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Shear experiments on mortise and tenon joints with top and bottom notches in the beam end were conducted with the length of the tenon as a variable. In addition, material experiments were performed to investigate the structural performance of the fracture modes of the joint. The experimental results show that when the lower notch at the beam end experiences splitting, the shear forces were identical for different tenon lengths and did not decrease. In addition, the deformation performance of the joint up to yielding was largely due to the compressive deformation perpendicular to the grain of the wood on the sides of the tenon. Based on the theory of the calculation method of the splitting strength of a notched beam, a formula for the splitting strength when the end of the beam is moment-resisting was proposed. It was confirmed that the proposed formula could estimate the shear force that caused the splitting fracture of the lower notch. In addition, the increase in shear force after the lower notch experienced splitting fracture was due to the increase in clamping force of the beam end due to rotational deformation. [ABSTRACT FROM AUTHOR]

Pregnant women with increased insulin resistance, characterized by elevated levels of tumor necrosis factor-alpha (TNF-α) and insulin-like growth factor-I (IGF-I), are at high risk of preeclampsia. We hypothesized that TNF-α and IGF-I affect the placentas and cause pathological changes leading to preeclampsia. To understand the genetic and epigenetic effects of TNF-α and IGF-I on trophoblast cells, gene expression microarray and DNA methylation array of BeWo cells stimulated by TNF-α (100 pg/ml, 100 ng/ml) and IGF-I (100 ng/ml) were conducted. Microarray analysis revealed the differential gene expression patterns in BeWo cells co-stimulated by TNF-α and IGF-I. Enrichment analysis identified the terms associated with NF-kappa B signaling pathways and arachidonic acid cascades such as PTGS2 and PTGER2. DNA methylation array revealed the distinct CpG methylation pattern in BeWo cells stimulated by high-TNF-α and IGF-I, while neither of them showed independent effects. Enrichment analysis identified the terms associated with major histocompatibility complex proteins. Integration of transcriptome and DNA methylome analyses identified three differentially expressed genes with significant DNA methylation change: C3, GP1BA, and NFKBIE, which are all possibly associated with pathogenesis of preeclampsia. In conclusion, co-stimulation of TNF-α and IGF-I induced the genetic and epigenetic changes associated with preeclampsia in BeWo cells. The results suggested that BeWo cells stimulated by TNF-α and IGF-I is a good in vitro model of preeclamptic placenta in pregnancy with increased insulin resistance. [ABSTRACT FROM AUTHOR]

At various stages of petroleum reservoir development, we encounter a large degree of geological uncertainty under which a rational decision has to be made. In order to identify which parameter or group of parameters significantly affects the output of a decision model, we investigate decision-theoretic sensitivity analysis and its computational issues in this paper. In particular, we employ the so-called expected value of partial perfect information (EVPPI) as a sensitivity index and apply multilevel Monte Carlo (MLMC) methods to efficient estimation of EVPPI. In a recent paper by Giles and Goda, an antithetic MLMC estimator for EVPPI is proposed and its variance analysis is conducted under some assumptions on a decision model. In this paper, for an improvement on the performance of the MLMC estimator, we incorporate randomized quasi-Monte Carlo methods within the inner sampling, which results in an multilevel quasi-Monte Carlo (MLQMC) estimator. We apply both the antithetic MLMC and MLQMC estimators to a simple waterflooding decision problem under uncertainty on absolute permeability and relative permeability curves. Through numerical experiments, we compare the performances of the MLMC and MLQMC estimators and confirm a significant advantage of the MLQMC estimator. [ABSTRACT FROM AUTHOR]

Background: Prognostic clinicopathological factors for type 1 endometrial cancer are unknown and the purpose of the current study was to determine the independent prognostic variables for type 1 endometrial cancer. Methods: We performed a retrospective study of 168 patients with type 1 endometrial cancer primarily treated with comprehensive staging surgery. The median follow-up time was 68 (12-100) months. Independent risk factors for disease-free survival (DFS) and overall survival (OS) were determined using multivariate Cox regression models. Sub-group analysis of stage I was also performed. We also assessed the patterns of failure among patients with recurrences and investigated the associations with the prognostic variables determined by multivariate analysis. Results: Twenty patients (11.9%) had recurrence and 13 patients (7.7%) died of the disease overall. Multivariate analysis revealed that grade 2 (G2) histology ( p = 0.008) and positive peritoneal cytology ( p = 0.001) predicted the recurrent event in type 1 endometrial cancer. G2 histology ( p = 0.007) and positive peritoneal cytology ( p = 0.003) were also found to be independent risk factors for tumor-related deaths. Among stage I patients, G2 histology and positive peritoneal cytology were also independent prognostic variables for DFS and OS. Patients with G2 histology and/or positive peritoneal cytology were more likely to have recurrence at distant sites. Conclusions: G2 histology and positive peritoneal cytology were independent prognostic factors for DFS and OS in type 1 endometrial cancer. [ABSTRACT FROM AUTHOR]

Klippel -Trenaunay -Weber syndrome (KTWS), a congenital disease characterized by cutaneous hemangiomas, soft tissue and bone hypertrophy, and occasionally arteriovenous malformations, is extremely rare and its natural history in utero is unknown. We present a prenatally diagnosed case of KTWS complicated with Kasabach -Merritt syndrome in utero and fetal hydrops from acute anemia. The fetus was diagnosed with KTWS at 24 weeks of gestation based on the ultrasound findings of hemangiomas and unilateral hypertrophy of the lower extremity. Acute enlargement of the hemangiomas and the appearance of new retroperitoneal hemangiomas were detected at 27 weeks, along with skin edema and cardiomegaly. Doppler examination showed elevated peak systolic velocity in the middle cerebral artery, indicating acute fetal anemia. We believe the fetus's condition was complicated with Kasabach -Merritt syndrome in utero, which caused acute hemolytic anemia leading to high-output cardiac failure and fetal hydrops. [ABSTRACT FROM AUTHOR]

We report a case of rapid progression of bilateral pyothorax exacerbated by viral influenza in an infant. The patient, an 11-month-old girl, was diagnosed with viral influenza, and oseltamivir phosphate was administered. However, after only 4 days the influenza was followed by rapid progression of methicillin-susceptible Staphylococcus aureus (MSSA) pneumonia and pyothorax, resulting in disseminated intravascular coagulation. Because thoracentesis and antibiotics could not control the pyothorax, a serious condition, we performed bilateral video-assisted thoracoscopic decortication on the eighth hospital day. She recovered with excellent lung expansion and was discharged on the 37th hospital day. [ABSTRACT FROM AUTHOR]

A 4-year-old boy diagnosed with a double outlet right ventricle with transposition of the great arteries in a discordant atrioventricular connection. The anatomical characteristics of the ventriculoarterial relationships resulting from leftward deviation were quite similar to a mirror image of those in the malformation reported by Patrick and McGoon. Hence, it was most appropriate to perform the double switch operation associated with Patrick-McGoon’s intraventricular rerouting and Senning’s atrial switch. This intraventricular rerouting could be performed without damaging the conduction system because of existence of the anterior node. The cardiac catheterization 1 month after the operation showed no pressure gradient of the new reconstructed left ventricular outflow tract, good left ventricular function and no significant pressure gradient of the right ventricular outflow tract. The patient has been staying in class 1 of New York Heart Association for more than 3 years after the operation. [ABSTRACT FROM AUTHOR]

The preoperative risk characteristics and surgical outcome were reviewed in 24 patients who underwent a one-stage Fontan procedure (One -stage Group) and in 16 patients who underwent bidirectional cavopulmonary shunt as an interim procedure prior to a subsequent Fontan procedure (Two-stage Group) to clarify the role of the staged approach for high-risk Fontan candidates. There were 2 hospital deaths after the one-stage Fontan, and another 2 after the takedown of the fenestrated Fontan to BCPS in patients considered to be less than ideal candidate because of the presence of 3 or more risk factors. In contrast, among the total of 16 patients in the Two-stage Group who had significantly more risk factors than those in One-stage Group (2.8 ± 1.4, vs 1.1 ± 1.2, p < 0.001), 14 patients survived after bidirectional cavopulmonary shunt, and a subsequent Fontan procedure was accomplished in 12 patients of theses 14, with 2 operative deaths after the takedown to bidirectional cavopulmonary shunt The rate of final Fontan completion in the Two-stage Group (10/16, 62.5%) was considered to be reasonable, considering the fact that this patient group essentially includes non-Fontan candidates. Additionally, in the category of high-risk with 3 or more risk factors, the rate of successful Fontan completion was higher in the Two-stage Group than in the One-stage Group (50% vs 25%). In the survivors of the Two-stage Group, the average number of risk factor decreased from 2.7 ± 1.3 (range 0 to 5) to 1.0 ± 1.0 (range 0 to 4) after bidirectional cavopulmonary shunt with concomitant procedures (ie, extended pulmonary artery reconstruction in 8, and repair of atrioventricular valve regurgitation in 4), predominantly due to improved Fontan candidacy, relating to pulmonary and/or ventricular characteristics, and eliminated anatomical risks. In conclusion, the two-stage approach with bidirectional cavopulmonary shunt accompanied by concomitant repair of associated anomaly may be useful to lower the risk enough to allow subsequent Fontan completion in high-risk patients. [ABSTRACT FROM AUTHOR]

14 living flaps in 8 children were used to repair for the congenital heart disease, because artificial material and xeno grafts were shrunk in growing children but living flaps were going to glow with children. It were possible to use the living flaps to reconstruct of pulumonary outflow in truncus arteriosus, for septoplasty in partial anomarous of pulumonary venous return and reconstruction of unloofed coronary sinus in endcardial defect with triatriatum and intra-atrial tunnel in TCPC or Fontan type operation. [ABSTRACT FROM AUTHOR]

In the original publication of the article, the author names were abbreviated in the author group. The corrected list of author names is presented above. [ABSTRACT FROM AUTHOR]

Acute pulmonary thromboembolism in a patient who had undergone bidirectional Glenn anastomosis was treated by percutaneous selective intravascular thrombolysis. A 20-year-old woman was diagnosed with pulmonary stenosis and right ventricular hypoplasia, complete occlusion of the left pulmonary artery secondary to a Blalock-Taussig shunt, and atrial septal defect. The patient developed thromboembolism of the subsegmental branches of the right pulmonary artery resulting in critical hemodynamic deterioration 2 weeks after undergoing one and a half ventricle repair (bidirectional Glenn shunt). The patient was treated with tissue plasminogen activator administered directly into the right pulmonary artery via an intravascular cathe. Progressive recanalization of the obstruction began immediately. Pulmonary angiography 3 months after thrombolytic therapy demonstrated patent subsegmental vessels. Early detection of the pulmonary thromboembolism and prompt intervention are crutial to relieving this fatal complication after a Fontan operation. [ABSTRACT FROM AUTHOR]