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Using scanning tunneling microscopy (STM), we study the adsorption of copper-phthalocyanine (CuPc) on the anisotropic Au(110)-(1 × 2) surface as a function of coverage. For the initial adsorption at room temperature, we observe CuPc monomers as well as a molecular chain that forms along the step edge. By STM manipulation, we reveal that the CuPc adsorption is accompanied by surface reconstruction from the initial adsorption stage; the periodicity beneath the monomer and the chain changes locally from (1 × 2) to (1 × 1) and (1 × 3), respectively. This finding highlights that the Au atom mobility of the surface plays an essential role in CuPc adsorption. At higher coverage, we observe the development of CuPc chains along the [110] direction on the terrace with periodicities of (7 × 5) and (5 × 5), and compare the obtained results with those from the previous studies by diffraction methods.

The interaction of Ag atoms with graphene moiré on Rh(111) was studied by scanning tunneling microscopy. Upon adsorption at 15 K, the Ag atoms existed mainly as monomers at specific sites in the moiré unit cell because thermal diffusion was suppressed. The Ag atoms exhibited a dI/dV peak at ~0.5 V above the Fermi level, which was assigned to Ag(5s)-C(2p) anti-bonding state. At elevated temperature, the Ag adatoms were thermally activated to diffuse and form clusters, wherein the activation barrier depended on the moiré periodicity. Furthermore, migration was induced by injecting tunneling electrons into the anti-bonding state. This work provides atomic-scale insight into the aggregation process of metal adatoms on metal-supported graphene.

The structure and electronic states of copper phthalocyanine (CuPc) on Cu(100) and Cu(110) were studied mainly using scanning tunneling microscopy/spectroscopy (STM/STS). We observed that the molecule adsorbs flat on Cu(100), and the lowest unoccupied molecular orbital (LUMO, e) is shifted down to the Fermi level, which indicates a partially filled state. The inherent fourfold symmetry of the molecule remains intact upon adsorption, and thus, the degeneracy of LUMO is maintained on the surface. Conversely, the molecule adsorbs in a low-symmetry configuration on Cu(110) and preferentially forms a dimer. Thus, the degeneracy of LUMO is lifted, and the split LUMO is shifted below the Fermi level. We propose that the hybridization with surface d band plays an important role in the energy level alignment and its structure dependence for CuPc on Cu surfaces.

Thin film MnSi has been epitaxially grown on Si(111) substrate and investigated in terms of magnetoresistance and Hall measurements under applied hydrostatic pressure up to 2.58 GPa. Although the behavior of the thin films is qualitatively similar to bulk material, at a high pressure above 2 GPa, an additional magnetic ordering occurs, resulting in a reduction of the potential scattering by spin fluctuations. This ordering is stabilized at the applied pressure showing visible effects in the magnetotransport data. Comparing the behavior of thin films with the bulk material under pressure, it seems quite likely that this additional ordering is of skyrmionic nature, which has as yet not been unambiguously evidenced in epitaxial B20 thin films on a substrate under ambient pressure.

Introduction The purpose of this study was twofold: to investigate whether edoxaban significantly decreases the rate of venous thromboembolism (VTE) following closed-wedge high tibial osteotomy (CWHTO), in terms of phlebographic event, and to determine whether edoxaban is safe or increases the rate of hemorrhagic complications. We hypothesized that edoxaban would decrease the incidence of VTE and would not increase the rate of hemorrhagic complications. Materials and methods We randomly enrolled 60 patients undergoing CWHTO. The patients were divided into two groups: one group receiving edoxaban (15 mg in 5 patients, 30 mg in 23 patients) and a non-edoxaban group. All patients underwent computed tomography venography on day 7to diagnose postoperative VTE. Blood samples were obtained on the day before CWHTO and on postoperative days 1, 3, 7 and 14. The incidence of VTE and hemorrhagic events in both groups was compared using unpaired Student t-test or chi-square test. Results The incidence of VTE was significantly greater in the non-edoxaban group (31.3% versus 7.1%; P = 0.02). The incidence of deep vein thrombosis (DVT) was also significantly greater in the non-edoxaban group (28.1% versus 3.6%; P = 0.01). A single patient from the edoxaban group experienced major bleeding. On days 3 and 7, D-dimer levels were significantly lower in the edoxaban group (P = 0.03 and 0.003, respectively). On days 3, 7 and 14, activated partial thromboplastin time was significantly greater in the edoxaban group (P = 0.02, 0.01 and 0.006, respectively). Conclusion Patients undergoing CWHTO are at risk of postoperative VTE. Edoxaban helps prevent asymptomatic phlebographic VTE and DVT following CWHTO; however, the risk of major bleeding must be considered. Level of evidence II.

We performed experimentally the electron-density mapping on the crystal structure of the iron-based superconductor Lu2Fe3Si5 which revealed the Fe-Si covalent-bonding network with the fully ionized Lu-sites. And, for Lu2Fe3Si5, we investigated the effect of Fe- and Si-site substitutions on the superconductivity. The Fe-site-substitution study revealed that, in addition to the disorder-sensitive superconductivity, the additionally-provided 3d electrons or holes tend to be itinerant rather than localized. Taking into account that the localized magnetic moments introduced on the Lu-sites are inactive as magnetic pair breakers, the present results suggest that, in Lu2Fe3Si5, the Fe-Si bonding network should be the playground for the exotic superconductivity which is characterized by the sign-reversed superconducting gap function.

Introduction The purpose of this study was twofold: to investigate whether edoxaban significantly decreases the rate of venous thromboembolism (VTE) following closed-wedge high tibial osteotomy (CWHTO), in terms of phlebographic event, and to determine whether edoxaban is safe or increases the rate of hemorrhagic complications. We hypothesized that edoxaban would decrease the incidence of VTE and would not increase the rate of hemorrhagic complications. Materials and methods We randomly enrolled 60 patients undergoing CWHTO. The patients were divided into two groups: one group receiving edoxaban (15 mg in five patients, 30 mg in 23 patients) and a non-edoxaban group. All patients underwent computed tomography venography on day 7 to diagnose postoperative VTE. Blood samples were obtained on the day before CWHTO and on postoperative days 1, 3, 7 and 14. The incidence of VTE and hemorrhagic events in both groups was compared using unpaired Student t-test or chi-square test. Results The incidence of VTE was significantly greater in the non-edoxaban group (31.3 % versus 7.1 %; P = 0.02). The incidence of deep vein thrombosis (DVT) was also significantly greater in the non-edoxaban group (28.1 % versus 3.6 %; P = 0.01). A single patient from the edoxaban group experienced major bleeding. On days 3 and 7, D-dimer levels were significantly lower in the edoxaban group (P = 0.03 and 0.003, respectively). On days 3, 7 and 14, activated partial thromboplastin time was significantly greater in the edoxaban group (P = 0.02, 0.01 and 0.006, respectively). Conclusion Patients undergoing CWHTO are at risk of postoperative VTE. Edoxaban helps prevent asymptomatic phlebographic VTE and DVT following CWHTO; however, the risk of major bleeding must be considered. Level of evidence II.

We concluded high gradient magnetic separation experiments of iron (ferromagnetic) nano-particles with a nominal diameter of 50 nm by using a superconducting magnet. In the experiment, we fabricated fine iron particles using a thermal reactive plasma method in argon and hydrogen mixed gas and sent them directly to the magnetic separator. We present the experimental results, functions of the capture ratio on the magnetic flux density, and velocity of flow. We conclude that high gradient magnetic separation can separate nano-particles and is useful for nano-technology

Background: Intrathoracic stomach is an uncommon condition in infants. We report our experience managing such a condition successfully by laparoscopy in four patients. Methods: Patients’ ages at the time of operation ranged from 30 days to 14 months. In all cases, the intrathoracic stomach was easily pulled down into the abdominal cavity. The phrenoesophageal ligament was completely resected, and the enlarged hiatus was narrowed by intraabdominal suturing technique. The esophagus was wrapped with the mobilized fundus in a floppy fundoplication. Anchoring sutures were placed between the wrapping cuff and crura. Result: One patient had paraesophageal hernia (type 2), whereas the other had combined hiatal hernia (type 3). No adverse complications were observed in any of the cases. Symptomatic gastroesophageal reflux and radiographic recurrence of hernia were not seen in any case. The cosmesis was excellent in all cases. Conclusions: We conclude that laparoscopic repair for intrathoracic stomach is a safe and feasible method when preoperative evaluation is conducted adequately.

In this study, we attempted to define the lower esophageal sphincter (LES) motor events associated with the occurrence of gastroesophageal reflux (GER) in neurologically impaired children in whom of GER disease recurred after laparoscopic Nissen fundoplication (LNF). Of 45 neurologically impaired children who had previously undergone LNF, six children in whom recurrence of GER disease was documented by 24-h esophageal pH monitoring were studied. Concurrent esophageal manometry and pH monitoring were conducted for 1 h both before and after the administration of apple juice (10 ml/kg). A total of 89 reflux episodes were recorded in the course of the study. Of these, 51 episodes (57%) were associated with transient LES relaxation. In the remainder, reflux occurred across a contracted LES in 21 episodes (24%) and during absent basal LES tone in 15 episodes (17%). In four of six patients, transient LES relaxation was responsible for more than half of the reflux episodes. Transient LES relaxation is the predominant mechanism of reflux in neurologically impaired children with recurrent GER after LNF.

MTJ stack is optimized for TMR at low RA region, high PMA and 400oC post annealing capability. Atomic level smooth bottom electrode with 0.5A roughness was developed and positive effects on annealing capability and PMA was demonstrated. The scaling challenge of STT-MRAM read operation down to sub-10nm is discussed. Various contributing factors to the MTJ cell resistance variation were investigated with focus on MRAM cell variation due to advanced lithography patterning techniques. With SADP or DSA, the MRAM cell size can be scaled down to 18nm physical dimension with 4.2% σ/μ cell area variation, good enough for sub-10nm technology node.

We fabricated thick (5 μm) tungsten (W) film patterns by sputtering and dry etching, and realized a new deep X-ray lithography mask. The X-ray mask with 5-μm-thick W absorbers could expose about 1-mm-thick resist structures. In the deposition process of W films, the column structure of about 0.2 μm grain size, from which pattern edge roughness originates, disappeared by adding nitrogen into the sputtering gas. W film etching was carried out by reducing gas pressure and cooling the substrate (−40 °C), and a side etch width of below 0.2 μm was obtained. From the results of the pattern edge roughness and the side etch width, a pattern fabrication accuracy below ±0.5 μm was achieved. Furthermore, film stress, which induces pattern distortion, was reduced to below 50 MPa by controlling the sputtering gas pressure. The obtained mask achieved a pattern distortion below ±0.3 μm.

We developed microconnectors with an automatic connecting/disconnecting mechanism using magnetic force. The electrical terminals were designed to minimize the friction force during connection/disconnection and were fabricated using a deep X-ray lithography technique. The diameter and thickness of the microconnector are 2.5 mm and 2 mm, respectively. We confirmed the electrical connection at 160 mA/line and the automatic connection/disconnection at a distance of 600 μm between opposing microconnectors.

We examined the clinical significance of the lung-thorax transverse-area ratio (L/T) in fetuses with cystic lung disease (CLD). The transverse section of the thorax was analyzed at the level of the 4-chamber view of the heart. L/T was calculated as the bilateral normal lung area divided by the thoracic area. Within a 9-year period, ultrasonography was performed in 15 fetuses with CLD, 13 of which were histologically diagnosed: congenital cystic adenomatoid malformation of the lung (CAM; n = 8), pulmonary sequestration (n = 4), and bronchial atresia (n = 1). Although the initial L/T measurement (29.6 +/- 4.2 weeks) showed significantly lower values than in the controls, the final measurement (36.4 +/- 1. 6 weeks) indicated that the L/T in CLD excluding CAM was significantly higher than that in CAM. Six patients with a final L/T of less than 0.21 required mechanical ventilation immediately after birth. Two of these patients died, and the autopsy findings indicated pulmonary hypoplasia. In these cases, a significant correlation was observed between the maximal value of L/T and preductal alveolar-arterial oxygen difference (A-aDO(2)), although the final L/T was not correlated to A-aDO(2). These results indicate that serial measurements of L/T may be useful in the diagnosis of CLD and may help to predict postnatal respiratory conditions.

This paper describes the measured and calculated results of airflow rates and pollutant concentration profiles in an airtight test house, the aim being to evaluate the calculation model COMIS for multizone air infiltration and pollutant transport. Firstly, the leakage areas of internal doors, exterior walls and windows were measured by the fan pressurization method. Secondly, two measurements were carried out, assuming that the test house consisted of ten zones. The concentrations and injection rate of SF6 were measured in order to determine the airflow rates by a system identification method. The boundary conditions, such as indoor and outdoor temperatures, wind speed and direction, and wind pressures were also recorded in situ and saved simultaneously on diskettes, using a computerized data acquisition system. Thirdly, the measured boundary data and leakage characteristics were used as input in the simulation of airflow using COMIS; initial concentrations, injection rate, along with the previous data were used for simulating pollutant transport, assuming tracer gas SF6 as a pollutant. Lastly, the comparisons between measurement and simulation results of airflow rates and pollutant concentrations were carried out by linear regression analysis. The correlation coefficient between the measured and calculated air change rates was 0.72, and that for pollutant concentration was 0.94.

Using ion-channeling methods, the thermal stability of crystallinity for heavily Ga-doped ZnSe epitaxial layers grown on GaAs (100) substrates was investigated. Some distinctive features were found: The crystallinity of as-grown heavily Ga-doped ZnSe is similar to that of undoped ZnSe. After thermal annealing at 450 °C, the crystallinity of Ga-doped ZnSe is degraded, although that of undoped ZnSe is not significantly changed. It is expected that doped Ga atoms are displaced from the regular lattice sites after annealing. The degree of this degradation depends on the crystallinity of the as-grown Ga-doped ZnSe itself. These results indicate the degradation of the crystallinity for Ga-doped ZnSe epilayers is mainly caused by the interaction between the doped Ga atoms and grown-in point defects in the epitaxial layers.

A intenção dos autores é verificar qual tipo histológico prevalece, se o intestinal ou difuso, segundo a classificação de Lauren. Os preparados histopatológicos de 650 casos de um hospital da cidade de São Paulo, cobrindo um período de trinta anos, foram revistos, aplicando-se as definições da classificação acima mencionada. Os resultados mostraram que o tipo intestinal tornou-se prevalente após a década de 50, atingindo a cifra de 62,74% entre todos os casos de carcinoma na década de 80, sendo de 1,71 a razão intestinal/difuso. Outras séries de casos cujos diagnósticos seguiram a nomenclatura da Classificação Histológica da WHO não se mostraram adequadas para este tipo de estudo. A prevalência do tipo intestinal contrasta, aparentemente, com o decréscimo das taxas de mortalidade por esta doença no Estado de São Paulo no mesmo período. São necessários estudos futuros, incluindo análises de taxas de incidência e prevalência do Helicobacter pylori, entre outros, para melhor interpretação desses dados.

The outcome of fetuses with congenital diaphragmatic hernia (CDH) has been reported to be fatal when pulmonary hypoplasia (PH) is severe. As an indicator of PH, we attempted to measure the lung-thorax transverse area ratio (L/T) using ultrasonic echography. Immediate postnatal surgery was performed using high-frequency oscillatory ventilation (HFOV) and sometimes followed by extracorporeal membrane oxygenation (ECMO). Eighteen fetuses were treated and 14 survived. L/T correlated well with the best preductal arterial blood gas data before surgical reduction during manual ventilation and HFOV, while preductal PO2 and alveolar-arterial oxygen differences from patients managed with HFOV were better than those in patients with manual ventilation. Although L/T also correlated with the duration of O2 therapy and hospitalization in survivors without major anomalies, there was no significant difference between L/T in survivors and nonsurvivors. Because delayed institution of ECMO and complications related to ECMO management seemed to be a major cause of death in non-survivors, the unsalvageable L/T due to PH was estimated to be below 0.06 for HFOV and below 0.1 for conventional ventilation based on the correlation between L/T and preductal P02. These results suggest that L/T is a useful indicator of PH in patients with CDH and also that HFOV is advantageous in treating CDH with PH. The advantage of prenatal diagnosis in predicting unsalvageable L/Ts, should be considered in the therapeutic strategy.

Although respiratory management with high-frequency oscillatory ventilation (HFOV) has generally been used for neonates with congenital diaphragmatic hernia (CDH), entry criteria for extracorporeal membrane oxygenation (ECMO) based on data from patients who underwent HFOV have not yet been reported. To establish entry criteria for ECMO in such patients, we retrospectively studied 36 neonates with CDH treated by HFOV in our institutions between 1986 and 1994. From the admission records, preductal and postductal arterial blood gas data and HFOV ventilation conditions for 72 h after admission were extracted. Oxygenation index (01) and alveolar-arterial oxygen gradient (A-aD02) time interval combinations were calculated. Patients were divided into two groups: candidates for ECMO (n = 22) who underwent ECMO (n = 18) or died without ECMO (n = 4); and non-candidates (n = 14), who survived without ECMO. Blood gas data in patients placed on ECMO were comparable to those in patients who died without ECMO: mean pre- and postductal OI for 4 h > 30, postductal A-aD02 ≥620 mmHg for 4 h, postductal A-aD02 ≥580 mmHg for 8 h, and postductal A-aD02 ?550 mmHg for 12 h showed better sensitivity with a specificity of more than 90% compared to entry criteria that had previously been used in our institutions: a postductal OI >40 for 4 h and postductal A-aDO2 ≥610 mmHg for 8 h. In addition, a combination of preand postductal OI >30 for 4 h indicated a sensitivity of 95.5% and a specificity of 92.9%.

The force generation capacities during a single as well as repetitive maximal knee extensions were investigated in speed skaters in relation to the cross-sectional area (CSA) of quadriceps femoris muscles. The subjects were 15 male and 12 female speed skaters, and an age-matched untrained group (20 men and 21 women). An isokinetic dynamometer was used to determine force output at three constant velocities of 1.05, 3.14 and 5.24 rad.s-1 and to perform 50 repetitive maximal contractions at 3.14 rad.s-1. The CSA was measured by using a B-mode ultrasound technique at the midpoint of the thigh length. The isokinetic force produced at each test velocity was significantly correlated to CSA in all the subjects (r = 0.867-0.920, P < 0.05). There was no significant difference in force (F) per unit CSA (F.CSA-1) at the three test velocities between the speed skaters and untrained subjects within the same sex. In both the speed skaters and untrained subjects, the women showed significantly lower F.CSA-1 at 3.14 and 5.24 rad.s-1 than the men. The means of force output (F) of every five consecutive and all trials during the repetitive maximal bout were significantly correlated to CSA in all the subjects (r = 0.889-0.934, P < 0.05). Compared to the untrained subjects, the speed skaters showed significantly higher F for every five consecutive contractions even when calculated per unit of CSA (F.CSA-1), and had lower percentage of decline of F during a trial span between the 6th-10th and 41st-45th trials. For the untrained subjects, F.CSA-1 for every five consecutive contractions was significantly lower in the women than in the men. For the speed skaters, the men showed significantly higher F.CSA-1 than the women during a trial span from the 1st-5th trial to the 31st-35th trial, although there was no significant sex difference in the ratio on and after the 36th-40th trial. From these results, it is concluded that the speed skaters show a higher muscle performance in a repetitive maximal contraction task rather than in a single contraction compared to the untrained subjects. In addition, judging from the results for the speed skaters, the women might be less trainable than the men in the F.CSA-1 during a single contraction at a fast velocity as well as repetitive maximal contractions.

The prostacyclin analogue TTC-909 is incorporated in lipid microspheres and is chemically very stable. We examined the efficacy of TTC-909 on cerebral microcirculation following focal cerebral ischaemia. Focal cerebral ischaemia was produced by the occlusion of the distal middle cerebral artery in stroke-prone spontaneously hypertensive rats. Intravenous administration of TTC-909 (100 ng/kg/day) or vehicle was started 30 minutes after the occlusion and repeated for 7 days. On day 7, cerebral blood flow and blood-brain barrier permeability were measured autoradiographically. Brain oedema was estimated by the gravimetric method. The size of the infarction was calculated from area measurements on serial histologic sections. Treatment with TTC-909 resulted in significant improvement in regional blood flow in the ischaemic rim (p < 0.01) and the surrounding area (p < 0.05). With TTC-909 treatment, the increased permeability was significantly reduced in the ischaemic centre (p < 0.01) and rim (p < 0.05). A decrease in specific gravity in the ischaemic region and the remote non-ischaemic regions was prevented by the treatment (p < 0.01). We assumed that the efficacy of TTC-909 maintains the blood supply in the ischaemic area, improves disruption of the blood-brain barrier and prevents development of ischaemic oedema.

Background/purpose: Rectourethral (RUF) or rectovaginal fistula (RVF) is a troublesome complication after anorectal surgery because of dense adhesions around the fistula. The authors applied a new technique for the redo surgery. Methods: Case 1 is Hirschsprung's disease in a 1-year-old boy who underwent modified Duhamel's procedure and had RUF. Case 2 is rectovestibular fistula in an 11-year-old girl who had anterior sagittal anorectoplasty complicated by RVF. Case 3 is multiple urogenital anomalies including rectovesical fistula in a 4-year-old boy in whom transvesical repair was unsuccessful. The colon was mobilized as far as possible at laparotomy. The rectum was opened via a posterior sagittal approach leaving 1 cm of the anal canal. Extended endorectal mucosectomy was performed to the dentate line, and the fistula was closed from inside of the rectum. The remaining mucosal cuff was everted out of the anus and the intact colon was pulled through the rectum and anastomosed to the cuff extraanally. Results: The postoperative contrast enema showed no recurrent fistula, and defecation was not impaired. Conclusions: Endorectal pull-through of the intact colon can spare troublesome mobilization of the fistula and can prevent the recurrence of fistula. Rectal incision via a posterior sagittal approach provides a direct view of the fistula.

Based on two different experiments and an optical field calculation, we show that the free‐carrier absorption αfc in Zn(Cd)Se/ZnMgSSe semiconductor lasers is about 4 cm−1 and that it is smaller than that of GaAs/AlGaAs semiconductor lasers. We have measured the dependence of the L‐I characteristics on the cavity length of double heterostructure (DH) lasers under photopumped operation and of single quantum well‐separate confinement heterostructure (SQW‐SCH) lasers under current‐injected operation. For the DH laser, the total absorption coefficient αi and β×J0 product (β is a gain constant, and J0 is the nominal current density that makes the gain equal to zero) are estimated to be 4.2 cm−1 and 8.6×10 cm−1, respectively. For the SQW‐SCH laser, αi, β, and J0 are estimated to be 21 cm−1, 4.23×10−3 cm×μm/A, and 1.9×10−3 A/(cm2×μm), respectively. By calculating the optical fields of these lasers, we have estimated that the absorption in a GaAs substrate is 16.53 cm−1 in the SQW‐SCH laser and that it is negligib...

This paper discusses the basic properties of thin-film inductors driven at high flux densities. We made inner-coil-type thin-film inductors, each with either a closed or an open magnetic circuit, and developed a technique for measuring the impedance of the inductors at high flux densities. We used this technique to reduce the multiple voltage reflections between amplifier and inductor. The impedance of the magnetic thin-film inductors varied according to the magnetic field intensity, because of flux saturation.

Thermal transport measurements have been made on the Fe-based superconductor ${\mathrm{Lu}}_{2}{\mathrm{Fe}}_{3}{\mathrm{Si}}_{5}$ (${T}_{c}\ensuremath{\sim}6\text{ }\text{ }\mathrm{K}$) down to a very low temperature ${T}_{c}/120$. The field and temperature dependences of the thermal conductivity confirm the multigap superconductivity with fully opened gaps on the whole Fermi surfaces. In comparison to ${\mathrm{MgB}}_{2}$, ${\mathrm{Lu}}_{2}{\mathrm{Fe}}_{3}{\mathrm{Si}}_{5}$ reveals a remarkably enhanced quasiparticle heat conduction in the mixed state. The results can be interpreted as a consequence of the unequal weight of the Fe $3d$-electron character among the distinct bands.

To document outcome and to explore prognostic factors in fetal left congenital diaphragmatic hernia (CDH).This was a multicenter retrospective study of 109 patients with prenatally diagnosed isolated left CDH born between 2002 and 2007. The primary outcome was intact discharge, defined as discharge from hospital without major morbidities, such as a need for respiratory support including oxygen supplementation, tube feeding, parenteral nutrition or vasodilators. All patients were managed at perinatal centers with immediate resuscitation, gentle ventilation (mostly with high-frequency oscillatory ventilation) and surgery after stabilization. Prenatal data collected included liver and stomach position, lung-to-head ratio, gestational age at diagnosis and presence or absence of polyhydramnios. Stomach position was classified into four grades: Grade 0, abdominal; Grade 1, left thoracic; Grade 2, less than half of the stomach herniated into the right chest; and Grade 3, more than half of the stomach herniated into the right chest.Overall intact discharge and 90-day survival rates were 65.1% and 79.8%, respectively. Stomach herniation was classified as Grade 0 in 19.3% of cases, Grade 1 in 45.9%, Grade 2 in 13.8% and Grade 3 in 21.1%. Multivariate analysis revealed that liver position was the strongest prognostic variable for intact discharge, followed by stomach position. Based on our results, we divided patients into three groups according to liver (up vs. down) and stomach (Grade 0-2 vs. Grade 3) position. Intact discharge rates declined significantly from liver-down (Group I), to liver-up with stomach Grade 0-2 (Group II), to liver-up with stomach Grade 3 (Group III) (87.0%, 47.4% and 9.5% of cases, respectively).Current status and outcomes of prenatally diagnosed left CDH in Japan were surveyed. Stomach herniation into the right chest was not uncommon and its grade correlated with outcome. The combination of liver and stomach positions was useful to stratify patients into three groups (Group I-III) with different prognoses.

Thermal transport measurements have been made on the Fe-based superconductor Lu2Fe3Si5 (T(c) ∼ 6 K) down to a very low temperature T(c)/120. The field and temperature dependences of the thermal conductivity confirm the multigap superconductivity with fully opened gaps on the whole Fermi surfaces. In comparison to MgB2, Lu2Fe3Si5 reveals a remarkably enhanced quasiparticle heat conduction in the mixed state. The results can be interpreted as a consequence of the unequal weight of the Fe 3d-electron character among the distinct bands.

To assess the severity of lung hypoplasia, we have attempted to measure the lung thorax transverse area ratio (L/T) by using ultrasonic echography and to select immediate surgery after delivery by caesarian section. The evaluation of L/T for an index of lung hypoplasia was made by arterial blood gas data and clinical courses. Of 14 fetuses diagnosed, 13 had left sided CDH and one right sided case, from 11 to 38 weeks of pregnancy, 10 cases survived. The L/T in 14 fetuses with CDH was from 0.08 to 0.36 (mean 0.2 ± 0.073) and was significantly lower than that of the controls. L/T was correlated best with data of arterial pH, PCO 2 , preductal A-aDO 2 before operation and the duration of mechanical ventilation in survivors. Although L/T was also significantly low in the cases with severe grade, diaphragmatic patch closure and ECMO therapy, no significant differences were noted in L/T between survivors and non-survivors. These results indicated that L/T may predict the severity of lung hypoplasia in CDH and that the combination of perinatal management bases on prenatal diagnosis of CDH and ECMO support may improve the outcome of fatal CDH with severe lung hypoplasia.

We studied the effect of nonmagnetic and magnetic impurities on superconductivity in ${\text{Lu}}_{2}{\text{Fe}}_{3}{\text{Si}}_{5}$ by small-amount substitution of the Lu site and investigated structural, magnetic, and electrical properties of nonmagnetic ${({\text{Lu}}_{1\ensuremath{-}x}{\text{Sc}}_{x})}_{2}{\text{Fe}}_{3}{\text{Si}}_{5}$, ${({\text{Lu}}_{1\ensuremath{-}x}{\text{Y}}_{x})}_{2}{\text{Fe}}_{3}{\text{Si}}_{5}$, and magnetic ${({\text{Lu}}_{1\ensuremath{-}x}{\text{Dy}}_{x})}_{2}{\text{Fe}}_{3}{\text{Si}}_{5}$. The rapid depression of ${T}_{c}$ by nonmagnetic impurities in accordance with the increase in the residual resistivity reveals the strong pair breaking dominated by disorder.

The effects of dietary alpha-linolenate (18:3, n-3) and linoleate (18:2, n-6) on platelet-activating factor (PAF) production were examined. Rats were fed an alpha-linolenic acid-rich (perilla oil) diet or a linoleic acid-rich (safflower oil) diet for 6 wk, and polymorphonuclear leukocytes (PMN) were elicited by peritoneal injection of casein. The overall phospholipid content and composition as well as the subclass distribution of choline and ethanolamine glycerophospholipids in PMN were not altered by these diets. However, with the perilla oil diet their content of a putative precursor of PAF, 1-alkyl-2-arachidonoyl-sn-glycero-3-phosphocholine was approximately 50% of that with safflower oil diet. On exposure to various concentrations of FMLP, PAF formation by PMN in the perilla oil group was less than 50% of that by PMN in the safflower oil group. A larger difference in PAF productions by PMN in the two dietary groups was observed on their stimulation with calcium ionophore A23187. These results demonstrate that PAF production is modulated in some as yet unknown way by changing the alpha-linolenate/linoleate balance of the diet.

The aim of this study was to determine whether barium enema reduction (BER) is safe and effective in patients with a long duration of intussusception. Over the last 17 years, 104 patients were admitted to our hospital with a diagnosis of intussusception. All except 1 with peritonitis underwent BER primarily. Of the 103 intussusceptions treated primarily by BER, 84 (82%) were reduced by the enema alone, whereas 19 (18%) underwent surgical reduction. There were no differences in mean duration of disease between the patients with successful and failed enema reduction (successful: 15 +/- 14 h; failures: 14 +/- 11 h, P = 0.6). The success rate of BER was 85% within 12 h of symptoms, 76% for 12-24 h, and 71% for more than 24 h. Of 8 cases with a second trial, 4 (50%) were reduced by repeated barium enema. There were no deaths and no intestinal perforations. The success rate of more than 70% even in patients with a long duration of intussusception suggests that BER is safe and effective regardless of the duration of the disease.

An ultrahigh-speed full adder using resonant-tunneling diodes (RTDs) has been investigated by circuit simulation. The adder uses NOR logic gates, each of which consists of four RTDs (called 4RTD logic gate), with a four-phase pipelined scheme. Circuit simulation has been carried out by assuming an InP-based RTD device model, the peak current density and the peak-to-valley ratio of which are 5.0 times 105 A/cm2 and 10, respectively. The simulation shows that the full adder operates at a clock frequency as high as 50 GHz.

We evaluated a new portable device (CoaguCheck XS) for measuring the prothrombin time-international normalized ratio (PT-INR) in 63 patients after cardiac surgery, and compared the results with those of the conventional method. There was a good correlation between the PT-INR values measured conventionally and those obtained with the CoaguCheck XS. This new device was easy to use, data were obtained rapidly, and the results were reliable. The CoaguCheck XS will be particularly useful for outpatients. PT-INR self-management is expected to be introduced as soon as health insurance coverage is obtained.

A NAND/NOR logic gate using four resonant-tunneling diodes (RTD's), which is introduced by the analogy of RTD current-voltage characteristics to those of superconducting Josephson junctions (JJ's), has been investigated. The NAND/NOR function is obtained by a simple configuration consisting of four RTD's without using any conventional transistors, such as HEMT's or HBT's. The operation principle is analyzed by a graphical method, and a condition required for a normal logic operation is clarified. A NAND/NOR circuit was fabricated by using an InP technology. The experimental result agrees well with our circuit simulation

A 63-year-old man was diagnosed as having grade IV mitral regurgitation (MR). Intraoperative examination revealed perforation (13x7 mm) of the anterior mitral leaflet (AML) and prolapse of the posterior mitral leaflet (PML). The prolapsing part of the PML was resected as a rectangle and the AML perforation was covered with this resected PML patch. A Carpentier-Edwards rigid ring (30 mm) was used to secure the mitral valve annulus after suturing the PML. The patient had an uneventful course after surgery and postoperative echocardiography showed no regurgitation.

Introduction of off-pump coronary artery bypass grafting (off-pump CABG : OPCAB) makes it possible to shorten the bypass time and cardiac arrest time in patients with both ischemic heart disease and valvular disease. This may be beneficial in patients with poor cardiac function and renal dysfunction. However, it is unclear whether such patients can tolerate the changes of hemodynamics during vertical displacement of the heart. In 3 patients who had ischemic heart disease with non-ischemic mitral regurgitation, we performed OPCAB prior to mitral valve plasty. The changes of mitral regurgitation observed by transesophageal echocardiography and several hemodynamic parameters were monitored as the heart was moved to various positions during OPCAB. When a heart positioner (Starfish) was used, hemodynamic deterioration was not observed, and there was also no aggravation of mitral regurgitation. Based on these results, we conclude that it may be possible to carry out OPCAB safely in patients with associated mitral regurgitation.

We recently introduced the laparoscopic percutaneous extraperitoneal closure (LPEC) method for the treatment of girls with inguinal hernia. Using the LPEC method, 129 girls underwent laparoscopic herniorrhaphy. A 5 mm laparoscope was inserted via the umbilicus. A 3 mm "snake retractor" was advanced through the lateral abdominal wall to measure the length of the hernia sac and contralateral patent processus vaginalis (PPV), respectively. The hernia sac and PPV were closed at the level of the internal inguinal ring with a 2-0 non-absorbable purse-string suture using Lapaherclosure, a special 19G needle that can hold a suture at the tip. The length of the hernial sac was significantly longer than that of contralateral PPV (mean 41 mm; range 18-70 mm; P < 0.05). There were no serious complications associated with the procedure. No recurrence of hernia or metachronous contralateral hernia has been identified so far. This approach enables us to perform contralateral exploration without any additional techniques, followed by immediate and accurate closure of the hernia sac and PPV. We conclude that the LPEC method is a safe and efficacious procedure with a low recurrence rate that should be viewed as an acceptable alternative to the traditional open approach.

Since the first operation of II-VI laser diode (LD) by Haase et al.,1 much effort has been devoted to studies on II-VI semiconductors for realization of short-wavelength LDs. Recently, a continuous wave (cw) operation of a few seconds was achieved by using ZnMgSSe as the cladding layer.2 In this presentation, we show the latest results of II-VI LD.

The infarct exclusion technique with a xeno-pericardial patch which Komeda and associates firstly reported in 1990 is one of the best procedure to close ventricular septal perforation. A large patch can protect the perforation and the surrounding weak tissue from the internal left ventricular pressure. However, suturing this large patch to the left ventricular wall through the small incision is not technically easy because of the patch design in the ventricle. We modified the design of the patch. This round shaped bovine pericardial patch was sutured continuously to the left ventricular wall. Then, excessive part of the patch was trimmed to make a corn shape. Finally, the corn shaped patch fit the left ventricular wall naturally.

Background/Purpose Laparoscopically assisted endorectal pull-through (EPT) via a perineal approach using a prolapsing technique (PA) for Hirschsprung's disease (HD) has been reported. However, the clinical outcome after this approach has not been reported. The purpose of this study was to compare the clinical outcome of PA and the conventional transabdominal approach (TA). Methods In the period between 1990 and 2001, 20 cases of HD underwent EPT with TA (group O), and 21 underwent EPT with PA (group L). There was no difference in age and weight distribution between the 2 groups. Clinical outcome was assessed 3 years after surgery. Results The operation time was comparable in the 2 groups (4.9 ± 0.8 v 5.2 ± 0.8 hr), whereas blood loss (98 ± 52 v 36 ± 30 mL) and postoperative complications requiring surgical intervention (26% v 0%) were significantly lower in group L. The incidence of postoperative enteritis (27% v 28%) and voluntary defecation (more than once every/2 days) were compatible in the 2 groups (70% v 87%). Soiling (small amount of involuntary stooling; >1 per month) was significantly less frequent in group L (45% v 14%). Conclusions Laparoscopically assisted ETP with PA is less invasive and can provide a better clinical outcome compared with TA in terms of postoperative soiling.