[Show abstract][Hide abstract] ABSTRACT: We herein describe the case of a 63-year-old man who died from relapsed epidermal growth factor receptor gene (EGFR) exon 19 deletion lung adenocarcinoma treated with erlotinib. According to the autopsy results, he was confirmed to have small cell carcinoma without the EGFR T790M mutation in his pancreas and left kidney metastatic specimens, while the adenocarcinoma metastatic lesion in his right kidney had the EGFR T790M mutation; both retained the somatic EGFR exon 19 deletion. We herein report an autopsy case of resistance to an EGFR tyrosine kinase inhibitor via small cell carcinoma transformation and the EGFR T790M mutation in separate metastatic organs.
[Show abstract][Hide abstract] ABSTRACT: A 72-year-old man was hospitalized in Okinawa due to a high fever and rash, after returning from Bali, Indonesia, in February 2014; dengue was clinically suspected, and IgM for dengue is positive in commercial kit. Serologically, the patient showed secondary sero-reactivity. Significant rises in neutralization titers (N-titers) against all four serotypes of dengue virus (DENV) and Japanese encephalitis virus (JEV) strains were recognized between acute- and convalescent-phase sera. N-titer against dengue virus serotype 1 (DENV-1) was the highest among those for all serotypes of DENV. Interestingly, N-titers against JEV strains, were significantly higher than those against all types of DENV. Virus was isolated from the acute-phase serum, and identified as DENV-1 designated as RD14/Okinawa. The symptoms of the case were due to DENV-1 infection. Phylogenetic analysis by sequencing indicated that isolate RD14/Okinawa furthermore belongs to genotype I of DENV-1, which is closely related to Southeast Asian strains and isolates during the dengue outbreak in Japan in 2014. We should undertake control measures against dengue in Okinawa, which is a subtropical area with Aedes albopictus activity throughout year.
[Show abstract][Hide abstract] ABSTRACT: IL-17A is involved in the immune system of the lung. Legionella can potentially cause severe pneumonia. The present study was aimed to evaluate the role of IL-17A in Legionella pneumonia cases. IL-17A was quantified in sera from patients with Legionella pneumonia and control subjects. IL-17A was detected in sera from 4 out of 31 Legionella pneumonia cases; the cytokine was not detected in any control cases. There was no difference in peripheral white blood cell counts or other serum biomarkers (C-reactive protein, and lactate dehydrogenase) between IL-17A positive cases and IL-17A negative cases. The IL-17A positive cases all survived, while 8 out of 27 IL-17A negative cases did not survive in this cohort. IL-17A could be detected in broncho-alveolar (BA) fluids from available 7 samples of Legionella pneumonia cases within our cohort. Concentrations of IL-17A and IFN-γ in BA fluids were not associated with each other. IL-17A might have significant role in some cases of Legionella pneumonia.
Full-text · Article · Dec 2014 · Japanese journal of infectious diseases
[Show abstract][Hide abstract] ABSTRACT: In recent clinical practice, high-flow nasal cannula (HFNC) therapy has been used to improve oxygenation in adults with acute respiratory failure (ARF). However, bronchoscopy using HFNC in ARF has not yet been reported. Herein, we describe 5 cases of ARF where bronchoalveolar lavage (BAL) was employed successfully using an HFNC. We were able to discontinue or reduce the HFNC fraction of inspired oxygen (FiO2) 30 min after completion of the bronchoscopy. Only 1 patient needed non-invasive positive pressure ventilation for 16 h after bronchoscopy. The HFNC may be a useful tool for ARF patients who require bronchoscopy.
No preview · Article · Sep 2014 · Respiratory Investigation
[Show abstract][Hide abstract] ABSTRACT: Combined pulmonary fibrosis and emphysema (CPFE) is an important and recently defined syndrome. The diagnosis of this syndrome is based on the radiological findings at computed tomography which consists of emphysema of the upper lung zones and fibrosis of the lower lung zones. In this study, we analysed relevance horizontal to vertical ratio of a chest x ray and body mass index (BMI) of CPFE for researching for clarifying the feature of radiographic finding and physique in patients with CPFE retrospectively. In conclusion, patients with CPFE has smaller horizontal to vertical ratio of a patient with chest x ray than chronic obstructive pulmonary disease (COPD), but larger than patients with interstitial pneumonia (IP). In addition, the average of BMI value of CPFE patients was between COPD and IP patients. These characteristics may help to diagnose CPFE in patients with COPD or IP.
[Show abstract][Hide abstract] ABSTRACT: High mobility group box 1 (HMGB-1) protein is involved in acute lung injury due to various etiologies. We evaluated HMGB-1 levels in sera and bronchoalveolar fluids in patients with pneumonia caused by Legionella pneumophila. Levels of HMGB-1 in the sera of patients with L. pneumophila pneumonia (32 cases) and control subjects (24 cases) were determined. Serum HMGB-1 levels in Legionella pneumonia were similar to those of the control subjects. No significant correlation between HMGB-1 levels and other biomarkers and the outcome of cases was observed. In contrast, HMGB-1 levels, as well as interferon-γ, in bronchoalveolar (BA) fluids from severe L. pneumophila pneumonia (7 cases) were significantly higher than those in the sera of identical patients. HMGB-1 levels in BA fluids were relatively higher in pneumonia cases with ALI than those without ALI. Our findings suggest that intra-pulmonary HMGB-1 may be involved in the pathophysiology of pneumonia caused by L. pneumophila.
No preview · Article · Dec 2013 · Journal of Infection and Chemotherapy
[Show abstract][Hide abstract] ABSTRACT: A 61-year-old woman who had received treatment for tuberculous pleurisy for 2 months visited our outpatient clinic. Chest computed tomography (CT) showed the presence of a lens-shaped pleural mass with pulmonary infiltration, despite the decreased pleural effusion. Two weeks later, chest CT showed an increase in the size of the mass and expansion of the intrapulmonary shadow. Percutaneous CT-guided lung biopsy was performed, and histopathological examination revealed granulomatous inflammation without caseous necrosis or acid-fast bacilli. Sputum culture was negative for acid-fast bacilli. Anti-tuberculosis medication was continued, and the lesions eventually resolved. These lesions were diagnosed as pleural tuberculomas, and the intrapulmonary infiltration was considered to be due to the paradoxical worsening of the patient's condition.
No preview · Article · Nov 2013 · Kekkaku: [Tuberculosis]
[Show abstract][Hide abstract] ABSTRACT: We demonstrate dynamic control of the effective area (A
eff) of photonic crystal fibers (PCFs) in the range of 18.1–8.22 μm2 and the mode field diameter in the range of 4.78–3.42 μm. This control was realized by altering their structural properties and varying the germanium (Ge) doping rate, which changed the refractive index difference (Δn
Ge) between 1.0 and 3.0% relative to the refractive index of the silica cladding. This was achieved by adjusting the Ge doping rate in the core and changing the radius (d
core) of the doped region, i.e., by changing the equivalent refractive index, using numerical calculations. Numerical results were verified by comparison with experimental results for a fabricated Gedoped PCF obtained by far-field scanning based on the ITU-T Petermann II definition. The proposed approach will simultaneously decrease Aeff and achieves high light confinement and high nonlinearity in PCFs. It enables architectonics/controllability of highly nonlinear PCFs with passive optical devices in photonic networks and life science applications.
[Show abstract][Hide abstract] ABSTRACT: With the increase in global transportation, imported malaria has become a significant public health concern in Japan. In the present study, we retrospectively analyzed all imported malaria cases in Okinawa Prefecture from 1988 to 2012. In that period, 23 patients with imported malaria were admitted to the University of the Ryukyus Hospital. Malaria types observed included Plasmodium falciparum (14 cases), P. vivax (7 cases), combined P. falciparum and P. ovale (1 case), and combined P. vivax and P. malariae (1 case). All cases were resolved by anti-malarial treatment. The clinical data from these patients highlights the importance of collecting patient travel history and ensuring an adequate supply of both diagnostic test and drug treatments in Okinawa.
[Show abstract][Hide abstract] ABSTRACT: We can obtain important optical transmission values of Germanium (Ge) doped-photonic crystal fibers (PCFs) of the effective area (Aeff) (variable range 7 to 25 [μm2]), extreme higher nonlinear coefficient (γ) (variable range 8.22-18.1[W-1 km-1]), and lower confinement loss (Lc) than conventional pure-SiO2 based PCFs by changing Ge-doped rate, respectively with core regions, using numerical analysis and actual measurement results, bi-directionally.
[Show abstract][Hide abstract] ABSTRACT: This paper discusses about the tailoring supercontinuum (SC) generation based on a highly nonlinear germanium (Ge) doped photonic crystal fiber (HNL-GePCF) with all normal group velocity dispersion (GVD). Using finite element method (FEM) with a circular perfectly matched boundary layer (PML), it is shown through simulations that how simply the center wavelength can be shifted from one center point to another after optimizing at a particular wavelength using the proposed HNL-GePCF. Moreover, SC spectra at 1.06, 1.31 and 1.55μm have been generated using picosecond optical pulses produced from relatively less expensive laser sources.
[Show abstract][Hide abstract] ABSTRACT: Climatic conditions may have affected the incidence of influenza during the pandemic of 2009 as well as at other times. This study evaluated the effects of climatic conditions on influenza incidence in Okinawa, a subtropical region in Japan, during the 2009 pandemic using surveillance data from rapid antigen test (RAT) results. Weekly RAT results performed in four acute care hospitals in the Naha region of the Okinawa Islands from January 2007 to July 2011 were anonymously collected for surveillance of regional influenza prevalence. Intense epidemic peaks were noted in August 2009 and December 2009-January 2010 during the influenza pandemic of 2009. RAT positivity rates were lower during the pandemic period than during the pre- and post-pandemic periods. Lower ambient temperature was associated with higher influenza incidence during pre- and post-pandemic periods but not during the pandemic of 2009. Lower relative humidity was associated with higher influenza incidence during the pandemic as well as during the other two periods. The association of climatic conditions and influenza incidence was less prominent during the pandemic of 2009 than during pre- and post-pandemic periods.
[Show abstract][Hide abstract] ABSTRACT: The effective area (Aeff) can be dynamically controlled from 7 μm2 to 25 μm2, bidirectionally, by adjusting the dosage of germanium doping in the core region, as demonstrated through numerical analysis and experimental measurements.
[Show abstract][Hide abstract] ABSTRACT: A dispersion flattened photonic crystal fiber (PCF) having nonlinear coefficient 13.8 W−1km−1 at 1.55µm is proposed in this paper to generate supercontinuum (SC) in a telecommunication window (wavelength 1.45µm to 1.65µm). As this PCF has an ultra-flattened dispersion and near zero dispersion slope at the center wavelength 1.55 µm, simulation results show that this simple PCF offers the possibility to generate the SC spectrum at telecommunication window using picosecond pulse easily produced by less expensive laser sources. Moreover, this PCF also provides very low confinement loss in entire operating window.
[Show abstract][Hide abstract] ABSTRACT: We have demonstrated that the correction factor kn = Aeff/(πw2), is above 1.20 for photonic crystal fibers (PCFs) with structural parameters in the range of d/Λ ≅ 0.40-0.90. By using the far field scanning (FFS) technique and the finite difference method (FDM), the results of experimental measurements and numerical simulations differed by only 0.8% to 3.0% for two types of PCFs. The finding that kn≠1.0 for PCFs indicates that their electrical field distribution is non-Gaussian and cannot be determined by assuming a conventional step-index structure distribution for PCFs.
[Show abstract][Hide abstract] ABSTRACT: We have demonstrated that the correction factor k
2), where ω = MFD/2 (MFD: mode field diameter), is above 1.20 for photonic crystal fibers (PCFs) with structural parameters in the range of d/Λ ≅ 0.40 to 0.90 (d/Λ ratio of hole diameter d and pitch Λ). By using the far-field scanning (FFS) technique and the finite difference method, the results of experimental measurements and numerical simulations differed by only 0.9 to 3.0% for two types of PCFs. The finding that k
≠ 1.0 for PCFs indicates that their electrical field distribution is non-Gaussian and cannot be determined by assuming a conventional step-index distribution for PCFs. It was also found that the ITU-T Petermann II definition is the most suitable for MFD measurements of PCFs with non-Gaussian distribution.
[Show abstract][Hide abstract] ABSTRACT: We investigated nonlinear coefficients 110, 74, and 54 [Wkm]-1 at 1.06, 1.31 and 1.55um wavelengths, respectively based on finite difference method. Also, broadband supercontinuum spectrum is numerically obtained in optical coherence tomography and telecommunication windows.
[Show abstract][Hide abstract] ABSTRACT: Electromagnetic wave analysis of two-dimensional metal waveguides is carried out by the finite element Galerkin time domain method (FEGTD). A TE10 wave excites a waveguide in which a rectangular or circular dielectric post is loaded, and the time course of the spatial distribution of the electromagnetic wave is calculated. We use Galerkin's method to discretize Maxwell's scalar equations directly in the spatial domain and solve the linear system of equations, which is a first-order differential equation with respect to time. To solve open-region problems, we postulate attenuated one-directional traveling waves in non-reflection absorbing regions arranged at the two terminal ends. Isoparametric finite elements and attenuated infinite elements are used.