Cholelithiasis is one of the commonest diseases in gastroenterology. Remarkable improvements in therapeutic modalities for cholelithiasis and its complications are evident. The Japanese Society of Gastroenterology has revised the evidence-based clinical practice guidelines for cholelithiasis. Forty-three clinical questions, for four categories-epidemiology and pathogenesis, diagnosis, treatments, and prognosis and complications-were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. This article preferentially describes the clinical management of cholelithiasis and its complications. Following description of the diagnosis performed stepwise through imaging modalities, treatments of cholecystolithiasis, choledocholithiasis, and hepatolithiasis are introduced along with a flowchart. Since there have been remarkable improvements in endoscopic treatments and surgical techniques, the guidelines ensure flexibility in choices according to the actual clinical environment. The revised clinical practice guidelines are appropriate for use by clinicians in their daily practice.

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This study demonstrated that ART-123 inhibits the expression of inflammatory cytokines and decreases the plasma HMGB1 levels in experimental endotoxemia. In addition, ART-123 administration markedly reduced liver dysfunction and mortality even with delayed treatment of ART-123. The use of ART-123 may therefore be a beneficial treatment for septic patients.

Recently there has been a marked increase in wind power generation. From a power system point of view, because a wind turbine is an intermittent generator with large output fluctuation, any increase in the number of wind turbines gives rise to concerns about the adverse effects of wind turbines on power quality. The smoothing effects of wind turbine output fluctuation are of great importance in assessing the impacts of a large number of wind turbines. This article examines smoothing effects at a wind farm. First it presents a summary of wind measurements taken at two locations with six masts over a period of 1 year on both flat and complex terrain.Then the spatial coherence of wind speed is analysed, paying special attention to its dependence on the distance between observation points, wind direction, wind velocity and fluctuation frequency. Approximation equations for coherence of frequency and distance are obtained by applying Davenport's expression to the observed data. Second, coherence between turbine output at a wind farm is investigated; the results indicate that coherence for wind speed and turbine output shows a considerable resemblance. The article also examines smoothing effects at a wind farm using power spectral density through a theoretical approach. The study proves that smoothing effects can be approximated with a lowpass filter and that the effects at a wind farm should not be taken into account for periods of more than 10 min in case of assessing them on the safe side.

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Recently there has been a marked increase in wind power generation. From a power system point of view, because a wind turbine is an intermittent generator with large output fluctuation, any increase in the number of wind turbines gives rise to concerns about the adverse effects of wind turbines on power quality. The smoothing effects of wind turbine output fluctuation are of great importance in assessing the impacts of a large number of wind turbines. With regard to impacts on power system frequency (generation-demand balance), smoothing effects on a power system-wide scale need to be examined in greater detail, because impacts of wind turbines on power system frequency are dominated by the total power output of wind turbines interconnected to the system. This article examines smoothing effects of wind power output on a power system-wide scale. First a summary of wind measurements, in which observations were made at 16 sites, is presented. Next, correlation coefficients of wind power output of distant wind turbines are analysed; considerable differences are observed in the correlation coefficients from day to day. Then a new indicator for assessing the smoothing effects-average coherence-is introduced to resolve difficulties of conventional indicators such as coherence. Average coherence is evaluated for the measured data; the results show that smoothing effects among wind farms distributed over some hundreds of kilometres may not be so significant for periods of more than about 100 min. ; 7:75-85 *The results presented in this article are based on the observed wind at a height of 40 m. † Sonic anemometer with 0·1 s sampling was used at one of the 30 masts. The average value for 1 s was used for this anemometer in comparing the data with those at other masts. sum =1 80T. Nanahara et al.

Three new hydrolyzable tannins, cocciferins D(1) (1), D(2) (2), and T(1) (4), were isolated from the leaves of Quercus coccifera. Cocciferin D(2) (2) and two additional new tannins, cocciferins D(3) (3) and T(2) (5), were also obtained from the leaves of Quercus suber. Their oligomeric structures were elucidated on the basis of spectroscopic methods and chemical evidence. Compounds 2, 3, and 5 were rare oligomers possessing glucose cores with both open-chain and pyranose forms.

Peripheral blood mononuclear cells collected from 13 patients with chronic fatigue syndrome and 13 healthy controls were analyzed for the presence of human herpesvirus 6 (HHV-6) DNA by variant-specific polymerase chain reaction and dot blot hybridization. HHV-6 DNA was detected in 7 of 13 (53%) patients, and of those 7 patients, 4 were positive for HHV-6 variant A DNA and 3 were for variant B. No HHV-6 DNA was detected in the controls. Serum antibody titers to the late antigen and antibody prevalence to the early antigen of HHV-6 were significantly higher in the patient group. These results suggest active replication of HHV-6 in patients with chronic fatigue syndrome.