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Background Transcatheter aortic valve replacement (TAVR) has caused a paradigm shift in the treatment of severe aortic stenosis. Although less invasive and good early results of TAVR have been reported, the long-term durability of the transcatheter aortic valve is still unclear. Case presentation We performed an emergent surgical aortic valve replacement (SAVR) for two cases of acute heart failure due to sudden transcatheter aortic valve dehiscence after 7 or 6 years of primary TAVR. In both cases, transthoracic echocardiography revealed severe transvalvular regurgitation of the transcatheter aortic valve. Intraoperative findings revealed dehiscence on both sides of the anatomical non-coronary cusp without evident signs of degeneration, such as thickening, calcification, or infection. The postoperative course of the cases was uneventful, and the patients were discharged home on days 20 and 48 after the reoperation. Conclusions Although the cause of the valvular disease is unknown, we are seriously concerned that the number of similar cases will increase in the future. We should be cautious in expanding the application of TAVR without evidence of long-term safety.

Background and aim of the study: Coronary artery fistula (CAF) is a relatively rare cardiac anomaly. We investigated long-term outcomes following surgical repair of CAF in adults. Methods: We retrospectively investigated 13 consecutive patients undergoing surgical repair of CAF in our institution between 2008 and 2019 (67.3±10.4 years old, 38% male). CAF types were coronary artery-pulmonary artery fistula (77%), coronary artery-coronary sinus fistula (15%), and both (8%). CAFs originated from the left coronary artery (38%), right coronary artery (8%), and bilateral coronary arteries (38%). Pulmonary and systemic flow (Qp/Qs) was measured in seven patients (54%), with a mean value of 1.52. Seven patients underwent surgery for CAFs alone, and others simultaneously underwent surgery for comorbid cardiac diseases. Results: All procedures were conducted under cardiopulmonary bypass. Surgical procedures were direct epicardial ligation of fistula (92%), direct closure of CAF through pulmonary artery incision (38%), direct closure of CAF through coronary sinus incision (8%), or patch closure of CAF through coronary artery incision (8%). Myocardial perfusion scintigraphy showed asymptomatic myocardial ischemia in the right coronary area after surgery in one patient. There were no deaths perioperatively or during follow-up (mean 66.6 months). There were no coronary or other CAF-related events. Conclusions: Several anatomical variations in CAF were observed which coexist with cardiac disease. Long-term outcomes following surgical repair were satisfactory, and the concurrent intervention of CAFs during surgery for comorbid cardiac disease is useful to prevent future complications related CAFs in adults.

BACKGROUND The effect of multiple prior percutaneous coronary interventions (PCIs) before subsequent coronary artery bypass grafting (CABG) on long-term outcomes has not been well elucidated.Methods and Results:Between 2007 and 2016, 1,154 patients undergoing primary isolated CABG in our institution had no prior PCI (Group N), 225 had a single prior PCI (Group S), and 272 had multiple prior PCIs (Group M). Cumulative incidences of all-cause death, cardiac death and myocardial infarction (MI) at 10 years post-CABG were highest in Group M. After adjusting for confounders, the risk of all-cause death was higher in Group M than in Group N (hazard ratio [HR] 1.45; 95% confidence interval [CI], 1.10-1.91; P

Background The optimal treatment for aortic thrombus remains to be determined, but surgical treatment is indicated when there is a risk for thromboembolism. Case presentation A 47-year-old male presented with weakness in his left arm upon awakening. Contrast-enhanced computed tomography and transesophageal echocardiography revealed a mobile pedunculated object suggestive of a thrombus arising from the ascending aorta and extending to the left common carotid artery. It was removed under hypothermic circulatory arrest and direct cannulation of the left carotid artery to avoid carotid thromboembolism. Histopathological examination revealed that the object was a thrombus. The patient had an uneventful postoperative course and was discharged 9 days after surgery. Conclusion When a thrombus in the aortic arch extends to the neck arteries, direct cannulation of the neck arteries with selective cerebral perfusion via cervical incision is a useful technique.

We experienced a rare case of acute heart failure due to prosthetic valve regurgitation seven years after the transcatheter aortic valve implantation (TAVI). We performed an emergent surgical aortic valve replacement. Intraoperative findings revealed the dehiscence of both sides of the anatomical noncoronary cusp without evident signs of degenerations such as thickening, calcification, or infection. Postoperative course was uneventful, and the patient discharged home 20 days after surgery. Although cause of valve failure was unclear, we are seriously concerned about the increase of similar cases in the future. Application of TAVI especially to younger patients should be avoided until long-term safety is demonstrated.

In recent years, there has been considerable research into functional materials inspired by living things. Much attention has been paid to the development of adhesive materials that mimic the adhesive proteins secreted by a mussel’s foot. These mussel-inspired materials have superior adhesiveness to various adherents owing to the non-covalent interactions of their polyphenolic moieties, e.g., hydrogen bonding, electrostatic interactions, and even hydrophobic interactions. Various factors significantly affect the adhesiveness of mussel-inspired polymers, such as the molecular weight, cross-linking density, and composition ratio of the components, as well as the chemical structure of the polyphenolic adhesive moieties, such as l-3,4-dihydroxyphenylalanine (l-Dopa). However, the contributions of the position and distribution of the adhesive moiety in mussel-inspired polymers are often underestimated. In the present study, we prepared a series of mussel-inspired alkyl methacrylate copolymers by controlling the position and distribution of the adhesive moiety, which are known as “forced gradient copolymers”. We used a newly designed gallic-acid-bearing methacrylate (GMA) as the polyphenolic adhesive moiety and copolymerized it with 2-ethylhexyl methacrylate (EHMA). The resulting forced gradient adhesive copolymer of GMA and EHMA (poly(GMA-co-EHMA), Poly1) was subjected to adhesion and dispersion tests with an aluminum substrate and a BaTiO3 nanoparticle in organic solvents, respectively. In particular, this study aims to clarify how the monomer position and distribution of the adhesive moiety in the mussel-inspired polymer affect its adhesion and dispersion behavior on a flat metal oxide surface and spherical inorganic oxide surfaces of several tens of nanometers in diameter, respectively. Here, forced gradient copolymer Poly1 consisted of a homopolymer moiety of EHMA (Poly3) and a random copolymer moiety of EHMA and GMA (Poly4). The composition ratio of GMA and the molecular weight were kept constant among the Poly1 series. Simultaneous control of the molecular lengths of Poly3 and Poly4 allowed us to discuss the effects on the distribution of GMA in Poly1. Poly1 exhibited apparent distribution dependency with regard to the adhesiveness and the dispersibility of BaTiO3. Poly1 showed the highest adhesion strength when the composition ratio of GMA was approximately 9 mol% in the portion of the Poly4 segment. In contrast, the block copolymer consisting of the Poly3 segment and Poly4 segment with only adhesive moiety 1 showed the lowest viscosity for dispersion of BaTiO3 nanoparticles. These results indicate that copolymers with mussel-inspired adhesive motifs require the proper design of the monomer position and distribution in Poly1 according to the shape and characteristics of the adherend to maximize their functionality. This research will facilitate the rational design of bio-inspired adhesive materials derived from plants that outperform natural materials, and it will eventually contribute to a sustainable circular economy.

BackgroundOptimal treatment for aortic thrombus remains to be determined, but surgical treatment is indicated when there is a risk for thromboembolism. Case PresentationA 47-year-old male presented with weakness in his left arm upon awakening. Contrast-enhanced computed tomography and transesophageal echocardiography revealed a mobile pedunculated object suggestive of a thrombus arising from the ascending aorta and extending to the left common carotid artery. It was removed under hypothermic circulatory arrest and direct cannulation of the left carotid artery to avoid carotid thromboembolism. Histopathological examination revealed that the object was a thrombus. The patient had an uneventful postoperative course and was discharged 9 days after surgery. ConclusionWhen a thrombus in the aortic arch extends to the neck arteries, direct cannulation of the neck arteries with selective cerebral perfusion via cervical incision is a useful technique.

Although surgical ventricular restoration for ischemic cardiomyopathy is expected as an alternative or bridge to heart transplantation, post-operative remodeling of left ventricle (LV) needs to be addressed. This study aimed to examine the effect of basic fibroblast growth factor (bFGF), which induces angiogenesis and tissue regeneration in ischemic myocardium, to prevent remodeling after surgical ventricular restoration (SVR) using a rat ischemic cardiomyopathy model. Four weeks after coronary artery ligation, rats were divided into two groups: rats treated with SVR alone (SVR; n = 21), and rats treated with SVR and local sustained release of bFGF using gelatin hydrogel sheet (SVR + bFGF; n = 22). Cardiac function was assessed by serial echocardiography and cardiac catheterization. Cardiac tissue sections were histologically examined for vascular density and fibrosis. Higher systolic function and lower LV end-diastolic pressure (LVEDP) were observed in rats treated with SVR + bFGF (SVR vs SVR + bFGF; Ees: 0.22 ± 0.11 vs 0.33 ± 0.22 mmHg/μL, p = 0.0328; LVEDP: 12.7 ± 7.0 vs 8.5 ± 4.3 mmHg, p = 0.0230). LV area tended to be lower in rats treated with SVR + bFGF compared to rats treated with SVR alone (left-ventricular end-diastolic area: 0.66 ± 0.07 vs 0.62 ± 0.07 cm2, p = 0.071). Vascular density tended to be higher in rats treated with SVR + bFGF than those without bFGF (23.3 ± 8.1 vs 28.8 ± 9.5/mm2, p = 0.0509). BFGF induced angiogenesis and attenuated remodeling after SVR which secured the efficacy of SVR in a rat ischemic cardiomyopathy model.

OBJECTIVES To determine the incidence of bioprosthetic structural valve deterioration in dialysis patients undergoing aortic valve replacement compared to that in patients without dialysis. METHODS This single-centre retrospective observational study included 1159 patients who underwent aortic valve replacement using bioprosthetic valves for aortic stenosis and/or regurgitation at our institution between 2007 and 2017 [patients with dialysis (group D, n = 134, 12%) or without dialysis (group N, n = 1025, 88%)]. To adjust for potential differences between groups in terms of initial preoperative characteristics or selection bias, a propensity score analysis was conducted. The final sample that was used in the comparison included 258 patients, as follows: 129 patients with dialysis (group D) and 129 patients without dialysis (group N). The cumulative incidences of all-cause death, cardiac death and moderate or severe structural valve deterioration were estimated using the Kaplan–Meier method. RESULTS Operative mortality was significantly higher in group D than group N (9% vs 0%, P = 0.001). Kaplan–Meier analysis revealed that in group D, the incidence was significantly higher for all-cause death (P CONCLUSIONS The incidence of structural valve deterioration in dialysis patients undergoing aortic valve replacement was higher than that in patients without dialysis. Bioprosthetic valves should be carefully selected in dialysis patients undergoing aortic valve replacement.

Crystal structure of the title compound, 7-methoxy-1-{[( E )-2,6-dimethylphenylimino] (phenyl)methyl}-2-naphthol, which has N -aryl group instead of ketonic carbonyl group has been comparatively analysed with the precursor compound of 1-benzoyl-2-hydroxy-7-methoxynaphthalene. The distinct features in the molecular accumulation structures of title triarylimine compound and the precursor diaryl ketone demonstrate that the spatial organization of the former is mainly determined π-π stacking interaction and for the latter the non-classical hydrogen bondings govern the spatial organization. Besides both of the compounds show non-coplanaryl accumulation of aromatic rings molecular structure, the title compound has molecular core of imino group which attaches three aromatic rings of C- 1-naphthyl, C -phenyl, and N -phenyl stems of nearly perpendicular alignment of each aryl groups to residual two aryl ones respectively, giving highly congested circumstance at the inner site of molecules. On the other hand, the precursor aromatic ketone molecule has relatively large space compared to title compound, enabling conformational flexibility to some extent within restriction of maintaining non-coplanar organization. The molecules of the precursor compound in crystal are stabilized by a number of non-covalent bonding interactions, mainly by non-classical hydrogen bondings. The achievement stabilization contributed a number of non-classical hydrogen bonding is considered to be due to the inner-molecular motility of single molecular structure. Contrarily, the congested inner-molecular situation of title compound makes largely rigid molecular conformation, which affords at the same time exposure of three aromatic planes outside the molecular core. The single molecular organization permits π-π stacking interaction stabilization instead of formation of a number of weak interactions. Thus, the governing factors for the distinct feature of the single molecular and the accumulation structures of title compound and the precursor are interpreted from the viewpoint of predominantly effective intermolecular interaction, a strong π-π stacking interaction or sum of weak non-classical hydrogen bondings, determined by the inner-molecular congestive conditions directly affects the inner-molecular motility.

As Japan has one of the most rapidly aging populations in the world, transcatheter aortic valve implantation (TAVI) is likely to be performed in increasing numbers of older people. There is little information on either the efficacy or the safety of TAVI in nonagenarians in Asia.From October 2013 to June 2015, 112 consecutive patients underwent TAVI with Edwards SAPIEN XT valves in our institution. We compared 25 patients aged at least 90 years (mean 91.6 ± 1.7 years) with 87 patients aged under 90 years (mean 82.5 ± 6.0 years) at the time of TAVI. All definitions of clinical endpoints and adverse events were based on the Valve Academic Research Consortium 2 definitions.The median follow-up interval was 561.5 days (the first and third quarters, 405.0 and 735.8 days). Nonagenarians had a higher logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE), Euro II score, and the Society of Thoracic Surgeons predictive risk of mortality (STS) score, and a prevalence of clinical frailty scale ≥ 4. The rate of device success, and the 30-day and 6-month mortalities were not different between patients aged ≥ 90 years and < 90 years (96.0% versus 92.0%, P = 0.68; both 0%, P = 1.00; 4.0% versus 3.5%, P = 0.32, respectively). At six months, clinical efficacy and time-related valve safety were also similar in the two groups (12.5% versus 13.4%, P = 1.00; 4.5% versus 10.3%, P = 0.68, respectively). The cumulative 1-year mortalities were not significantly different between the two groups (8.4% versus 9.4%, P = 0.94, respectively).TAVI can contribute to acceptable clinical results and benefits in a carefully selected group of nonagenarians in Asia.

Effective reuse of mechanical parts is one of the important challenges to achieve sustainable society. In this paper, the authors propose a method to exchange modules between manipulators based on part agent system to promote reuse of mechanical parts. The paper describes a plan of experiment with ten manipulators.

To realize effective reuse of mechanical parts for the development of a sustainable society, it is essential to manage individual parts over their entire life cycle. Part agent system that supports maintenance of part and/or product using network agent and RFID technology has been developed to support reuse of products by giving users advices on replacement of products. We have reported the development of a function of part agent that supports disassembly of products. For that purpose, assembly model and disassembly process model relating to it were developed. Based on this information that is predefined and stored in a part agent of used product, the part agent shows the user the procedure how to disassemble an appropriate part from the product by displaying it using augmented reality. In this paper, a prototype system is proposed that supports disassembly of used products with improved function that deals with possible deterioration of parts. The paper shows a preliminary result of the experiment with the implemented system and discusses remaining issues.

To realize effective reuse of mechanical parts for the development of a sustainable society, it is essential to manage individual parts over their entire life cycle. Product users have difficulties carrying out appropriate maintenance on the multitude and variety of parts in their products. Addressing these considerations, we propose a scheme whereby a part manages itself and supports user maintenance activities. In previous work, we proposed and developed an application of Bayesian estimation to a part agent system that advises a user regarding the replacement of hard disk drives (HDDs). In this study, we create a Bayesian network on the deterioration of the HDD to find the probability of an unobservable event. We also discuss the application of this method to life cycle simulation performed by part agents.

Freeze-thaw stress causes various types of cellular damage, survival and/or proliferation defects, and metabolic alterations. However, the mechanisms underlying how cells cope with freeze-thaw stress are poorly understood. Here, model dough fermentations using two baker's yeast strains, 45 and YF, of Saccharomyces cerevisiae were compared after 2 weeks of cell preservation in a refrigerator or freezer. YF exhibited slow fermentation after exposure to freeze-thaw stress due to low cell viability. A DNA microarray analysis of the YF cells during fermentation revealed that the genes involved in oxidative phosphorylation were relatively strongly expressed, suggesting a decrease in the glycolytic capacity. Furthermore, we found that mRNA levels of the genes that encode the components of the proteasome complex were commonly low, and ubiquitinated proteins were accumulated by freeze-thaw stress in the YF strain. In the cells with a laboratory strain background, treatment with the proteasome inhibitor MG132 or the deletion of each transcriptional activator gene for the proteasome genes ( RPN4 , PDR1 , or PDR3 ) led to marked impairment of model dough fermentation using the frozen cells. Based on these data, proteasomal degradation of freeze-thaw-damaged proteins may guarantee high cell viability and fermentation performance. We also found that the freeze-thaw stress-sensitive YF strain was heterozygous at the PDR3 locus, and one of the alleles (A148T/A229V/H336R/L541P) was shown to possess a dominant negative phenotype of slow fermentation. Removal of such responsible mutations could improve the freeze-thaw stress tolerance and the fermentation performance of baker's yeast strains, as well as other industrial S. cerevisiae strains. IMPORTANCE The development of freezing technology has enabled the long-term preservation and long-distance transport of foods and other agricultural products. Fresh yeast, however, is usually not frozen because the fermentation performance and/or the viability of individual cells is severely affected after thawing. Here, we demonstrate that proteasomal degradation of ubiquitinated proteins is an essential process in the freeze-thaw stress responses of S. cerevisiae . Upstream transcriptional activator genes for the proteasome components are responsible for the fermentation performance after freezing preservation. Thus, this study provides a potential linkage between freeze-thaw stress inputs and the transcriptional regulatory network that might be functionally conserved in higher eukaryotes. Elucidation of the molecular targets of freeze-thaw stress will contribute to advances in cryobiology, such as freezing preservation of human cells, tissues, and embryos for medical purposes and breeding of industrial microorganisms and agricultural crops that adapt well to low temperatures.

The J Graft Open Stent Graft, the first commercialized stent graft in Japan, has been available since February 2014, and we have used this new device as a frozen elephant trunk technique for distal aortic arch aneurysm. Here, we present our surgical method and result with this new device. Between October 2014 and October 2016, 30 patients (26 males, mean age 74.3 ± 9.7 years) underwent total aortic arch replacement using the frozen elephant trunk technique with the J Graft Open Stent Graft for distal aortic arch aneurysm. The follow-up period was 10 months. In-hospital mortality and 30-day mortality were 0%. Stroke occurred in three cases (10%), paraplegia in one case (3.3%), respiratory complication in two cases (6.7%), and renal failure in two cases (6.7%). During the follow-up period, there was no aorta- related death, and two patients needed an aortic operation (re-hemiarch replacement for pseudoaneurysm of proximal anastomotic site; axilloaxillary bypass for occlusion of the left subclavian artery), and two patients needed catheter embolization for type II endoleak for reopening of the left subclavian artery. Our short-term surgical results were acceptable. This new device is useful for distal aortic arch aneurysms.

A 50-year-old man was admitted with fever and chill sensation 6 months ago. Transthoracic echocardiography (TTE) showed left and right coronary cusp prolapses and a thickened tissue of the aortic curtain. Congestive heart failure due to active infective aortic valve endocarditis was diagnosed, and he underwent aortic valve replacement. The aortic annulus was reconstructed using a glutaraldehydetreated autologous pericardium. Six months after surgery, TTE showed severe aortic regurgitation and saccular change in the aortic annulus. Transesophageal echocargiography showed some echo free space from left to noncoronary cusp and abnormal movement of the prosthetic valve annulus. Intraoperative examination showed dehiscence of the pericardial patch from the aortic wall, but no finding of infection. Aortic valve rereplacement was performed with reconstruction of the aortic annulus using a bovine pericardium. To prevent the dehiscence of the pericardial patch from the aortic wall, sutures fixing the prosthetic valve were passed from outside of the aortic wall.

Replacement of parts is a crucial task for the reuse of parts. In this paper, functions of part agent we are developing that support the reuse are described. A part agent manages life cycle of a part using a network agent and an RFID tag attached on the part and generates advices for the user on the maintenance of the part in order to promote the reuse. Part agent we are developing to support the replacement has the following functions. First function is to detect deterioration of the part from its sensory data. As an example, simple 3d of manipulator is developed with modularized link structure. Part agent is assigned for each module and generates advice on its replacement. Second function is to calculate the possibility of failures of part based on causal relation among user operations and detected events. Third function is to support users to disassemble used parts. Part agent generates disassembly procedure of the part and shows it to the user using augmented reality technique. In this paper, the planned scheme for part agent to support reuse of part with these functions is described and preliminary result of the development is shown.

Background There are contradictory reports on outcomes of patients treated for Stanford type A acute intramural hematoma (IMH) and acute aortic dissections (AAD) with thrombosed false lumens. We evaluated short-term clinical outcomes and predictors of adverse outcomes. Methods We retrospectively analyzed 59 symptomatic patients with type A acute IMH and AAD with thrombosed thoracic false lumens who initially received treatment. Survival, aortic death (death from aortic events and sudden deaths), and aortic event-free survival rates were investigated. False lumen thickness ratios (FTR [false lumen thickness/aortic diameter]) were measured by computed tomography scan and the relationship with aortic events was evaluated. Results Survival, aortic death-free survival, and aortic event-free survival rates at 2 years were 90.0%, 96.6%, and 55.8%, respectively. Ascending aortic diameters, false lumen thickness of the ascending aortas, and rate of penetrating aortic ulcers in the ascending aortas were higher among patients with aortic events. The FTR of the ascending aorta (FTRA)/FTR of the descending aorta (FTRD) was also higher in these patients (1.3 ± 0.9 versus 0.8 ± 0.5, p = 0.0021). Multivariate analysis revealed FTRA/FTRD greater than 0.98 (odds ratio 5.35; 95% confidence interval: 0.05 to 1.72; p = 0.0431) as an independent predictor of aortic events. An FTRA/FTRD greater than 0.98 predicted aortic events with 87.1% sensitivity and 58.4% specificity. Conclusions High aortic event rates were seen after treatment for type A acute IMH and AAD with thrombosed thoracic false lumens. Nevertheless, short-term survival rates were favorable. An FTRA/FTRD greater than 0.98 may be a highly sensitive predictor for aortic events.

The X-ray crystal structures of C,C,N-triaryl-substituted imine compounds, which have methoxy or hydroxy group adjacent to the imino moiety, are reported and discussed in comparison with those of the precursor ketone compounds, 1-(4-chlorobenzoyl)-2,7-dimethoxynaphthalene and 1-(4-chlorobenzoyl)-2-hydroxy-7-methoxynaphthalene. In crystals, three aromatic rings in a molecule of the methyl ether-retained imine compound are positioned almost perpendicularly to each other by giving non-coplanar spatial organization of the single molecular structure [dihedral angles: 85.32(18)° for C-linked phenyl ring and naphthalene ring; 79.27(17)° for N-linked phenyl ring and naphthalene ring; 84.78(17)° for C-linked phenyl ring and N-linked phenyl ring]. Spatial organization of the analogous methyl ether-cleaved imine compound has essentially same topology [dihedral angles 80.39(6)° for the C-linked phenyl ring and naphthalene ring; 82.35(6)° for the N-linked phenyl ring and naphthalene ring; 87.09(7)° for C- and N-linked phenyl rings]. These structural features of triarylimines apparently differ from those of the precursor ketones. Two aromatic rings in the methyl ether-cleaved ketone compound make smaller dihedral angle [58.10(6)°] by intramolecular hydrogen bond between ketonic carbonyl group and hydroxy group [2.5573(16) A] than that of the methyl ether-retained ketone [72.06(7)°]. In molecular packing, the methyl ether-retained imine forms tubular molecular alignments composed of R—S dimeric molecular pairs, whereas the methyl ether-retained ketone affords consecutively stacks of one configurated molecules.

症例は73歳，男性．遠位弓部大動脈の最大径66 mmの嚢状瘤に対し全弓部置換術を施行した．胸骨正中切開，上行大動脈送血と上下大静脈脱血で人工心肺を確立し，中等度低体温循環停止，選択的順行性脳灌流を行いエレファントトランク，ステップワイズ法にて遠位側吻合を行った．その後頸部3分枝再建を先行し，最後に中枢側吻合を行った．手術時間515分，人工心肺時間305分，大動脈遮断時間213分，脳分離灌流時間143分，下半身循環停止時間97分であった．術後5日目に発熱と右側腹部痛，炎症反応上昇を生じ，翌日になっても症状は改善せず，CTで急性胆嚢炎および急性腹膜炎と診断し，術後6日目に緊急開腹胆嚢摘出術を施行した．胆嚢周囲に漏出した胆汁性腹水が存在したが，培養結果は陰性であった．病理所見は，胆嚢頸部に虚血による非細菌性非貫璧性の胆嚢壊死が存在するとの結果であった．胆嚢摘出術術後は経過良好であり，初回手術から16日目に独歩退院となった．全弓部置換術後は下半身循環停止やdebrisの飛散など消化管虚血のリスクは高く，術後の急性腹症の鑑別診断として稀ではあるが重篤化することもある胆嚢梗塞を考慮する必要があると考えた．

僧帽弁位の活動期IEに対して積極的にMVPが試みられるようになっているが，弁組織が感染により高度に破壊され，広範囲の郭清を必要とした場合には，形成困難となりMVRが必要となる場合も多い．症例は27歳，男性．発熱が持続するために当院を受診し，心エコー検査で僧帽弁前尖に径13 mmの可動性のある疣贅が判明し，IEと診断され緊急入院となった．後交連を中心として広範囲に逸脱し，MRはsevereであった．巨大疣贅による塞栓症のリスクが高いと判断し，入院2日後に手術を施行した．僧帽弁を観察すると，後交連（PC）を中心にA3からP3の一部にかけて腱索の断裂による逸脱と弁尖の破壊，多数の疣贅の付着を認め，断裂した腱索の先端にも疣贅が付着していた．破壊の著しいPCとA3，P3の一部を疣贅とともに切除したが，比較的形態の保たれたA3は弁尖を温存して表面の疣贅を鋭匙，剪刀などで可及的に郭清するにとどめた．切除した弁尖に対応した弁輪部をcompression sutureにより縫縮し，弁尖を結節縫合で閉鎖した．28 mmのphysio ringを用いてMAPを施行し，逆流試験でMRの消失を確認した．術後経過は良好で，術後9カ月が経過し心機能は良好でMRの再発はなく，NYHA I°で外来通院中である．

This paper describes a maximum power point tracking (MPPT) control method for propeller-type compact wind power generators with passive self-pitch-controlled blades, which quickly makes the output current and voltage converge on the maximum power point based on wind speeds detected from an anemometer. The voltage and current output from these wind power generators vary with wind speeds at locations such as the roofs of buildings. Transient characteristics of the voltage output from compact wind power generators have two modes because of the self-pitch-controlled blades: mode I in which the output voltage hardly increases and mode II in which it rapidly increases. Thus, in order to acquire the generated power effectively, irrespective of how the wind speeds may change, a method to perform the MPPT control while searching for mode II is needed. Thus, by judging the mode from the change of the sign of the time differential of the voltage deviation between sampling times, the MPPT control method proposed here makes the output current converge on the maximum point using relationships between the maximum power and optimal current which give the maximum power and the wind speed. Effectiveness of the proposed MPPT control method is verified through simulations and experiments using a wind tunnel. IEEJ Trans 2010 DOI: 10.1002/tee.20609

Our research group has developed an ultra slim and bendable backlight system, which was manufactured by a continuous roll-to-roll process, with a unified component for liquid crystal display (LCD). This backlight system, which has a thickness of 0.26 mm, is simply composed of a light guide film and an optically patterned film made of photocurable resin with micro particles, consequently it does not require any additional optical films such as prism sheets or diffuser. In addition, we have developed a new light guide component which is composed of bundled optical fibers in order to collimate light from the light source to the light guide film. We found that the backlight system could be radiated uniformly across the LCD surface whether plane or curved, and we were able to realize an advanced LCD with good flexibility, high efficiency and high productivity.

Enantiomerically pure phosphinamides containing a pendant hydroxyl group catalyse the Al(III)-promoted ring opening of the meso epoxide in cyclohexene oxide with thiophenol in up to 80% enantiomeric excess.

We studied the surface modification technology using photosensitive material for control of surface free energy. This photosensitive material is composed of both photo-curable resin and surface modifier. The surface modification phenomena can be controlled by the medium having different surface free energy. In the medium of the high surface free energy, such as water, photosensitive material is modified to be high surface free energy after curing. Whereas, in the medium of the low surface free energy such as air, photosensitive material is modified to be low free surface energy. We calculated surface free energy and analyzed chemical composition of surface by ESCA. As a result, we explained that these surface modification phenomena were caused by the migration of surface modifier into photo reactive resin. Finally, we applied these surface modification phenomena to precision printing technology and micro processing technology in order to fabricate optical devices.

X-prolyl dipeptidyl aminopeptidase (X-PDAP) from Lactobacillus helveticus IF03809 expressed nearly full activity under high salt conditions, such as 2 M NaCl. We cloned and sequenced the pepX gene for X-PDAP. The calculated M, of deduced X-PDAP (803 amino acids) was 90,847 and the protein was distantly related (35 to 44% identity) to known X-PDAPs of Lactobacillus sp. including L. helveticus CNRZ32 (40% identity). Native and recombinant X-PDAP were purified to homogeneity from both L. helveticus IF03809 and Escherichia coli DH5alpha harboring the pepX gene on a plasmid, respectively. The native enzyme appeared to be a dimer of 220 kDa, as estimated by gel filtration column chromatography. It hydrolyzed an X-prolyl-linkage, but not prolyl- or X-prolyl-X-peptide bonds, and tolerated up to 2 M NaCl as well as some other chlorides of monovalent cations. Determination of the flanking sequences revealed two divergent genes. The upstream region of the pepX gene encodes oppA gene for a putative oligopeptide permease, while the downstream region encodes tnp gene specifying a possible transposase of the IS3 family. The oppA gene shares a 176 bp-promoter region with pepX in the intergenic region, implying a relationship between this oligopeptide transport system and X-PDAP.

An 86-year-old woman was referred for transcatheter aortic valve implantation (TAVI) because of recurrent severe aortic stenosis after balloon aortic valvuloplasty in May 2014. We planned to implant a 23-mm Sapien XT valve by transfemoral approach. During procedure, aortic dissection was detected by transesophageal echocardiography (TEE). The dissection limited to the descending aorta and did not include the ascending aorta. Therefore, our team decided to implant the 23-mm Sapien valve as planned. After the procedure, the dissection was treated conservatively without surgical repair. Three weeks later, she was discharged without any complications.

The allylation of the dienolate derived from the chiral α, β- or β, γ-unsaturated imidefollowed by the Cope rearrangement is shown to effect the net remote asymmetric induction to create a new chirality of either configuration at the γ-position in high % de. The utility of this approach is shown in the asymmetric synthesis of the C6 side chain of Zaragozic acid A.

In the title compound, C35H28O6·C7H8, the dihedral angle between the mean planes through the naphthalene ring systems of the dibenzo[a,g]fluorene moiety is 22.44 (3)°. The aromatic ring system of the naphthalenone unit is approximately perpendicular to the mean plane of the five-membered ring, forming a dihedral angle of 87.51 (5)°. An intramolecular C—H...O hydrogen bond is observed. In the crystal, pairs of C—H...π interactions link the molecules, forming inversion dimers.

In the title compound, C23H18O3, the dihedral angle between the two naphthalene ring systems is 78.02 (3)°. The bridging carbonyl C—C(=O)—C plane makes a dihedral angle of 70.56 (5)° with the naphthalene ring system in the 2,7-dimethoxynaphthalene moiety and a dihedral angle of 11.53 (5)° with the naphthalene ring system in the naphthoyl group. In the crystal, adjacent molecules are linked via C—H...π interactions, forming chains along [010].

In the title molecule, C23H18O3, the dihedral angle between the two naphthalene ring systems is 80.44 (4)°. The mean plane of the bridging carbonyl C—C(=O)—C group makes a torsion angle of −68.55 (17)° with the naphthalene system of the 2,7-dimethoxynaphthalene unit and a torsion angle of −9.01 (19)° with the naphthalene ring system of the naphthoyl group. In the crystal, a weak C—H...O hydrogen bond occurs between the carbonyl O atom and an H atom of the naphthalene ring in the 2,7-dimethoxynaphthalene unit of a symmetry-related molecule.

Canonical Wnt signaling critically regulates cell fate and proliferation in developmental stages and adult tissues. Redox regulation through nucleoredoxin (NRX) has recently been identified in canonical Wnt signaling. However, the source of reactive oxygen species (ROS) affecting the redox state of NRX remains elusive. Our principal aim in this study was to investigate whether superoxide-generating NADPH oxidase1 (Nox1) is involved in NRX-regulated Wnt signaling in intestinal and colon epithelial cells. Here, we demonstrate that Wnt treatment of mouse intestinal cells induces production of ROS through Nox1. This Nox1 action is regulated by Rac1 GTPase through Wnt-induced activation of the Rac1 guanine nucleotide exchange factor Vav2 by Src-mediated tyrosine phosphorylation. Nox1-generated ROS oxidize and inactivate NRX, thereby releasing the NRX-dependent suppression of Wnt-β-catenin signaling through dissociation of NRX from Dvl. Nox1 small-interference RNA inhibits cell response to Wnt, including stabilization of β-catenin, expression of cyclin D1 and c-Myc via the TCF transcription factor, and accelerated cell proliferation. Nox1 mediates Wnt-induced cell growth in colon cancer cells with the normal Wnt pathway, but not in APC-deficient colon cancer cells, which are constitutively active in Wnt signaling. Together, these results suggest the mediating role of Nox1 in redox-dependent regulation of canonical Wnt-β-catenin signaling and provide further insight into the regulatory mechanism of the Wnt pathway.

In the title compound, C19H16O3, an intramolecular O—H...O=C hydrogen bond is formed between the hydroxy and carbonyl groups on the naphthalene ring system, resulting in an S(6) ring. The angles between the C=O bond vector and the least-squares planes of the naphthalene ring system and the benzene ring are 27.63 (6) and 47.99 (7)°, respectively. The dihedral angle between the latter planes is 61.39 (5)°. In the crystal, two molecules are connected by pairs of intermolecular O—H...O=C hydrogen bonds, forming centrosymmetric dimers with an R22(4) graph-set motif. The molecular packing features C—H...π interactions.

In the title molecule {systematic name: [2,7-dimethoxy-8-(4-phenoxybenzoyl)naphthalen-1-yl](4-phenoxyphenyl)methanone}, C38H28O6, the 4-phenoxybenzoyl units adopt a syn orientation with respect to the naphthalene ring system. The internal benzene rings, A and B, make dihedral angles of 86.72 (5) and 79.22 (5)° with the naphthalene ring system. The two terminal benzene rings, C and D, of the 4-phenoxybenzoyl groups are twisted with respect to benzene rings A and B, with dihedral angles of A/C = 62.72 (8) and B/D = 87.61 (6)°. In the crystal, H atoms in the naphthalene system make two types of intermolecular C—H...O interactions with the carbonyl O atom and the phenyl etheral O atom of neighbouring molecules. Molecules are further linked by C—H...π interactions involving a H atom of terminal benzene ring D and the π-system of the internal benzene ring A, forming dimers centered about an inversion center.

In the crystal structure of the title cocrystal, 2C24H18ClNO2·C6H12N2, the 1,4-diazabicyclo[2.2.2]octane molecule is located on a twofold rotation axis and linked to the two triarylimine molecules by O—H...N hydrogen bonds, forming a 2:1 aggregate. C—H...Cl interactions are also observed. In the triarylimine molecule, the naphthalene ring system makes dihedral angles of 80.39 (6) and 82.35 (6)°, respectively, with the phenyl and benzene rings. The dihedral angle between these two latter rings is 87.09 (7)°.

In the title compound, C25H16Cl2O4·C2H6O, the two 4-chlorobenzoyl groups are in syn orientations with respect to the naphthalene ring system and are approximately parallel to each other: the dihedral angle between the benzene rings is 11.43 (16)°. The conformation around each of the carbonyl C—(C=O)—C groups forms a larger angle to the plane of the naphthalene ring system than that to the benzene ring; the angles of the C=O bond vector with the naphthalene ring system and the benzene ring are 55.4 (3) versus 13.5 (3)° and 52.2 (3) versus 17.9 (3)°. An intramolecular O—H...O=C hydrogen bond generates a six-membered ring. In the crystal structure, intermolecular O—H...O hydrogen bonds including the ethanol solvent molecule are observed. A C—H...O interaction also occurs. The ethyl group of the ethanol molecule is disordered over two positions with site occupancies of 0.63 and 0.37. The crystal studied was an inversion twin.

The methylation of the lithium dienolate generated from (E)-α,β-olefinic amide with Katsuki’s chiral auxiliary affords the α-methylated β,γ-enamide in an exceptionally high Z-selectivity (99%) over the terminal olefinic bond along with 99% de at the α-chiral center. The origin of the high Z-selectivity is discussed.

In the title compound, C19H14BrClO3, the naphthalene ring system and the benzene ring make a dihedral angle of 77.36 (10)°. The conformation around the central C=O group is such that the C=O bond vector forms a larger angle to the plane of the naphthalene ring system than to the plane of the benzene ring, viz. 75.73 (15)° versus 2.33 (17)°. In the crystal structure, a π–π interaction is formed between naphthalene ring systems, with a centroid–centroid distance of 3.8363 (14) Å and a lateral offset of 1.606 Å. Intermolecular C—H...Br and C—H...O hydrogen bonds and a C—H...π contact are present in the crystal structure.

In the title compound, C19H15FO3, the dihedral angle between the naphthalene ring system and the benzene ring is 62.93 (5)°. The bridging carbonyl C—C(=O)—C plane makes dihedral angles of 45.55 (6) and 28.62 (7)°, respectively, with the naphthalene ring system and the benzene ring. Weak intermolecular C—H...O hydrogen bonds and C—H...π interactions stabilize the crystal packing.

In the title compound, C18H12BrClO3, the naphthalene ring system and the benzene ring make a dihedral angle of 82.18 (9)°. The conformation around the central C=O group is such that the C=O bond vector forms a larger angle to the plane of the naphthalene ring system than to the plane of the benzene ring, viz. 60.91 (16)° versus 13.94 (16)°. In the crystal structure, two π–π interactions formed between the naphthalene ring systems [centroid–centroid distances of 3.8014 (13) and 3.9823 (13) Å] and intermolecular O—H...O and C—H...O hydrogen bonds are present.