Denatured lysozyme was refolded by a dilution method. The refolding yield depended greatly on the lysozyme concentration in the refolding mixture. When the concentration of denatured lysozyme was 0.02 g/L, the refolding yield was as high as 60%. However, when the concentration of denatured lysozyme was 0.2 g/L, the refolding yield was as low as 10% due to the formation of aggregates. To prevent the formation of aggregates and to increase the refolding yield at a low cost, inexpensive additives were screened. The addition of acetone, acetoamide, or urea derivatives was very effective for improving the refolding yield. To clarify why the addition of acetoamide in the refolding mixture improved the refolding yield at the high lysozyme concentration, the time courses of the concentration and the average diameter of the aggregates in the refolding mixture were monitored by the dynamic light scattering method. The experimental results showed that acetoamide played a role in preventing the formation and growth of aggregates and secondary aggregation between the lysozyme aggregates.

Many patients, after artificial valve replacement surgery, receive warfarin anticoagulant therapy. However, it has been reported that warfarin administration during pregnancy can cause fetal teratogenicity. With reference to this case, we will discuss how warfarin administration in mid-pregnancy caused severe cerebral hemorrhage in the newborn child. The 36-year-old patient in this case underwent aortic valve replacement surgery when she was 11 years old; this requires the continued use of warfarin after surgery. Although she was advised otherwise, the patient became pregnant. The warfarin treatment was discontinued at 5 weeks of gestation and she began self-injection of heparin; however, her health quickly deteriorated requiring an emergency, warfarin treatment. On gestation week 21, she was admitted to our hospital with a high likelihood of a spontaneous abortion. A week later, transesophageal ultrasonography revealed a thrombus in the patient's aortic valve. Because of this finding, we re-started warfarin administration. At 32 weeks of gestation, cardiotocography showed decreased fetal heart rate; thus, an emergency Cesarean section was performed. A baby was delivered, weighing 1,702 g with an Apgar Score of 1 at 1 minute and 4 at 5 minutes. Cranial computed tomography of the infant showed bilateral intraventricular hemorrhage and ventricular dilation. In order to protect the mother and prevent hemorrhage in the newborn, it is recommended that a continuous heparin infusion should be administered to the pregnant woman after the 36th week of gestation. Regarding the impact on the infant, it is considered that continuous intravenous administration of heparin is safer during the third trimester of pregnancy. However, administration of heparin alone makes the preventive effect of thrombosis uncertain. When warfarin is administered in pregnancy, pregnancy management should be performed bearing the risk of fetal cerebral hemorrhage in mind.

•A second case of low-grade myofibroblastic sarcoma of the vulva.•Six-year follow-up with no evidence of disease after radical local excision.•Adequate margin resection is important.

Purpose: The dcm4chee is an open source software for making a high‐performance DICOM server. The process of dcm4chee is recorded in a log as text file. It takes a lot of time to read the log file for checking DICOM server performance. Therefore, we made a log analyzer for dcm4chee, which compiles the statistics on image transfer between DICOM server and imaging devices. Methods: The log analysis program was written in Perl (practical extraction and report language). ChartDirector, a chart component for creating charts for web applications was also used. The log analyzer was installed in DICOM server and invoked with a common gateway interface (CGI). The dcm4chee‐2.18.1‐mysql version using MySQL database software was used in this study. The hardware of our DICOM server for educational use was an Apple Mac mini computer (2.6GHz, Intel Core i5, 8 GB RAM) and two 6TB hard disks. Results: Users can specify the beginning and end dates to analyze in the start page of this log analyzer. Three types of output can also be chosen, which are the number of transferred images from each imaging device to the DICOM server in sequence, the total number of transferred images from each imaging device to the server in the period, and the temporal variation in free disk space of the server. These results are shown in the tabular and graph form on a web page. Conclusion: The log analyzer in this study makes it easy to get information on the usage of a dcm4chee DICOM server and should be available for the management of the PACS system using dcm4chee.

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