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ABO-incompatible (ABOi) dual-graft (DG) adult living donor liver transplantation (ALDLT) is not commonly performed due to its inherently intricate surgical technique and immunological complexity. Therefore, data are lacking on the short- and long-term clinical outcomes of ABOi DG ALDLT. We performed a retrospective study by reviewing the medical records of patients who underwent ABOi DG ALDLT between 2008 and 2014. Additionally, computed tomography volumetric analysis was conducted to assess the graft regeneration rate. The mean age of a total of 28 recipients was 50.2 ± 8.5 years, and the mean model for end-stage liver disease score was 12.2 ± 4.6. The 1-, 3-, and 5-year patient survival rate was 96.4% during the mean follow-up period of 57.0 ± 22.4 months. The 1-, 3-, and 5-year graft survival rate was 96.4%, 94.2%, and 92.0%, respectively, and no significant differences were observed between ABO-compatible (ABOc) and ABOi grafts (P= .145). The biliary complication rate showed no significant difference (P= .195) between ABOc and ABOi grafts. Regeneration rates of ABOi grafts were not significantly different from those of ABOc grafts. DG ALDLT with ABOi and ABOc graft combination seems to be a feasible option for expanding the donor pool without additional donor risks.

Over the past two decades, the age of liver transplantation (LT) recipients has been increasing. We reviewed our experience with LT for patients aged ≥70 years (range: 70–78 years) and investigated the feasibility of performing LT, especially living donor LT (LDLT), for older patients. We retrospectively reviewed the medical records of 25 patients (15 LDLT recipients, 10 deceased donor LT recipients) aged ≥70 years who underwent LT from January 2000 to April 2016. Their perioperative morbidity rate was 28.0%, and the in-hospital mortality rate was 16.0%; these results were comparable to those of matched patients in their 60s (n = 73; morbidity, p = 0.726; mortality, p = 0.816). For patients in their 70s, the 1- and 5-year patient survival rates were 84.0% and 69.8%, and the 1- and 5-year graft survival rates were 83.5% and 75.1%, respectively. Comparisons of patient and graft survival rates between matched patients in their 60s and 70s showed no statistically significant differences (patient survival, p = 0.372; graft survival, p = 0.183). Our experience suggests that patients aged ≥70 years should not be excluded from LT, or even LDLT, based solely on age and implies that careful selection of recipients and donors as well as meticulous surgical technique are necessary for successful results.

This paper present multi-physical transient analysis of eddy current damper (ECD) for reaction force compensation device. A reaction force compensation mechanism with a movable magnet track and an ECD (or conductor plate) is developed. Lumped model of the ECD is derived and effects of both the location and width of the conductor plate are discussed. Multi-physical transient analysis of ECD is analyzed using commercial finite element software, which is compared with the lumped parameter analysis.

The goal of this study is to present an efficient strategy for reliability analysis of multidisciplinary analysis systems. Existing methods have performed the reliability analysis using nonlinear optimization techniques. This is mainly due to the fact that they directly apply multidisciplinary design optimization (MDO) frameworks to the reliability analysis formulation. Accordingly, the reliability analysis and the multidisciplinary analysis (MDA) are tightly coupled in a single optimizer, which hampers the use of recursive and function-approximation-based reliability analysis methods such as the first-order reliability method (FORM). In order to implement an efficient reliability analysis method for multidisciplinary analysis systems, we propose a new strategy named sequential approach to reliability analysis for multidisciplinary analysis systems (SARAM). In this approach, the reliability analysis and MDA are decomposed and arranged in a sequential manner, making a recursive loop. The key features are as follows. First, by the nature of the recursive loop, it can utilize the efficient advanced first-order reliability method (AFORM). It is known that AFORM converges fast in many cases and requires only the value and the gradient of the limit-state function. Second, the decomposed architecture makes it possible to execute concurrent subsystem analyses for both the reliability analysis and MDA. The concurrent subsystem analyses are conducted by using the global sensitivity equation (GSE). The efficiency of the SARAM method was verified using two illustrative examples taken from the literatures. Compared with existing methods, it showed the least number of subsystem analyses over the other methods while maintaining accuracy.

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Neurite formation, an essential feature of neuronal development, is believed to involve participation of the ras-mitogen-activated protein kinase (MAPK) and cAMP-dependent protein kinase A (cAMP/PKA)-mediated signaling pathways. These pathways have been studied extensively in the rat pheochromocytoma cell line PC12, and current hypotheses suggest a single effector mechanism resulting from the convergence of cAMP/PKA and MAPK signaling. However, based on observations using a central neuronal progenitor cell line, AS583-8, there also exists evidence that the two signaling pathways may act independently resulting in neurites with differing dynamic features. In the present study, the upstream components of cAMP/PKA signaling were examined in AS583-8 cells as well as possible interactions with the MAPK pathway. We found that activation of PKA is both necessary and sufficient for the elaboration of rapidly forming processes, typical of the cAMP response. In addition, blockade of the MAPK pathway has no effect on the cAMP response, suggesting that activation of the cAMP/PKA pathway can stimulate neurite formation independent of the MAPK pathway. In order to evaluate which cell line model, PC12 vs AS583-8, best reflects the signaling features of developing central neurons, we examined interactions between cAMP/PKA and MAPK signaling in primary neuronal cultures from several brain regions. In immature cultures (1-day-old), at a point where the initiation of neurite formation is maximal, no interaction was observed. In more mature cultures (7 days old), where synaptic contacts have been established, we found a weak but reproducible activation of MAPK following stimulation of the cAMP/PKA pathway. These results suggest that cAMP/PKA and MAPK signaling act independently at the initiation of neuritogenesis but become coupled during later stages of neuronal development. Therefore, the interaction of the two pathways may be cell stage (younger vs older) specific and may participate in cellular functions that take place after initial neurite formation.

The increasing use of carotid artery stenting has inevitably resulted in more carotid artery stenting-related complications.