Search

Study Design Retrospective multicenter studyObjectives To investigate changes over a 10-years period in the profile of cervical spine and spinal cord injuries among the elderly in Japan.Methods The current multicenter study was a retrospective analysis of inpatients aged ≥65 years, suffering cervical fracture (CF) and/or cervical spinal cord injury (CSCI). We analyzed 1413 patients’ epidemiology (from 2010 to 2019). Moreover, 727 patients who underwent surgical treatment were analyzed in 2 groups: the early (2010-2014) and late period (2015-2019).Results Both the number of patients and number of surgical patients showed a significant increasing trend (P< .001), while the mean age, the distribution of injury levels and paralysis severity, and the proportion of surgical indications remained the same. The number of surgical patients doubled from 228 to 499 from the early to late periods. Posterior surgery was the most common approach (90.4%), instrumentation surgery with screws increased significantly, and the range of fusion was significantly longer in the late period (2.1 vs 2.7 levels, P= .001). Significantly worsening neurological symptoms were recorded in the late period (1.3% vs 5.8%, P= .006), with C5 palsy being the major one. Otherwise, perioperative, major, and other complications, including mortality, did not differ significantly in incidence.Conclusions Both the number of elderly CF and/or CSCI patients and number of patients undergoing surgery increased dramatically over the decade without any change in profile. Instrumentation surgeries with screws increased, without an increase in systemic complications.

Study design: Retrospective cohort study. Objectives: To define the prognosis and predictive factors for neurological improvement in older patients with incomplete spinal cord injury (SCI) of American Spinal Injury Association Impairment Scale grade C (AIS-C). Settings: Multi-institutions in Japan. Methods: We included patients aged ≥65 years with traumatic SCI of AIS-C who were treated conservatively or surgically with >3 follow-up months. To identify factors related to neurological improvement, patients were divided into three groups according to their neurological status at the final follow-up, with univariate among-group comparisons of demographics, radiographic, and therapeutic factors. Significant variables were included in the multivariate logistic regression analysis. Results: Overall, 296 older patients with SCI of AIS-C on admission were identified (average age: 75.2 years, average follow-up: 18.7 months). Among them, 190 (64.2%) patients improved to AIS-D and 21 (7.1%) patients improved to AIS-E at final follow-up. There were significant among-group differences in age (p= 0.026), body mass index (p= 0.007), status of pre-traumatic activities of daily living (ADL) (p= 0.037), and serum albumin concentrations (p= 0.011). Logistic regression analysis showed no significant differences in variables in the stratified group of patients who improved to AIS-D. Meanwhile, serum albumin was a significant variable in patients who improved to AIS-E (p= 0.026; OR: 6.20, pre-traumatic ADL was omitted due to data skewness). Conclusions: Most older patients with incomplete AIS-C SCI demonstrated at least 1 grade of neurological improvement. However, &lt;10% of patients achieved complete recovery. Key predictors of complete recovery were high serum albumin levels on admission and independent pre-traumatic ADL. Sponsorship: No funding was received for this study.

Study design Retrospective Cohort StudyObjective The purpose of this study was to investigate the prognosis of respiratory function in elderly patients with cervical spinal cord injury (SCI) and to identify predictive factors.Methods We included 1353 cases of elderly cervical SCI patients collected from 78 institutions in Japan. Patients who required early tracheostomy and ventilator management and those who developed respiratory complications were defined as the respiratory disability group. Patients’ background characteristics, injury mechanism, injury form, neurological disability, complications, and treatment methods were compared between the disability and non-disability groups. Multiple logistic regression analysis was used to examine the independent factors. Patients who required respiratory management for 6 months or longer after injury and those who died of respiratory complications were classified into the severe disability group and were compared with minor cases who were weaned off the respirator.Results A total of 104 patients (7.8%) had impaired respiratory function. Comparisons between the disabled and non-disabled groups and between the severe and mild injury groups yielded distinct trends. In multiple logistic regression analysis, age, blood glucose level, presence of ossification of posterior longitudinal ligament (OPLL), anterior vertebral hematoma, and critical paralysis were selected as independent risk factors.Conclusion Age, OPLL, severe paralysis, anterior vertebral hematoma, hypoalbuminemia, and blood glucose level at the time of injury were independent factors for respiratory failure. Hyperglycemia may have a negative effect on respiratory function in this condition.

This study achieves the continuous synthesis of Fe3O4nanoparticles by coprecipitation in a microchannel, capitalizing on strong mixing in the gas–liquid segmented flow and using oxygen to partially oxidize Fe2+to Fe3+before the coprecipitation phase. The optimum conditions for nucleating agent addition, partial oxidation time, acid additive source, and H+:Fe2+and OH–:Fe2+ratios were determined through different experiments. X-ray diffraction and transmission electron microscopy were employed to evaluate the product. The results indicate that adding a nucleating agent to the NaOH solution and HCl to the FeCl2solution, with an oxidation time of 19.2 s and a H+:OH–:Fe2+ratio of 0.67:8.5:1, yields Fe3O4nanoparticles with diameters of approximately 8 nm and a narrow size distribution range of 5–13 nm. These findings have implications for the industrial production of Fe3O4nanoparticles and contribute to the understanding of microreactor systems.

Study design: Retrospective multicenter study. Objectives: To investigate the neurological outcomes of older individuals treated with surgery versus conservative treatment for cervical spinal cord injury (CSCI) without bone injury. Setting: Thirty-three medical institutions in Japan. Methods: This study included 317 consecutive persons aged ≥65 years with CSCI without bone injury in participating institutes between 2010 and 2020. The participants were followed up for at least 6 months after the injury. Individuals were divided into surgery (n= 114) and conservative treatment (n= 203) groups. To compare neurological outcomes and complications between the groups, propensity score matching of the baseline factors (characteristics, comorbidities, and neurological function) was performed. Results: After propensity score matching, the surgery and conservative treatment groups comprised 89 individuals each. Surgery was performed at a median of 9.0 (3–17) days after CSCI. Baseline factors were comparable between groups, and the standardized difference in the covariates in the matched cohort was &lt;10%. The American Spinal Injury Association (ASIA) impairment scale grade and ASIA motor score (AMS) 6 months after injury and changes in the AMS from baseline to 6 months after injury were not significantly different between groups (P= 0.63, P= 0.24, and P= 0.75, respectively). Few participants who underwent surgery demonstrated perioperative complications such as dural tear (1.1%), surgical site infection (2.2%), and C5 palsy (5.6%). Conclusion: Conservative treatment is suggested to be a more favorable option for older individuals with CSCI without bone injuries, but this finding requires further validation.

To realize stable long-term operation of microdevices with gas-liquid slug flow, the slug lengths have to be monitored and controlled, because they influence mass transfer performance. In this study, an experimental investigation was carried out to analyze the gas-liquid slug flow in a T-shaped microdevice with a liquid film. The experimental result showed that the pressures in gas and liquid feeding tubes oscillate periodically along the formation of a pair of gas and liquid slugs. Then, the correlation equation between the liquid film thickness and the number of capillaries was identified on the basis of the experimental data. Based on these results, a method for estimating slug lengths and liquid film thickness from measurements of feed pressure and feed flowrate was developed. The developed method is non-invasive and does not affect slug formation or the manner of gas-liquid slug flow. Its effectiveness was assessed through an experimental case study, and the relative root mean square errors of estimated slug lengths were within 8.5%. The result show that the developed method can be applied to the monitoring of slug lengths.

Reports on a technique for making holograms out of magnetic fields by using electron beams, developed by Doctor Akira Tonomura of Hitachi's Advanced Research Laboratories. Oddity of quantum physics known as the Aharanov-Bohm effect; Potential to shed light on the workings of high-temperature superconductors; Details.

The History of Diesel Engines in japan Is the History of Yanmar Interviewer., Let us focus first on Yanmar's history so we can better appreciate the present and future of [...]

BACE1 is an attractive target for disease-modifying treatment of Alzheimer’s disease. BACE2, having high homology around the catalytic site, poses a critical challenge to identifying selective BACE1 inhibitors. Recent evidence indicated that BACE2 has various roles in peripheral tissues and the brain, and therefore, the chronic use of nonselective inhibitors may cause side effects derived from BACE2 inhibition. Crystallographic analysis of the nonselective inhibitor verubecestat identified explicit water molecules with different levels of free energy in the S2′ pocket. Structure-based design targeting them enabled the identification of propynyl oxazine 3with improved selectivity. Further optimization efforts led to the discovery of compound 6with high selectivity. The cocrystal structures of 7, a close analogue of 6, bound to BACE1 and BACE2 confirmed that one of the explicit water molecules is displaced by the propynyl group, suggesting that the difference in the relative water displacement cost may contribute to the improved selectivity.

Supplemental Digital Content is available in the text.

Study Design Retrospective study.Objectives To investigate the impact of diabetes mellitus on neurological recovery and determine the relationship between moderate-severe diabetes and neurological recovery in patients with cervical spinal cord injury (CSCI) without bone injury.Methods A retrospective study was conducted on 389 consecutive patients aged ≥65 years with CSCI without bone injury across 33 medical institutes. The patients were divided into a nondiabetic group (n = 270) and a diabetic group (n = 119). Neurological outcomes were compared between the two groups through propensity score matching. The impact of moderate-severe diabetes (defined as hemoglobin A1c ≥ 7.0% or requiring insulin treatment) on neurological recovery was evaluated through multiple linear regression analysis.Results Propensity score matching revealed no significant differences between the diabetic and nondiabetic groups in terms of American Spinal Injury Association (ASIA) impairment scale grade and mean total ASIA motor scores (AMS) at 6 months post-injury. Multiple linear regression analysis indicated that age on admission (B = −0.34; 95% confidence interval [CI], −0.59 to −0.08; P= 0.01), dementia (B = −16.50; 95% CI, −24.99 to −8.01; P< 0.01), and baseline total AMS (B = −0.62; 95% CI, −0.72 to −0.51; P< 0.01) were negative predictors of neurological recovery at 6 months post-injury. The presence of moderate-severe diabetes did not influence neurological recovery at 6 months post-injury.Conclusions Diabetic patients with CSCI without bone injury achieved improvements in neurological function comparable to those of nondiabetic patients. Moderate-severe diabetes did not affect neurological recovery in patients with CSCI without bone injury.

Study Design Retrospective multicenter study.Objectives To investigate the treatments of the geriatric population with hangman’s fractures using a multicenter database under the Japan Association of Spine Surgeons with Ambition (JASA).Methods The multicenter database included data from 1512 patients. We employed the Levine and Edwards classification for categorizing hangman’s fractures. The study incorporated epidemiological data, including the prevalence of hangman’s fractures, patient age, and follow-up duration. Bony fusion rates and length of hospitalization were recorded for Type I and Type II fractures, and the degree of neurological impairment was assessed.Results Hangman’s fractures represented 62 cases, accounting for 7.4% of all cervical spine injuries. The patients had an average age of 76.6 ± 6.5 years, and the mean duration of follow-up was 21.5 ± 23.6 months. The study found that the bony fusion rate for hangman’s fractures in the geriatric population was 88.9%. Surgical treatment was associated with a shorter hospitalization period for Type II fractures compared to conservative treatment. Thirteen cases of hangman’s fractures in the geriatric population, accounting for 21%, were complicated by spinal cord injury.Conclusions This is the largest study to date on hangman’s fractures in geriatric population ≥65 years. Type I and Type II fractures, according to the Levine and Edwards classification, had a bony fusion rate of up to 90%. In patients with Type II fractures, surgical treatment led to a shorter initial hospital stay. Geriatric patients are at risk of spinal cord injury due to hangman’s fractures.

Study Design Retrospective multicenter study.Objective The purpose of this study was to compare the prognosis of elderly patients with injuries related to cervical diffuse idiopathic skeletal hyperostosis (cDISH) to matched control for each group, with and without fractures.Methods The current multicenter study was a retrospective analysis of 140 patients aged 65 years or older with cDISH-related cervical spine injuries; 106 fractures and 34 spinal cord injuries without fracture were identified. Propensity score–matched cohorts from 1363 patients without cDISH were generated and compared. Logistic regression analysis was performed to determine the risk of early mortality for patients with cDISH-related injury.Results Patients with cDISH-related injuries with fracture did not differ significantly in the incidence of each complication and ambulation or severity of paralysis compared to matched controls. In patients with cDISH-related injury without fracture, those who were nonambulatory at discharge comprised 55% vs 34% of controls, indicating significantly poorer ambulation in those with cDISH-related injuries (P= .023). There was no significant difference in the incidence of complications and ambulation or paralysis severity at 6 months as compared with controls. Fourteen patients died within 3 months. Logistic regression analysis identified complete paralysis (odds ratio [OR] 36.99) and age (OR 1.24) as significant risk factors for mortality.Conclusions The current study showed no significant differences in the incidence of complications, ambulation outcomes between patients with cDISH-related injury with fracture and matched controls, and that the ambulation at discharge for patients with cDISH-related injury without fractures were significantly inferior to those of matched controls.

Study Design Retrospective multicenter study.Objectives The effectiveness of early surgery for cervical spinal injury (CSI) has been demonstrated. However, whether early surgery improves outcomes in the elderly remains unclear. This study investigated whether early surgery for CSI in elderly affects complication rates and neurological outcomes.Methods This retrospective multicenter study included 462 patients. We included patients with traumatic acute cervical spinal cord injury aged ≥65 years who were treated surgically, whereas patients with American Spinal Injury Association (ASIA) Impairment Scale E, those with unknown operative procedures, and those waiting for surgery for >1 month were excluded. The minimum follow-up period was 6 months. Sixty-five patients (early group, 14.1%) underwent surgical treatment within 24 hours, whereas the remaining 397 patients (85.9%) underwent surgery on a standby basis (delayed group). The propensity score-matched cohorts of 63 cases were compared.Results Patients in the early group were significantly younger, had significantly more subaxial dislocations (and fractures), tetraplegia, significantly lower ASIA motor scores, and ambulatory abilities 6 months after injury. However, no significant differences in the rate of complications, ambulatory abilities, or ASIA Impairment Scale scores 6 months after injury were observed between the matched cohorts. At 6 months after injury, 61% of the patients in the early group (25% unsupported and 36% supported) and 53% of the patients in the delayed group (34% unsupported and 19% supported) were ambulatory.Conclusions Early surgery is possible for CSI in elderly patients as the matched cohort reveals no significant difference in complication rates and neurological or ambulatory recovery between the early and delayed surgery groups.

Chitosan is a product of deacetylated chitin and a natural polymer that is attractive as a functional and biocompatible material in the pursuit of alternative materials to synthetic plastics for a sustainable society. Although hierarchical architectures, from precise molecular structures to nanofibers and twisted structures, have been clarified, the expansion of the anisotropic microstructures of chitosan into millimeter-scale materials is in the process of development. In this study, a chitosan network was reconstructed from an aqueous solution by using the meniscus splitting method to form a three-dimensionally ordered microstructure. A chitosan membrane deposited on the millimeter scale formed a useful anisotropically pH-responsive hydrogel. During the evaporation of the aqueous solution from a finite space, chitosan underwent ordered deposition by capillary force to form a membrane with oriented microstructures and microlayers. Unlike the cast films formed between solid–liquid and air–liquid interfaces, this membrane formed between two air–liquid interfaces. As a result, the membranes with ordered microstructures were capable of signifying directional swelling in aqueous environments and reversible/irreversible swelling–deswelling changes by controlling the pH range. We envision that the anisotropic pH response of the chitosan network can be utilized under physiological conditions as a next-generation material.

Describes how Hitachi Ltd. physicist Akira Tonomura, 48, has documented electrons exhibiting the behavior of both particles and waves, in stunning images, shot through one of the world's most powerful optical instruments. The field-emission electron microscope; Principles behind the instrument; Exploratory Research for Advanced Technology program; Promising uses; New discoveries.

Chronic total occlusion (CTO) of femoropopliteal artery (FP) continues to be a lesion subset where maintaining long-term patency after endovascular treatment is challenging. We evaluated the efficacy of cutting balloon angioplasty (CBA) for de novo FP-CTOs in patients with symptomatic lower limb ischemia.

A synthesis process for the ionic liquid (IL) 1-butyl-3-methylimidazolium chloride (BMIM.Cl) was developed using a flow microreactor (FMR) in this study. After the reaction rate analysis, the FMR was efficiently designed using computational fluid dynamics simulation, which can shorten the process development time by reducing trial-and-error experimentation. The designed FMR is composed of a V-shaped mixer and a tubular reactor having a millimeter-scale inner diameter. From the viewpoint of process operation and control, reactors with larger inner diameter are basically preferable. The influence of three inner diameters, 0.75, 2.16, and 4.35 mm, that satisfy temperature constraints on product quality, product yield, and production volume was investigated. It was found that as the inner diameter becomes large, the product yield becomes low because the mass transfer approaches the rate-limiting step of the reaction process. To avoid this problem, it was proposed that static mixers should be built in the reactor having the inner diameter of 4.35 mm. As a result, its production volume, without lowering the product yield, could be improved about 39 times compared with the conventional one.

Background: Takayasu arteritis (TAK) is an autoimmune large vessel vasculitis that affects the aorta and its major branches, eventually leading to the development of aortic aneurysm and vascular stenosis or occlusion. This retrospective and prospective study aimed to investigate whether the gut dysbiosis exists in patients with TAK and to identify specific gut microorganisms related to aortic aneurysm formation/progression in TAK. Methods: We analysed the faecal microbiome of 76 patients with TAK and 56 healthy controls (HCs) using 16S ribosomal RNA sequencing. We examined the relationship between the composition of the gut microbiota and clinical parameters. Results: The patients with TAK showed an altered gut microbiota with a higher abundance of oral-derived bacteria, such as Streptococcusand Campylobacter, regardless of the disease activity, than HCs. This increase was significantly associated with the administration of a proton pump inhibitor used for preventing gastric ulcers in patients treated with aspirin and glucocorticoids. Among patients taking a proton pump inhibitor, Campylobacterwas more frequently detected in those who underwent vascular surgeries and endovascular therapy for aortic dilatation than in those who did not. Among the genus of Campylobacter, Campylobacter gracilisin the gut microbiome was significantly associated with clinical events related to aortic aneurysm formation/worsening in patients with TAK. In a prospective analysis, patients with a gut microbiome positive for Campylobacterwere significantly more likely to require interventions for aortic dilatation than those who were negative for Campylobacter. Furthermore, patients with TAK who were positive for C. gracilisby polymerase chain reaction showed a tendency to have severe aortic aneurysms. Conclusions: A specific increase in oral-derived Campylobacterin the gut may be a novel predictor of aortic aneurysm formation/progression in patients with TAK.

Immunosensing is a bioanalytical technique capable of selective detections of pathogens by utilizing highly specific and strong intermolecular interactions between recognition probes and antigens. Here, we exploited the molecular mechanism in artificial nanopores for selective single-virus identifications. We designed hemagglutinin antibody mimicking oligopeptides with a weak affinity to influenza A virus. By functionalizing the pore wall surface with the synthetic peptides, we rendered specificity to virion–nanopore interactions. The ligand binding thereof was found to perturb translocation dynamics of specific viruses in the nanochannel, which facilitated digital typing of influenza by the resistive pulse bluntness. As amino acid sequence degrees of freedom can potentially offer variety of recognition ability to the molecular probes, this peptide nanopore approach can be used as a versatile immunosensor with single-particle sensitivity that promises wide applications in bioanalysis including bacterial and viral screening to infectious disease diagnosis.

Signal delay is a crucial factor in resistive pulse analyses using low-thickness-to-diameter aspect-ratio pores that aim to detect fine features in the ionic current blockade during the fast translocation of individual analytes to attain single-molecule tomography. Here we report on evaluations of the ionic current response to dynamic motions of nanoparticles in ultrathin solid-state nanopores. We systematically investigated the effects of pore resistance and membrane capacitance on resistive pulse waveforms under different salt concentration conditions and device configurations. The results revealed substantial modifications in the resistive pulse waveforms due to a slow charging/discharging processes at the water-touching thin dielectrics in the solid-state nanopore chips. We also provide a device design to improve the temporal resolution without compromising the spatial sensitivity. The present findings offer a breakthrough toward nanoporescopyto measure the nanoscopic shape of single-bioparticles and -molecules in electrolyte solution.

The objective of the present study was to investigate the effect of platelet-rich plasma (PRP) combined with gelatin β-tricalcium phosphate (β-TCP) sponge on bone generation in a lumbar vertebral body defect of ovariectomized rat. After creating critical-size defects in the center of the anterior vertebral body, the defects were filled with the following materials: (1) no material (control group), (2) gelatin β-TCP sponge with PRP (PRP sponge group), and (3) gelatin β-TCP sponge with phosphate-buffered saline (PBS sponge group). Microcomputed tomography and histological evaluation were performed immediately after surgery and at 4, 8, and 12 weeks to assess bone regeneration. Biomechanical test was also performed at postoperative week 12. In the PRP sponge group, both imaging and histological examination showed that visible osteogenesis was first induced and additional growth of bone tissue was observed in the transplanted sponge, compared with the PBS sponge group. There was no negative effect of either PRP sponge or PBS sponge transplantation on bone tissue generation around the periphery of the defect. Biomechanical test showed increased stiffness of the affected vertebral bodies in the PRP sponge group. These results indicate that PRP-impregnated gelatin β-TCP sponge is effective for facilitating bone regeneration in lumbar vertebral bone defect under osteoporotic condition. PRP combined with gelatin β-TCP sponges could be potentially useful for developing a new approach to vertebroplasty for osteoporotic vertebral fracture.

COURSE50 (CO2Ultimate Reduction in Steelmaking process by innovative technology for cool Earth 50) aims to increase the proportion of hydrogen reduction in the blast furnace. This objective raises the key issue of heat balance changes in individual regions as well as in the overall blast furnace. In order to compensate for the endothermic reactions of hydrogen, a decrease in direct reduction by carbon, a huge endothermic reaction, is being executed. Among the various hydrogen sources available in the industry, coke oven gas (COG) was chosen because of its availability and stability. However, COG requires reforming for it to be injected into the shaft of the blast furnace because this zone cannot combust the hydrocarbon components of COG. COURSE50 has carried out successful COG and reformed COG injection trials at LKAB’s experimental blast furnace in Luleå, Sweden, in cooperation with LKAB and Swerea MEFOS. Carbon consumption in both the COG and reformed COG injection periods decreased compared with the base period because of the planned increase in hydrogen reduction instead of direct reduction by carbon. These results indicate the possibility of increasing the amount of hydrogen reduction in the blast furnace.

Since FY2008, Japanese steel manufacturers (four blast furnace steel manufacturers and one engineering company) have been promoting projects for the “Development of technologies for an environmentally harmonized steelmaking process” under COURSE50 (CO2Ultimate Reduction in Steelmaking process by innovative technology for cool Earth 50), a national project commissioned by the New Energy and Industrial Technology Development Organization. The goal of COURSE50 is to establish technologies which contribute to a mitigation of approximately 30 % in CO2emissions at integrated steel plants by 2050. Two kinds of technologies are being investigated: (a) Intensified hydrogen reduction of iron ore using coke oven gas to curb carbon input in blast furnaces, and (b) Sequestration of CO2in the blast furnace gas through the chemical absorption method and physical adsorption method by the effective utilization of unused waste heat in the integrated steel plants. In the case of (a), the main challenge is the conservation of global and local heat balances in the blast furnace. In the case of (b), the main task is improving the energy consumption of chemical absorption and physical adsorption by improving the agents and materials as well as the process.

COURSE50 (ultimate reduction of CO2in the steelmaking process through innovative technology for Cool Earth 50) aims to capture, separate, and recover CO2from blast furnace gas. From a practical realization viewpoint, three points are important. The first is energy consumption to regenerate the absorbent, second is the energy cost of the heat for regeneration, and third is the facility cost. The advantage afforded by the COURSE50 approach in relation to the CO2capture process is the utilization of unused waste heat from the steel mills. Energy consumption to regenerate the absorbent is determined mainly by three factors: the regeneration reaction determined primarily by the structure of the chemical absorbent, the energy required to heat that volume of absorption liquid, which is affected by the absorption rate of the agent, and the heat loss from the processes. The most influential factor is the energy required for the regeneration reaction. We discovered high-performance absorbents with the advantages of high absorption rates, high cyclic capacities, and low heats of reaction, and we then compared these with monoethanolamine (MEA) and N-methyldiethanolamine (MDEA). The newly discovered absorbents performed well in terms of absorption rates and cyclic capacities. Among these absorbents, some showed lower heats of reaction than MDEA. These results provide a basic guideline for the discovery of potential amine-based absorbents that may lead to the development of new absorbent systems for CO2capture.

The basic principles and methods of off-axis electron holography are presented and illustrated by means of three examples related to its application in high resolution electron microscopy and the investigation of electric and magnetic fields in thin specimens.

The mechanism of persistent atrial fibrillation (AF) is multifactorial, and arrhythmogenic foci (AMF) might be involved in the occurrence of persistent AF. In this study, we examined the electrophysiological features of AMF during and immediately after ablation, and evaluated the relationship between the presence and number of residual AMF on the risk of AF recurrence after a vigorous sinus rhythm restoration ablation in patients with long-standing persistent AF.

Here we report a case of adenosine-sensitive focal atrial tachycardia that was successfully ablated from the left atrium at a site located adjacent to the posterior site of the left coronary cusp in spite of failed ablations from the superior-septal right atrium and non-coronary aortic cusp. In the case of an unsuccessful ablation from the right superoseptum and non-coronary aortic sinus, the left atrial septum represents a potential optional site for ablation.

Purpose To describe a novel technique using an antegrade wire in a retrograde microcatheter advanced through a transcollateral vessel for recanalization of challenging infrapopliteal chronic total occlusions.Technique A 75-year-old diabetic man presented with critical limb ischemia manifested as nonhealing ulcers on the toes. Baseline angiography revealed a blunt, long, total occlusion of the anterior tibial artery. A retrograde microcatheter was advanced over a guidewire tracking the collateral channel from the planter artery. Antegrade and retrograde microcatheters were aligned inside the occluded lesion. An antegrade wire was then advanced further down through the retrograde microcatheter. Final angiography of the anterior tibial artery following balloon dilation demonstrated a satisfactory result, without evidence of significant residual stenoses or flow-limiting dissections. Complete wound healing was achieved at 3 weeks.Conclusion This alternative wire method may be useful when traditional interventional approaches are unfeasible.

Peculiar magnetic domain walls produced in Heusler alloys, which have attracted renewed interest due to their potential application to actuators and spintronic devices, are studied here using electron holography. The observations reveal unexpectedly narrow magnetic domain walls, the width of which showed perfect agreement with that of the antiphase boundaries (APB, e.g., only 3 nm). While the results can be explained by the significant depression of ferromagnetism due to the local chemical disorder, the electron phase shift indicates that ferromagnetic correlation still remains in the APB region.

T-shaped microreactors (T-MRs) with engulfment flow can increase product yield but their high driving pressure is a considerable concern to engineers. Thus, it is important to design a T-MR that can give maximum product yield within a limitation on driving pressure. The use of computational fluid dynamics model is not practical for optimal design of T-MRs due to its heavy computational load. In this research, an extended pseudo three-dimensional lamellar model (eP3DLAM) is proposed as a simple model of non-isothermal T-MRs to efficiently solve the optimal design problems. The usefulness of eP3DLAM is evaluated through a case study on T-MR design. The design result shows that eP3DLAM can accurately predict the concentration and temperature distributions in T-MRs and that the design period of T-MRs can be drastically reduced by using eP3DLAM.

An Al2O3/SiO buffer layer was incorporated in a metal--insulator--semiconductor (MIS) Ta2O5capacitor for dynamic random access memory (DRAM) application. Al2O3was chosen for the buffer layer owing to its high band offset against silicon and oxidation resistance against increase in effective oxide thickness (EOT). It was clarified that post-deposition annealing in nitrogen at 800 °C for 600 s increased the band offset between Al2O3and the lower electrode and decreased leakage current by two orders of magnitude at 1 V. Furthermore, we predicted and experimentally confirmed that there was an optimized value of $y$ in (Si3N4)y(SiO2)(1-y), which is 0.58, for minimizing the leakage current and EOT of SiON. To clarify the oxidation resistance and appropriate thickness of Al2O3, a TiN/Ta2O5/Al2O3/SiON/polycrystalline-silicon capacitor was fabricated. It was confirmed that the lower electrode was not oxidized during the crystallization annealing of Ta2O5. By setting the Al2O3thickness to 3.4 nm, the leakage current is lowered below the required value with an EOT of 3.6 nm.

We describe an adult with Rasmussen's encephalitis associated with widespread decreased accumulation of tracer on 123‐I iomazenil (IMZ) SPECT. The patient had a form of epilepsia partialis continua and neurological deterioration associated with hemiatrophy. Cranial MRI showed cerebral atrophy in the left frontal, parietal, and temporal lobes, without abnormal intensity. Delayed IMZ SPECT showed widespread decreased accumulation of tracer in the left temporal and frontal regions. An early scan showed mildly decreased accumulation in the left temporal and frontal regions. Three‐dimensional stereotactic surface projection (3D‐SSP) analysis showed that the decreased regions on delayed IMZ images were slightly larger as compared with the previous IMZ study performed. Some regions without decreased accumulation of tracer on Tc‐ECD or early IMZ images showed decreased accumulation on delayed IMZ images. This case study suggests that benzodiazepine receptors may be reduced in the affected hemisphere of patients with Rasmussen's encephalitis.

We performed magnetic imaging of Ni-based ferromagnetic shape memory alloys. The magnetic microstructure was revealed by Lorentz microscopy and electron holography, which are powerful tools based on transmission electron microscopy. Observations of Ni51Fe22Ga27 and Ni50Mn25Al12.5Ga12.5 alloys, both of which have an L21-ordered structure in the parent phase, demonstrated that the antiphase boundaries (i.e., a type of planer defects) caused significant changes in the magnetization distribution due to depression of the atomic order—actually, the magnetization in these alloys depends upon the degree of chemical order. We propose a method which estimates the important magnetic parameters (the magnetocrystalline anisotropy constant and exchange stiffness constant) based on transmission electron microscopy observations. This method should be useful in magnetic measurements of nanometer-scale areas, for which conventional techniques cannot be applied.

A basic process to fabricate Ru/rutile-Co-doped TiO2/Ru capacitors for 20 nm-technology generation of DRAMs and beyond was developed. The aim of this study is that the basic process provides foresights into EOT and leakage-current density requirements. We chose rutile-TiO2 for the insulators to meet the requirement of relative permittivity and Ru to suppress leakage-current density. We found the as-deposited lower electrode of Ru crystallized into the rutile phase of TiO2 with a relative permittivity of 109 due to the similarity of crystal structures and lattice constants between rutile-TiO2 and rutile-RuO2, which was generated by oxidizing Ru with ambient oxygen. Furthermore, we confirmed that doping elements that had a small-ionic radius, such as Co, decreased leakage-current density. The dependence of the leakage current of Ru/Co-doped-TiO2/Ru capacitors on temperature and analysis of the band structure with X-ray photoelectron spectroscopy revealed that leakage-current density is determined by a balance between thermionic current and tunneling current through the Schottky barrier. Through calculations using a theoretical equation for these currents, the optimum percentage of Co was estimated to range from 0.3-0.6 % to meet requirement of leakage current for 20 nm- DRAMs.

The usefulness of lupus anticoagulant (LA) and several antibodies for predicting thrombosis was assessed in patients with idiopathic thrombocytopenic purpura (ITP), systemic lupus erythematosus (SLE), lupus like disease (LLD), recurrent abortion and primary antiphospholipid syndrome (APS). LA was measured using the diluted Russell Viper Venom test (DRVVT) and the diluted prothrombin time (dPT).In healthy volunteers, the median (range) of the DRVVT and dPT ratio were 0.97 (0.88 - 1.08) and 1.05 (0.85 - 1.29), respectively. The positive percent of dPT ratio was high in patients with ITP, SLE, recurrent abortion and primary APS. The sensitivity for thrombosis was highest for the dPT ratio and the specificity for thrombosis was highest for the DRVVT ratio. The sensitivity and the Odd’s ratio for both the dPT and DRVVT ratio were high. A positive predictive value in DRVVT and a negative predictive value in dPT were high. The receiver operating characteristic (ROC) curve analysis indicates that the dPT ratio might be more useful for predicting thrombosis than the DRVVT ratio. The DRVVT and dPT ratios are useful for both the diagnosis of APS as well as predicting thrombosis.

A Feasible fabrication process of Ru/rutile-Co-doped TiO2/Ru capacitor for 40-nm DRAM and beyond is developed. As-deposited Ru lower electrode is found out to crystallize Co-doped TiO2 overlayer into rutile having relative permittivity beyond 90 owing to lattice matching. Furthermore, we predicted doping of element having small ionic radius, such as Co, increase Schottky barrier, leading to decrease in leakage current. Temperature dependence of leakage current of RIR-Co-doped-TiO2 capacitor and band structure analysis with X-ray photoelectron spectroscopy shows that leakage current is determined by balancing between thermionic current and tunneling current through Schottky barrier. By doping of Co, the thermionic current decreases, whereas the tunneling current increases. With calculation using theoretical dependence of amount of doped element on leakage current, optimum percentage of Co is estimated as 0.3-0.6 % to achieve a sufficiently low leakage-current. This technology opens possibility to utilize 40-nm DRAM and beyond.

Humanized mice with a functional human immune system would be very useful for in vivo studies of human immunobiology. We have previously shown that cotransplantation of human fetal thymus/liver tissues and CD34+ fetal liver cells into immunodeficient nonobese diabetic severe combined immunodeficiency (NOD/SCID) mice leads to the development of multiple lineages of human lymphohematopoietic cells and formation of secondary lymphoid organs with normal architecture. Here, we evaluated the ability of these humanized mice to develop antigen-specific, T cell–dependent antibody responses after in vivo immunization with T-dependent antigen, 2,4-dinitrophenyl hapten-keyhole limpet hemocyanin (DNP23-KLH). Human T cells from DNP23-KLH–immunized mice showed strong proliferation in response to KLH in vitro. Furthermore, T cell–dependent production of DNP-specific human antibodies (mainly IgG1 and IgG2) was detected in all immunized mice. These results confirm that a functional human immune system can be established in immunodeficient mice through cotransplantation of human fetal thymus/liver tissues and CD34+ hematopoietic stem/progenitor cells.

Studies of the human immune system have been limited by the lack of an appropriate in vivo model. For this reason, efforts have been made to develop murine models with a functional human immune system. We report here that cotransplantation of human fetal thymus/liver tissues and CD34+ hematopoietic stem/progenitor cells led to the development of sustained human hematopoiesis and a functional human immune system in immunodeficient NOD/SCID mice. The humanized mice showed systemic repopulation with a comprehensive array of human lymphohematopoietic cells, including T cells, B cells, and dendritic cells, and the formation of secondary lymphoid organs. Furthermore, these mice produce high levels of human IgM and IgG antibodies and mediate strong immune responses in vivo as demonstrated by skin xenograft rejection. Thus, the humanized NOD/SCID mice described in this paper provide a powerful model system to study human immune function.

Studies of the human immune system have been limited by the lack of an appropriate in vivo model. For this reason, efforts have been made to develop murine models with a functional human immune system. We report here that cotransplantation of human fetal thymus/liver tissues and CD34+hematopoietic stem/progenitor cells led to the development of sustained human hematopoiesis and a functional human immune system in immunodeficient NOD/SCID mice. The humanized mice showed systemic repopulation with a comprehensive array of human lymphohematopoietic cells, including T cells, B cells, and dendritic cells, and the formation of secondary lymphoid organs. Furthermore, these mice produce high levels of human IgM and IgG antibodies and mediate strong immune responses in vivo as demonstrated by skin xenograft rejection. Thus, the humanized NOD/SCID mice described in this paper provide a powerful model system to study human immune function.

We have investigated the vortex dynamics for the ‘ratchet’ operation in a niobium superconductor via a direct imaging of Lorentz microscopy. We directly observe one-directional selective motion of field-gradient-driven vortices along fabricated channels. This results from the rectification of vortices in a spatially asymmetric potential under the oscillating magnetic field in a temporally symmetric manner. Based on the observation of the individual motion of vortices, we clarify the elementary process involved in this rectification.