Rationale:Severe fever with thrombocytopenia syndrome (SFTS) is a recently recognized fatal infectious disease caused by the SFTS virus, and severe cases are complicated by the presence of hemophagocytic lymphohistiocytosis (HLH) associated with a cytokine storm. Herein, we report on serial changes of serum cytokine levels and viral load in a severe case of SFTS.Patient concerns:A 63-year-old Japanese woman presented with high-grade fever, abdominal pain, diarrhea, impaired consciousness, leukocytopenia, and thrombocytopenia.Diagnosis:SFTS was diagnosed based on a positive serum test for SFTS virus RNA and electroencephalogram (EEG) findings of encephalopathy.Interventions:The patient was treated with supportive therapy, including steroid pulse therapy (intravenous methylprednisolone 1 g/d for 3 days) for HLH and intravenous recombinant thrombomodulin 19200 U/d for 7 days for disseminated intravascular coagulation.Outcomes:Treatment for 7 days improved both symptoms and abnormal EEG findings, and SFTS virus RNA disappeared from the serum at day 10 from the onset of symptoms. The serum cytokines and chemokines analysis during the clinical course revealed 2 distinct phases: the acute phase and the recovery phase. The cytokines and chemokines elevated in the acute phase included interleukin (IL)-6, IL-10, interferon (IFN)-α2, IFN-γ, tumor necrosis factor-α, interferon-γ-induced protein-10, and fractalkine, while the IL-1β, IL-12p40, IL-17, and vascular endothelial growth factor levels were higher in the recovery phase.Conclusion:These observations suggest that the cytokines and chemokines elevated in the acute phase may reflect the disease severity resulted in a cytokine storm, while those in the recovery phase may be attributed to T-cell activation and differentiation.

Spontaneous ilio-iliac arteriovenous fistula (AVF) associated with aneurysms affecting the abdominal aortic and iliac arteries is a rare condition. The classical clinical symptoms of ilio-iliac AVF include high-output heart failure, abdominal pain, abdominal bruits and thrills, a pulsatile abdominal mass, and venous congestion symptoms (leg edema and hematuria). The prompt repair of AVF is necessary to restore the patient’s hemodynamics.  We report a case in which a patient with aneurysms affecting the abdominal aortic and iliac arteries and an ilio-iliac AVF presented with high-output heart failure and leg ischemia and was successfully treated via endovascular stent graft repair.

It depends on flow patterns formed in pool-and-weir fishways whether fishes succeed in the access to upstream or not. However we had not focused on the relationship between the flow patterns and the swimming behaviors which is a key element concerning about the fish accessibility. As a result, although the pool-and-weir fishways have been installed in many weirs, we could not have evaluated the efficiency. With these backgrounds, eight two-dimensional flow patterns were formed by changing the pool length and pool depth, and swimming behaviors was observed in each flow patterns in this research. It was confirmed that there are three obvious swimming routes to access a upstream pool, and significantly it was certain that one route is more successful to access than the other routes. The result shows that the flow patterns in the pool could provide a fundamental element concerning about fish accessibility and that we have to design the pool length and depth to keep the successful route.

It is known that piloti-type structures, which have an open space on the ground floor, have advantages for tsunami hitting because tsunami can pass through the ground floor. There is a basic guideline for the design of piloti-type structures for tsunami forces but detailed information such as tsunami forces acting on the elevator hall or the ceiling is not speculated. Then, the hydraulic physical model tests were performed by using a newly-developed tsunami wave generator. As a result of the physical model tests, the tsunami force acting on an upper structure becomes significantly smaller compared with a normal (not piloti-type) structures. It should be noticed that tsunami reaches the upper structure and gives the significant tsunami force on the upper structure because the ground structure exists, even if the peak water level is somewhat lower than the ceiling level of the ground floor. The uplift force observed on the ceiling in front of the ground structure is much larger than the usual design force on the ceiling of the buildings.

The tsunami force acting on a land structure generated by the run-up tsunami was generally evaluated from the maximum inundation depth of the passing run-up tsunami, which is estimated on the supposition that the structure does not exist. However, the maximum depth does not always accompany the maximum tsunami force, e.g., in the case that the inundation depth gradually increase. Therefore the time series evaluation of the tsunami force not with the maximum depth is required. In this study, the physical model experiment to examine the tsunami forces acting on a wall structure in time series was conducted. It is found that the time series of the tsunami force was expressed with the inundation depth and the velocity of the passing tsunami at the same moment.