ni3Al and Co3(Al,W)) were selected as model compounds because their substitution behavior is well known. It was reported that various elements such as Ni, Co, Cu, Pd and Pt occupy the A-site, whereas Al, Si, Ga, Ge, Ti, V, Nb, Ta, Mo, and W occupy the B-site. These elements are expected to introduce local lattice distortion, which may affect the motion of dislocations over a wide range of temperatures. Several alloys composed of five or more elements including Ni, Co, Al, Mo, and W, were prepared using an Ar-arc melting machine and heat-treated. Several alloys were found to include an (Ni, Co)3(Al, Mo, W, …)-L12 compound as a constituent phase. The nano-hardness of these L12 phases was higher than that of the high-strength Co3(Al,W)-L12 compound, confirming that multi-element substitution is an effective way to improve the mechanical properties of an intermetallic compound without decreasing the phase stability.
Eosinophilic myocarditis is rare in children, and consequently, it is difficult to diagnose eosinophilic myocarditis rapidly. We report the clinical course of acute eosinophilic myocarditis with pericarditis in two adolescent boys and their associated electrocardiograms. The two patients, 13- and 14-year-old boys, developed cardiomegaly and chest pain with vomiting. On examination by two-dimensional echocardiography, thickening of the ventricular septum and a pericardial effusion were detected. The eosinophil count had increased by the pericardial effusion. Acute eosinophilic myocarditis often complicates a moderate to severe pericardial effusion owing to acute pericarditis. A cellular fraction analysis of the pericardial effusion is easy and useful for the diagnosis of eosinophilic myocarditis. Some serial changes in the electrocardiogram occur during each stage of acute eosinophilic myocarditis. They are induced by eosinophilic granules, which are capable of inducing tissue damage and dysfunction, and those changes in the electrocardiogram resemble the changes after an acute myocardial infarction. It is important to know the characteristics of eosinophilic myocarditis in order to prevent lethal complications.
We aimed to verify the effectiveness of real-time reverse transcription (rRT) polymerase chain reaction (PCR) for detecting cases of modified measles (M-Me) and for predicting super-spreader candidates through the experience of a measles outbreak dominated by M-Me in Yamagata, Japan, during March–April 2017. We applied rRT-PCR to specimens from 35 cases of M-Me, nine cases of typical measles (T-Me) and nine cases of prodromal stage of T-Me (P-Me). From rRT-PCR among the M-Me cases, peripheral blood mononuclear cells (PBMC) showed the highest positive rate (80.0%), followed by throat swab (48.6%), urine (33.3%) and serum (3.1%). The negative result of PBMC in M-Me cases was recovered by the result of a throat swab. In specimens of PBMC, throat swab and urine, M-Me group showed the significantly higher cycle of threshold (i.e., lower viral load) in the rRT-PCR than T-Me and P-Me groups, respectively. Furthermore, three super-spreaders in T-Me or P-Me showed an extremely low cycle of threshold in their throat swab specimens. rRT-PCR using PBMC and throat swab might be helpful for clinical management and measles control by certain detection of M-Me cases and by predicting super-spreading events resulting from measles cases with the high viral load.
This study aimed to molecularly survey Bartonella in dogs from Chile. Quantitative real-time PCR (qPCR) for Bartonella spp. based on nuoG gene was performed in 139 blood samples taken from dogs belonging to rural localities of the Valdivia Province, Los Ríos region, southern Chile. nuoG qPCR-positive samples were submitted to conventional PCR assays for ftsZ, gltA, rpoB and nuoG genes and sequencing for speciation and phylogenetic analysis. Based upon qPCR results, Bartonella spp. occurrence in dogs was 4.3% (6/139). Out of six nuoG qPCR-positive samples, six, three, two and none showed positive results in cPCR assays based on gltA, ftsZ, rpoB and nuoG genes, respectively. Consistent sequencing results were obtained only for the ftsZ gene from sample #1532 (GeneBank accession number: MG252491), and gltA gene from samples #1535 (MG252490) and #1532 (148 bp fragment that was not deposited in GenBank). Phylogenetic analysis of ftsZ and gltA genes allowed speciation of two nuoG-positive samples, one as Bartonella vinsonii subsp. berkhoffii and the other as B. henselae. Bartonella vinsonii subsp. berkhoffii and B. henselae are detected for the first time in dogs from Chile, highlighting the importance of the canine population as a source of zoonotic agents and potential infection risk to humans.
The impact of a deep-water plunging breaker on a finite height two-dimensional structure with a vertical front face is studied experimentally. The structure is located at a fixed horizontal position relative to a wave maker and the structure’s bottom surface is located at a range of vertical positions close to the undisturbed water surface. Measurements of the water surface profile history and the pressure distribution on the front surface of the structure are performed. As the vertical position,
axis is positive up and
is the mean water level), of the structure’s bottom surface is varied from one experimental run to another, the water surface evolution during impact can be categorized into three classes of behaviour. In class I, with
in a range of values near
is the nominal wavelength of the breaker, the behaviour of the water surface is similar to the flip-through phenomena first described in studies with shallow water and a structure mounted on the sea bed. In the present work, it is found that the water surface between the front face of the structure and the wave crest is well fitted by arcs of circles with a decreasing radius and downward moving centre as the impact proceeds. A spatially and temporally localized high-pressure region was found on the impact surface of the structure and existing theory is used to explore the physics of this phenomenon. In class II, with
in a range of values near the mean water level, the bottom of the structure exits and re-enters the water phase at least once during the impact process. These air–water transitions generate large-amplitude ripple packets that propagate to the wave crest and modify its behaviour significantly. At
, all sensors submerged during the impact record a nearly in-phase high-frequency pressure oscillation indicating possible air entrainment. In class III, with
in a range of values near
, the bottom of the structure remains in air before the main crest hits the bottom corner of the structure. The subsequent free surface behaviour is strongly influenced by the instantaneous momentum of the local flow just before impact and the highest wall pressures of all experimental conditions are found.
The covariance matrix of signals is one of the most essential information in multivariate analysis and other signal processing techniques. The estimation accuracy of a covariance matrix is degraded when some eigenvalues of the matrix are almost duplicated. Although the degradation is theoretically analyzed in the asymptotic case of infinite variables and observations, the degradation in finite cases are still open. This paper tackles the problem using the Bayesian approach, where the learning coefficient represents the generalization error. The learning coefficient is derived in a special case, i.e., the covariance matrix is spiked (all eigenvalues take the same value except one) and a shrinkage estimation method is employed. Our theoretical analysis shows a non-monotonic property that the learning coefficient increases as the difference of eigenvalues increases until a critical point and then decreases from the point and converged to the distinct case. The result is validated by numerical experiments.
Caregivers of people with dementia are likely to have psychological distress that sometimes results in mental health problems, such as depression. The objective of this study was to examine some predictive factors that are thought to be associated with psychological distress of caregivers of people with dementia in Japan.
Design: A cross-sectional study. Sample: As part of a study to estimate the cost of dementia in Japan, 1,437 people with dementia-caregiver dyads were enrolled in the current informal care time study. The measurements in the study included were the basic characteristics of the caregivers and the people with dementia, and the informal care time during a week.
Factors that predict caregivers’ psychological distress, which was measured by Kessler's Psychological Distress scale (K6) score, were evaluated using univariate and multivariate regression analyses.
Approximately 69% of the caregivers recorded a K6 score higher than 4, while 18% scored higher than 12. According to the results of the logistic regression analysis (cut-off 4/5), the K6 score was associated with mental and comorbid diseases of people with dementia, informal care time, its lower number of caregivers, and the level of nursing care. According to the results of logistic regression analysis (cut-off 12/13), the K6 score was associated with mental symptoms and comorbid disease of people with dementia, sex of caregivers, informal care time, and its lower number of caregivers.
Our findings indicated that the psychological distress of the caregivers is quite high and that informal care time and behavioral and psychological symptoms of dementia are associated with it. These results corroborate with previous findings.
The three-dimensional distribution of melt in partially molten synthetic samples compositionally corresponding to diopside (90 wt.%)–anorthite (10 wt.%) and doped with PbO, WO3, MoO3, or Cs2O to enhance contrast was studied by X-ray computed tomography (CT) with synchrotron radiation. The heavy elements were strongly concentrated in the melt and contributed to an increase of the X-ray linear attenuation coefficient (LAC) of it. PbO was found to be compatible with silicate melt (>20 wt.% in solution) and incompatible with diopside crystals. Other oxides WO3 (∼10 wt.%), MoO3 (∼5 wt.%) and Cs2O (< 5 wt.%) are also soluble only in the melt. Such doping is useful not only for LAC control in X-ray CT measurements, but also for systematic control of the structure (wetting properties, distribution and connectivity) of partial melt. This technique gives basic information for discussion of the 3D distribution of partial melt having different wetting properties. As PbO was most effective in visualization of the diopside–anorthite partially molten system, CT images of the PbO-bearing sample were used for further 3D investigation of distribution. A distribution of dihedral angles at solid-melt-solid triple junctions ranging from 22 to 55° was observed with the 3D data. This range in angle distribution was probably caused by anisotropy of crystals and the result supports the argument that there is some limitation in a theoretical framework of stereology which estimates the 3D structure based on 2D observations. Investigators have begun to apply X-ray CT to the study of the 3D distribution of partial melts in rocks using synchrotron radiation. Our study on the effect of doping is one approach for developing a technique to investigate 3D melt distribution.
Diverse environmental conditions surrounding preimplantation embryos, including available nutrients, affect their metabolism and development in both short- and long-term manner. Thioredoxin-interacting protein (TXNIP) is a possible marker for preimplantation stress that is implicated in in vitro fertilization- (IVF) induced long-term DOHaD effects. B vitamins, as participants in one-carbon metabolism, may affect preimplantation embryos by epigenetic alterations of metabolically and developmentally important genes. In vitro-produced bovine embryos were cultured with or without Roswell Park Memorial Institute 1640 vitamin mixture, containing B vitamins and B vitamin-like substances, from day 3 after IVF and we evaluated blastocyst development and TXNIP messenger RNA (mRNA) expression in the blastocysts by reverse transcription-quantitative polymerase chain reaction. The degree of trimethylation of histone H3 lysine 27 (H3K27me3) at TXNIP promoter was examined semi-quantitatively by chromatin immunoprecipitation polymerase chain reaction. Total H3K27me3 were also compared between the groups by Western blot analysis. The vitamin treatment significantly increased the rates of blastocyst development (P<0.05) and their hatching (P<0.001) from the zona pellucida by day 8. The mRNA expression of TXNIP was lower (P<0.01) in blastocysts in the vitamin-mixture-treated group concomitant with higher (P<0.05) level of H3K27me3 of its promoter compared with the control group. The total H3K27me3 in the vitamin-mixture-treated group was also higher (P<0.01) than that in the control group. The epigenetic control of genes related to important metabolic processes during the periconceptional period by nutritional conditions in utero and/or in vitro may have possible implication for the developmental programming during this period that may impact the welfare and production traits of farm animals.
Background: Cerebral arteriovenous malformations (AVMs) are a type of vascular abnormality characterized by abnormal connections between arteries and veins without the normal interposed capillary bed. The gold standard for diagnosis is digital subtraction angiography (DSA). Functional MRI (fMRI), particularly with the increased sensitivity at ultra-high field (>=7T), may help to further characterize AVMs, but has not been performed in this population. Methods: We present a functional and structural neuroimaging analysis of an AVM at 7T. Resting-state fMRI was analyzed using independent components analysis (ICA) and compared to normal controls. Structural T1-weighted images were obtained at 1.5T and 7T. The patient also underwent DSA. Results: A 44 year-old, right handed man presented with a generalized tonic-clonic seizure. MRI at 1.5T and 7T revealed an AVM located in the pineal region measuring 3.2 cm. Multiple large feeder vessels were identified, and the AVM drained into the vein of Galen, clearly visualized on the 7T images. Functional imaging revealed an altered default mode network and ICA-identified vascular networks corresponding to the AVM. Conclusions: Imaging at 7T clearly delineates AVM structure. Functional connectivity is altered by the AVM. Vessel-specific independent components were identified that may be helpful for AVM characterization.
Background: A significant part of the developmental delay (DD) population has epilepsy (26-70%) and live in an institution. These patients tend to have atypical presentation of epileptic seizures with higher risk of misdiagnosis. Distinguishing their ictal events from paroxysmal behaviors can be challenging.There often is a lack of description of the spells or inadequate history from the caregivers or the patients. These patients often have drug resistant epilepsy requiring polypharmacy with increased risk of morbidity and mortality. The aim of this study was to determine usefulness of Epilepsy Monitoring Unit (EMU) in diagnosis and management of these patients. Methods: This is a retrospective observational study of the patients with epilepsy and DD living in institutions that were admitted to the EMU. Results: Four patients met the inclusion criteria for this study. The mean age was 45(29-71), 3/4 (N=3) were male and 3/4 had focal epilepsy. All patients had mood disorders and 2 were taking antipsychotic medication. The mean admission-time was 6,25 days
(2-15) and there was a correlation with the events and seizures in 2/4 of the patients and the rest had a combination of behavioural-changes and seizures. Conclusions: EMU admission can provide an accurate diagnosis of spells in patients with DD and epilepsy, and improve their quality of life.
Background: Predicting epilepsy following a first seizure is difficult. Network abnormalities are observed in patients with epilepsy using resting-state functional MRI (rs-fMRI), which worsen with duration of epilepsy. We use rs-fMRI to identify network abnormalities in patients after a first seizure that can be used as a biomarker to predict development of epilepsy. Methods: Patients after a single, unprovoked seizure and age/sex matched healthy controls underwent 7 Tesla structural and resting-state functional MRI. Data were analyzed using graph theory measures. Patients were followed for development of epilepsy. Results: Nine patients and nine control subjects were analyzed. There were no differences in baseline characteristics. No patients developed epilepsy (average follow-up 3 months). No differences between groups occurred on a whole-brain network level. At a 20% threshold, significant differences occurred in the default mode network (DMN). Patients demonstrated an increased local efficiency (p=0.02) and clustering coefficient (p=0.04), and decreased path length (p=0.02) and betweenness centrality (p=0.02). Conclusions: No whole-brain network changes occur after a single unprovoked seizure. No patient has developed epilepsy suggesting this group does not have network alterations after a single seizure. In the DMN, the alterations noted indicate increased segregation of network function.