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Advancement in both surgical technique and medical equipment has enabled solo surgery. ViKY®Endoscope Positioning System (ViKY®) is a robotic system that remotely controls an endoscope and provides direct vision control to the surgeon. Here, we report our experience with ViKY®-assisted solo surgery. We retrospectively examined 25 cases of solo surgery TAPP with ViKY®. ViKY®was setup by the surgeon alone, and the setup duration was determined as the time at which the side rail was positioned and that when the endoscope was installed. For assessing the control unit, the number of false movements was counted. We compared the operative results between ViKY®-assisted solo surgery TAPP and the conventional method with an assistant. The average time to set up ViKY®was 7.9 min. The average number of commands for ViKY®during surgery was 98.3, and the average number of errors and no response of control unit was 7.9. The mean duration of surgery was 136 min for the ViKY®group, including the setup time, and 117 min for the conventional method. No case required an assistant during the operation. There was also no difference between the two groups with regard to postoperative complications and the rate of recurrence. ViKY®proved reliable in recognizing orders with very few failures, and the operations were performed safely and were comparable to the conventional operations with assistants. Solo surgery with ViKY®was beneficial in this clinical evaluation.

The Research Association of Hydrogen Supply/Utilization Technology (HySUT) was established in July 2009 by private companies and organizations with the aim of the commercialization of FCVs and the hydrogen infrastructure. Our objective is to solve the issues of technology, consumer awareness, and social acceptance in order to assist the business establishment through the demonstration. The Japan Hydrogen & Fuel Cell Demonstration Project (JHFC) is a major demonstration program of FCV and hydrogen infrastructure in Japan that began in 2002. We had been operating the technical and social demonstration program called JHFC3 from April 2011 to March 2014 after JHFC1 (2002-2005) and JHFC2 (2006-2010), as a joint research program with New Energy and Industrial Technology Development Organization (NEDO). We operated 13 hydrogen refueling stations (HRSs) in March 2014. 1. Technical and Social Demonstration (JHFC3) We have acquired demonstration data on durability, convenience and practicability of the FCVs and hydrogen infrastructure through the operation of our HRSs serving FCVs and fuel cell buses for the start of commercialization of FCVs. The program was focusing on four technology targets: 1) 70MPa filling technology, 2) Low cost station technology, 3) High frequency operation, 4) Demonstration of total system technology. 2. NEDO's New Project "Hydrogen utilization technology development" We are now leading five new R&D projects which are essential for the commercialization of HRSs in 2015, such as 1) Fueling, 2) Fueling Hose, 3) Hydrogen Quality Control, 4) Hydrogen Metering, 5) Infrastructure Safety under the NEDO program.

Amphiphysin 1 is involved in clathrin-mediated endocytosis. In this study, we demonstrate that amphiphysin 1 is essential for cellular phagocytosis and that it is critical for actin polymerization. Phagocytosis in Sertoli cells was induced by stimulating phosphatidylserine receptors. This stimulation led to the formation of actin-rich structures, including ruffles, phagocytic cups, and phagosomes, all of which showed an accumulation of amphiphysin 1. Knocking out amphiphysin 1 by RNA interference in the cells resulted in the reduction of ruffle formation, actin polymerization, and phagocytosis. Phagocytosis was also drastically decreased in amph 1 (–/–) Sertoli cells. In addition, phosphatidylinositol-4,5-bisphosphate–induced actin polymerization was decreased in the knockout testis cytosol. The addition of recombinant amphiphysin 1 to the cytosol restored the polymerization process. Ruffle formation in small interfering RNA-treated cells was recovered by the expression of constitutively active Rac1, suggesting that amphiphysin 1 functions upstream of the protein. These findings support that amphiphysin 1 is important in the regulation of actin dynamics and that it is required for phagocytosis.

Amphiphysin 1 is involved in clathrin-mediated endocytosis. In this study, we demonstrate that amphiphysin 1 is essential for cellular phagocytosis and that it is critical for actin polymerization. Phagocytosis in Sertoli cells was induced by stimulating phosphatidylserine receptors. This stimulation led to the formation of actin-rich structures, including ruffles, phagocytic cups, and phagosomes, all of which showed an accumulation of amphiphysin 1. Knocking out amphiphysin 1 by RNA interference in the cells resulted in the reduction of ruffle formation, actin polymerization, and phagocytosis. Phagocytosis was also drastically decreased in amph 1 (−/−) Sertoli cells. In addition, phosphatidylinositol-4,5-bisphosphate–induced actin polymerization was decreased in the knockout testis cytosol. The addition of recombinant amphiphysin 1 to the cytosol restored the polymerization process. Ruffle formation in small interfering RNA-treated cells was recovered by the expression of constitutively active Rac1, suggesting that amphiphysin 1 functions upstream of the protein. These findings support that amphiphysin 1 is important in the regulation of actin dynamics and that it is required for phagocytosis.

Objective. To develop an interactive simulation system “virtual ventilator” that demonstrates the dynamics of pressure and flow in the respiratory system under the combination of spontaneous breathing, ventilation modes, and ventilator options. The simulation system was designed to be used by unexperienced health care professionals as a self-training tool. Methods. The system consists of a simulation controller and three modules: respiratory, spontaneous breath, and ventilator. The respiratory module models the respiratory system by three resistances representing the main airway, the right and left lungs, and two compliances also representing the right and left lungs. The spontaneous breath module generates inspiratory negative pressure produced by a patient. The ventilator module generates driving force of pressure or flow according to the combination of the ventilation mode and options. These forces are given to the respiratory module through the simulation controller. Results. The simulation system was developed using HTML, VBScript (3000 lines, 100 kB) and ActiveX control (120 kB), and runs on Internet Explorer (5.5 or higher). The spontaneous breath is defined by a frequency, amplitude and inspiratory patterns in the spontaneous breath module. The user can construct a ventilation mode by setting a control variable, phase variables (trigger, limit, and cycle), and options. Available ventilation modes are: controlled mechanical ventilation (CMV), continuous positive airway pressure, synchronized intermittent mandatory ventilation (SIMV), pressure support ventilation (PSV), SIMV + PSV, pressure-controlled ventilation (PCV), pressure-regulated volume control (PRVC), proportional assisted ventilation, mandatory minute ventilation (MMV), bilevel positive airway pressure (BiPAP). The simulation system demonstrates in a graph and animation the airway pressure, flow, and volume of the respiratory system during mechanical ventilation both with and without spontaneous breathing. Conclusions. We developed a web application that demonstrated the respiratory mechanics and the basic theory of ventilation mode.

In humans during stimulated ventilation, substantial abdominal muscle activity extends into the following inspiration as postexpiratory expiratory activity (PEEA) and commences again during late inspiration as preexpiratory expiratory activity (PREA). We hypothesized that the timing of PEEA and PREA would be changed systematically by posture. Fine-wire electrodes were inserted into the rectus abdominis, external oblique, internal oblique, and transversus abdominis in nine awake subjects. Airflow, end-tidal CO2, and moving average electromyogram (EMG) signals were recorded during resting and CO2-stimulated ventilation in both supine and standing postures. Phasic expiratory EMG activity (tidal EMG) of the four abdominal muscles at any level of CO2stimulation was greater while standing. Abdominal muscle activities during inspiration, PEEA, and PREA, were observed with CO2stimulation, both supine and standing. Change in posture had a significant effect on intrabreath timing of expiratory muscle activation at any level of CO2stimulation. The transversus abdominis showed a significant increase in PEEA and a significant decrease in PREA while subjects were standing; similar changes were seen in the internal oblique. We conclude that changes in posture are associated with significant changes in phasic expiratory activity of the four abdominal muscles, with systematic changes in the timing of abdominal muscle activity during early and late inspiration.

Streptamine, actinamine and scyllo-inosatriamine-1,3,5 have been synthesized from 1,2,3,5-tetra-O-acetyl-4,6-diazido-4,6-dideoxy-myo-inositol. Hydrolysis of this compound gave 5-O-acetyl-4,6-diazido-4,6-dideoxy-myo-inositol, which was a key compound for the synthesis of streptamine and scyllo-inosatriamine-1,3,5, and 4,6-diazido-4,6-dideoxy-myo-inositol which was derived to actinamine. PMR spectra were mainly used to establish the configurations of the new compound obtained.

The Research Association of Hydrogen Supply/Utilization Technology (HySUT) was established in July 2009 by private companies and organizations with the aim of the commercialization of FCVs and the hydrogen infrastructure. Our objective is to solve the issues of technology, consumer awareness, and social acceptance in order to assist the business establishment through the demonstration. The Japan Hydrogen & Fuel Cell Demonstration Project (JHFC) is a major demonstration program of FCV and hydrogen infrastructure in Japan that began in 2002. We had been operating the technical and social demonstration program called JHFC3 from April 2011 to March 2014 after JHFC1 (2002-2005) and JHFC2 (2006-2010), as a joint research program with New Energy and Industrial Technology Development Organization (NEDO). We operated 13 hydrogen refueling stations (HRSs) in March 2014. 1. Technical and Social Demonstration (JHFC3) We have acquired demonstration data on durability, convenience and practicability of the FCVs and hydrogen infrastructure through the operation of our HRSs serving FCVs and fuel cell buses for the start of commercialization of FCVs. The program was focusing on four technology targets: 1) 70MPa filling technology, 2) Low cost station technology, 3) High frequency operation, 4) Demonstration of total system technology. 2. NEDO’s New Project “Hydrogen utilization technology development” We are now leading five new R&D projects which are essential for the commercialization of HRSs in 2015, such as 1) Fueling, 2) Fueling Hose, 3) Hydrogen Quality Control, 4) Hydrogen Metering, 5) Infrastructure Safety under the NEDO program.