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Background Skin rash often occurs upon oral administration of amoxicillin in children, due to non-immediate hypersensitivity. However, information on delayed hypersensitivity to amoxicillin is scarce. Moreover, the appropriate diagnostic method and actual diagnostic rate of delayed hypersensitivity to amoxicillin among Japanese children are unclear. We conducted intradermal tests (IDTs) and drug provocation tests (DPTs) and retrospectively investigated the proportion of children with a definitive diagnosis of non-immediate hypersensitivity to amoxicillin. We then evaluated the characteristics of patients with a positive allergic workup. Methods We enrolled children referred for suspected findings of mild or moderate non-immediate hypersensitivity to amoxicillin between August 2018 and March 2020. If the IDT in the delayed phase was negative, DPT with amoxicillin (60–90 mg/kg/day) was performed for 7 days. Non-immediate hypersensitivity to amoxicillin was defined when IDT or DPT was positive. We evaluated the potential of the drug-induced lymphocyte stimulation test (DLST) to reveal hypersensitivity to amoxicillin. Results This study enrolled 27 children. Fourteen children (52%) had hypersensitivity to amoxicillin, of whom 12 had positive IDTs and two had positive DPTs. No differences in age, sex, history of allergic disease, days from oral use to symptom onset, type of rash at symptom onset, generalized rash, and DLST results were observed between the hypersensitivity and non-hypersensitivity groups. Conclusions Examination should be performed for children with mild or moderate reactions because positive cases have no significant features and half of the suspected cases are negative.

Multiple physical properties are simultaneously optimized in the development of functional materials. However, it is difficult to satisfy all of the demand for physical properties because trade-offs are among multiple characteristics. To overcome this problem, we propose machine learning incorporating the concept of deviation value in this study. In our case, we optimized the monomer mixing ratio in polyurethane film by predicting an index that integrates multiple physical properties. We compared the number of trials required for improving the performance of thin films between that performed by the experimentalist and that by machine learning. As a result, we confirmed that the artificial intelligence (AI) model successfully found the high-performance films by a lower number of trials.

A multilayer depth-of-interaction positron emission tomography (DOI-PET) detector with an independent readout structure has a potential advantage as a time-of-flight (TOF)-PET detector. To evaluate the potential TOF capabilities of a multilayer DOI-PET detector, which consists of thin layers of a cerium-doped lutetium-yttrium oxyorthosilicate (LYSO:Ce) scintillator coupled to a multi-pixel photon counter (MPPC) array, we examined the detector's CTR performance via Monte Carlo simulations. We used several types of scintillator structures: a monolithic plate, laser-processing array with 3.2-mm pitch, fine laser-processing array with 1.6-mm pitch, and pixelated array with 3.2-mm pitch, with 2-, 4-, 6-, and 8-mm thickness values. Here, we note that the CTR performance also significantly depends on the timing-detection method, which generates a timing trigger signal for coincidence detection. Thus, we evaluated the CTRs for each scintillator structure by adopting four timing-detection methods: using the total sum signal of MPPC chips (T_sum), the maximum signal in the MPPC chips (Max), the sum signal of a partial number of MPPC chips located at and in the vicinity of the -ray interaction position (P_sum), and the average of the timestamps generated at several MPPC chips (Ave). When using the T_sum for timing detection, the CTR full width at half-maximum (FWHM) values were ~100 ps regardless of the scintillator structure. However, when using the Max signal approach, the CTRs of the monolithic plates, laser-processing arrays, and fine-pitch laser-processing arrays were drastically degraded with increasing thickness. On the other hand, the CTRs of the pixelated arrays exhibited almost no degradation. To improve the CTRs of the monolithic plate and the (fine pitch) laser-processing array that exhibit a large light spread in the scintillator block, we applied the P_sum and Ave methods. The resulting CTRs significantly improved upon using P_sum; however, the Ave approach only worked for thicknesses of >6 mm.

BACKGROUND Despite the powerful myocardial protection of ischemic preconditioning (IP) observed in experimental studies, it remains a challenge to observe such protection in humans. Thus, the aim of this study was to evaluate the possible effects of IP on clinical outcomes in patients with coronary artery disease (CAD). PATIENTS AND METHODS In this cohort study, patients with multivessel CAD, preserved systolic ventricular function, and stable angina were prospectively selected. They underwent two sequential exercise stress tests (EST) to evaluate IP presence. IP was considered present if patients had an improvement in the time to the onset of 1.0-mm STsegment deviation in the second EST. The primary end point was the composite rate of cardiac death, nonfatal myocardial infarction, or revascularization during 1-year follow-up. Patients with (IP+) and without (IP-) the cardioprotective mechanism were compared regarding clinical end points. RESULTS A total of 229 patients completed EST and had IP evaluated: 165 (72%) were IP+ and 64 (28%) were IP - patients. Of these, 218 patients had complete follow-up. At 1-year, event-free survival regarding the primary end point was 95.5 versus 83.6% (P = 0.0024) and event-free survival regarding cardiac death or myocardial infarction was 99.4 versus 91.7% (P=0.0020), respectively, in IP + and IP - groups. The unadjusted hazard ratio (IP + /IP-) for the primary end point was 4.63 (1.52-14.08). After multivariate analysis, IP was still significantly associated with better clinical outcomes (P = 0.0025). CONCLUSION This data suggest that IP may contribute to better clinical outcomes in patients with ischemic heart disease.

Ca-Mg-Si films were firstly prepared on (001)Al2O3 substrates by RF-magnetron sputtering method from Mg disc target together with Ca and Si chips. The composition of the deposited films was controlled by adjusting deposition temperature and Ca/Si area ratio of Ca and Si chips on Mg disk target. Ca0.32Mg0.33Si0.35 film deposited at 610 K consisted of a single phase of CaMgSi and this CaMgSi phase was stable after heat treated at 770 K under an atmospheric Ar with 5% -H2. As-deposited film shows the semiconductor behavior and have a power factor of 50 µW/(mK2) at 670 K, while annealed one showed the metallic behavior and its power factor down below 10 µW/(mK2) at 320-770 K. On the other hand, Ca0.27Mg0. 51Si0.2 film deposited at 590 K showed no obvious crystalline phase but became single phase of Ca7Mg7.25Si14 after heat treatment at 770 K under an atmospheric Ar with 5% -H2. As deposited film had a large power factor of 100 µW/(mK2) at 670 K. However, power factor decreased below 1 µW/(mK2) at 320-770K after the heat treatment at 770 K under an atmospheric Ar with 5% -H2.

Highlights • Ultrasonography or CT guided biopsy is useful for diagnosis of liver tumors. • Some tumors were not detectable with any modality except only MRI. • 3D simulation liver imaging can be created with CT and MRI images. • Excisional biopsy using preoperative 3D simulation could provide a certain biopsy. • Present biopsy method is effective for tumors that cannot be detected by CT or US., Introduction The imaging diagnostics of liver tumor are difficult. There are no effective biopsy examinations for liver tumors that cannot be detected even by ultrasonography (US) and computed tomography (CT). We report a remarkably useful biopsy method for such tumors. Presentation of case A 67-year-old man with hepatitis C underwent gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging, and the images revealed multiple delayed enhanced masses that showed high signal intensity in the hepatobiliary phase. The possibility of malignancy could not be ruled out due to the trend towards increased size of the masses. Percutaneous liver biopsy was considered impossible because CT and US could not detect the masses. Laparoscopic liver biopsy with preoperative simulation using 3D imaging was performed. The 3D imaging provided accurate information of liver surface irregularities with cirrhosis change. The tumor location was confirmed, and adequate tumor excisional biopsy was performed. Histological assessment revealed the tumor to be a focal nodular hyperplasia-like nodule. Discussion and conclusions Laparoscopic liver biopsy has been widely used because of its safety and accuracy. It enables accurate resection of tumors that are undetectable with CT and US by employing preoperative 3D imaging while maintaining the less-invasiveness.

Introduction Although endometriosis is a benign disease, it shares some features with cancers, such as invasiveness and the potential to metastasize. This study sought to investigate the epithelial-mesenchymal transition status in human endometriotic lesions. Material and methods Thirteen endometriosis patients and 10 control women without endometriosis undergoing surgery for benign indications were recruited. We examined the expression of E-cadherin, vimentin, and epithelial-mesenchymal transition-induced transcriptional factors, such as Snail and ZEB1, by immunohistochemistry. We evaluated the expression of each marker in epithelial cells of both endometriotic lesions (ovarian endometrioma, deep infiltrating endometriosis, adenomyosis) and normal endometria. The correlation between ZEB1 expression and serum level of CA125 was also investigated. Results Immunohistochemical analysis revealed that although E-cadherin, vimentin, and Snail were expressed in epithelia of normal endometria and endometriotic lesions, ZEB1 expression was only expressed in epithelia of endometriotic lesions. Additionally, ZEB1 was most frequently observed in epithelial cells of invasive endometriosis. The endometriosis patients with high serum CA125 level were more likely to have ZEB1-positive lesions. Conclusion This is the first observation of ZEB1 expression in epithelial cells of benign disease. The preferential expression of ZEB1 in epithelial cells of endometriotic lesions suggests that these cells may have, at least in part, a higher level of mesenchymal features possibly via ZEB1-driven epithelial-mesenchymal transition than normal endometria and that ZEB1 can be a potential indicator of invasiveness or severity of endometriosis.

Aim Because subclinical hypothyroidism (thyroid-stimulating hormone [TSH] > 4.5 IU/mL) is associated with adverse pregnancy outcome, including early pregnancy loss, TSH is recommended to be titrated to ≤2.5 mIU/L in levothyroxine-treated women before pregnancy. The purpose of this study was to determine whether borderline–subclinical hypothyroidism (borderline-SCH; 2.5 < TSH ≤ 4.5 IU/mL) affects the outcome of subsequent pregnancies in women with unexplained recurrent pregnancy loss (uRPL). Methods After workup for antinuclear antibody (ANA), anti-phospholipid syndrome, thrombophilia, uterine abnormalities, hormone disorders, and/or chromosomal abnormalities, 317 women with a history of uRPL were enrolled. The women were classified into two groups: borderline-SCH, and euthyroidism (0.3 ≤ TSH ≤ 2.5 IU/mL). All women had normal serum free thyroxine (T4) and did not receive levothyroxine before or during the subsequent pregnancy. Results There were no significant differences in age, number of previous pregnancy losses, number of live births, or body mass index between the borderline-SCH (n = 56) and the euthyroid (n = 261) groups, but the rate of ANA positivity differed significantly (53.6% vs 33.7%, respectively; P = 0.005). The subsequent pregnancy rate did not differ between the two groups (55.4%, 31/56 vs 51.3%, 134/261, respectively). The pregnancy loss rate (

© 2019 Levin, Bett, Gates, Heimbach, Howe, Janssen, McCurdy, Ruhl, Snelgrove, Stocks, Bailey, Baumann-Pickering, Beaverson, Benfield, Booth, Carreiro-Silva, Colaço, Eblé, Fowler, Gjerde, Jones, Katsumata, Kelley, Le Bris, Leonardi, Lejzerowicz, Macreadie, McLean, Meitz, Morato, Netburn, Pawlowski, Smith, Sun, Uchida, Vardaro, Venkatesan and Weller. The deep ocean below 200 m water depth is the least observed, but largest habitat on our planet by volume and area. Over 150 years of exploration has revealed that this dynamic system provides critical climate regulation, houses a wealth of energy, mineral, and biological resources, and represents a vast repository of biological diversity. A long history of deep-ocean exploration and observation led to the initial concept for the Deep-Ocean Observing Strategy (DOOS), under the auspices of the Global Ocean Observing System (GOOS). Here we discuss the scientific need for globally integrated deep-ocean observing, its status, and the key scientific questions and societal mandates driving observing requirements over the next decade. We consider the Essential Ocean Variables (EOVs) needed to address deep-ocean challenges within the physical, biogeochemical, and biological/ecosystem sciences according to the Framework for Ocean Observing (FOO), and map these onto scientific questions. Opportunities for new and expanded synergies among deep-ocean stakeholders are discussed, including academic-industry partnerships with the oil and gas, mining, cable and fishing industries, the ocean exploration and mapping community, and biodiversity conservation initiatives. Future deep-ocean observing will benefit from the greater integration across traditional disciplines and sectors, achieved through demonstration projects and facilitated reuse and repurposing of existing deep-sea data efforts. We highlight examples of existing and emerging deep-sea methods and technologies, noting key challenges associated with data volume, preservation, standardization, and accessibility. Emerging technologies relevant to deep-ocean sustainability and the blue economy include novel genomics approaches, imaging technologies, and ultra-deep hydrographic measurements. Capacity building will be necessary to integrate capabilities into programs and projects at a global scale. Progress can be facilitated by Open Science and Findable, Accessible, Interoperable, Reusable (FAIR) data principles and converge on agreed to data standards, practices, vocabularies, and registries. We envision expansion of the deep-ocean observing community to embrace the participation of academia, industry, NGOs, national governments, international governmental organizations, and the public at large in order to unlock critical knowledge contained in the deep ocean over coming decades, and to realize the mutual benefits of thoughtful deep-ocean observing for all elements of a sustainable ocean.

We propose a novel scintillation detector design for positron emission tomography (PET), which has depth of interaction (DOI) capability and uses a single-ended readout scheme. The DOI detector contains a pair of crystal bars segmented using sub-surface laser engraving (SSLE). The two crystal bars are optically coupled to each other at their top segments and are coupled to two photo-sensors at their bottom segments. Initially, we evaluated the performance of different designs of single crystal bars coupled to photomultiplier tubes at both ends. We found that segmentation by SSLE results in superior performance compared to the conventional method. As the next step, we constructed a crystal unit composed of a 3 × 3 × 20 mm3 crystal bar pair, with each bar containing four layers segmented using the SSLE. We measured the DOI performance by changing the optical conditions for the crystal unit. Based on the experimental results, we then assessed the detector performance in terms of the DOI capability by evaluating the position error, energy resolution, and light collection efficiency for various crystal unit designs with different bar sizes and a different number of layers (four to seven layers). DOI encoding with small position error was achieved for crystal units composed of a 3 × 3 × 20 mm3 LYSO bar pair having up to seven layers, and with those composed of a 2 × 2 × 20 mm3 LYSO bar pair having up to six layers. The energy resolution of the segment in the seven-layer 3 × 3 × 20 mm3 crystal bar pair was 9.3%–15.5% for 662 keV gamma-rays, where the segments closer to the photo-sensors provided better energy resolution. SSLE provides high geometrical accuracy at low production cost due to the simplicity of the crystal assembly. Therefore, the proposed DOI detector is expected to be an attractive choice for practical small-bore PET systems dedicated to imaging of the brain, breast, and small animals.

A novel depth-of-interaction (DOI) detector with a single-ended readout was proposed previously. Each crystal unit of the detector consisted of a U-shaped transform of a dual-ended readout detector constructed using scintillator pillars segmented by sub-surface laser engraving (SSLE), and two multi-pixel photon counters (MPPCs) were coupled at the bottom of the crystal unit. In this work, we applied a single-ended readout DOI to an MPPC module for positron emission tomography (PET) manufactured by HAMAMATSU Photonics K.K., which resulted in a more compact DOI detector than that proposed previously. Using the block detector, practical six-layer DOI information was obtained. The average energy resolution of the crystal unit was 10.9%, and the timing resolution of the six-layer DOI was 224–389 ps FWHM.

YO1.5-doped HfO2 films were deposited on yttria-stabilized zirconia substrates by RF magnetron sputtering at room temperature and under various atmosphere conditions. The deposited films were treated by rapid thermal annealing under both O2 and N2 flows. Epitaxial films with the orthorhombic phase, which is expected to exhibit ferroelectricity, are obtained under all conditions. The deposition in Ar atmosphere provided good ferroelectricity, while the deposition with O2 resulted in a low breakdown voltage inhibiting ferroelectricity. Current density–voltage characteristics show a significant increase in leakage current by the deposition in atmosphere containing O2 and also annealing under O2 flow. These results indicate that the treatment in atmosphere containing O2 leads to the degradation of insulation properties.

Large-dose cyclic tidal peritoneal dialysis (TPD) is an original prescription of TPD involving frequent infusion and drainage of the dialysate to increase weekly urea clearance normalized to total body water (Kt/Vurea ) and fluid removal. This study aimed to evaluate the efficiency of solute clearance and fluid removal achieved with large-dose cyclic TPD compared to that achieved with nightly peritoneal dialysis (NPD). Seventeen patients with end-stage renal disease, for whom maintenance PD was changed from NPD to large-dose cyclic TPD, were enrolled. Their median age at administration of PD was 4.9 years. Kt/Vurea and fluid removal were compared between large-dose cyclic TPD and NPD. The median peritoneal Kt/Vurea achieved with NPD and large-dose cyclic TPD was 1.5 and 2.7, respectively. The median peritoneal Kt/Vurea per hour with large-dose cyclic TPD was significantly higher than that with NPD (P = 0.0003). Among nine patients who used dialysates with the same glucose concentration for both NPD and large-dose cyclic TPD, nightly fluid removal amount per hour with large-dose cyclic TPD was significantly higher than that with NPD (P = 0.0039). Large-dose cyclic TPD is a useful prescription of PD for increasing Kt/Vurea and fluid removal.

In this study, we combined silver nanowires with cupro fabrics using a dipping-drying method to prepare electrically conductive fabrics. The silver nanowires were first adhered to and then absorbed by microfibers to form electrically conductive fibers. They also filled the gaps and spaces between the microfibers, and were stacked or piled together to form networks with high electrical conductivity. The electrically conductive fabric had low resistance and good stretchability, e.g., 0.0047–0.0091 Ω in the strain range of 0–190%. They also exhibited stable electrical conductivity, as well as excellent flexibility, which remained even when the fabric was stretched, shrunk, or bent. The results show that the electrically conductive fabric can be used as a smart textile, especially in fields associated with weaving, clothing, food products, lifestyle products, medicine, biology, electronics, aviation, and military equipment and accessories.

The present reconstruction method of Atom Probe Tomography (APT) has the problem that the parameter, in particular the shank angle which represents the region the signal of APT is detectable, is adjusted according to the internal length reference of the sample. The reliable APT reconstruction image could not be obtained in the sample without the reference. We propose the method to calculate the value of the shank angle from the shape of sample and the geometric position relationship between the sample and the detector. We compared the APT reconstruction image in this method to the image in the conventional method with the sample of Si isotope superlattice. The result is that APT 3D image by the new method was reconstructed equivalently to the image by the conventional method. [DOI: 10.1380/ejssnt.2015.235]

Transparent electrodes based on silver nanowire (AgNW) films have attracted considerable attention owing to their high electrical and thermal conductivity, optical transparency, and flexibility. However, the long-term reliability of AgNW electrodes, has seldom been studied. In this work, the effects of storage environment, such as, natural light and humidity, on the long-term reliability have been investigated in detail. The increase of electrical resistance with storage time greatly depended on the natural light illumination, especially ultraviolet (UV) illumination, and high humidity seriously accelerated the failure of AgNW electrodes. All the results were dependent on the storage temperature. Some over-coating layers have been used to protect the AgNW electrodes from light and humidity in environment and the results showed that an epoxy resin protecting layer exhibited the longest lifetime: over 40 days at 85 °C and 85% relative humidity.

In this paper, a novel vibration isolator based on a foldable cylinder with a torsional buckling pattern, which is also called Kresling's pattern, is proposed, and the performance of the proposed isolator in terms of preventing structural vibration is numerically evaluated. It is known that foldable cylinders with a torsional buckling pattern provide bistable folding motions under specific conditions. For simplification, a foldable cylinder with a torsional buckling pattern is modeled using horizontal, longitudinal, and diagonal truss elements connected by rotational joints and enforced by rigid frames, which are also called Rahmen, while maintaining the bistability of the structure. Additional linear springs are incorporated into the structure in order to obtain a nonlinear spring with quasi-zero-stiffness characteristics. It is numerically established that: (i) the resonance of the combined structure is effectively suppressed and (ii) the structure decreases the vibration response even at high frequencies when it is used around the equilibrium position at which the spring stiffness is quasi-zero.

Highlights • Very few studies have reported anastomotic strictures occurring soon after colectomy. No established treatment is available. • We describe our experience with a patient who had bowel obstruction due to an anastomotic stricture 12 days after colectomy. • Steroid local therapy has been reported to be effective when combined with gastrointestinal endoscopic treatment. However, few studies have reported on anastomotic strictures of the colorectum. • Transanal decompression therapy and local steroid therapy promptly improved symptoms in a patient with an anastomotic stricture of the colon. • Transanal decompression therapy combined with local steroid therapy may improve anastomotic strictures occurring soon after colectomy., Introduction Anastomotic strictures occurring after colectomy are a most challenging postoperative complication for gastroenterological surgeons. Reports documenting anastomotic strictures developing in the early postoperative phase are scant, and no established treatment is available. Presentation of case A 78-year-old man who had undergone a laparoscopic left hemicolectomy for lower colon cancer presented on postoperative day 12 because of abdominal pain and no bowel movement. Endoluminal decompression was performed with a transanal decompression tube, and local steroid treatment was administered by concurrent intralesional steroid injection (ILe-SI) and intraluminal steroid instillation (ILu- SI). The anastomotic stricture promptly improved. The patient recovered uneventfully, with no recurrence of anastomotic stricture. Discussion A transanal decompression tube should be inserted and placed in a cautious manner within a short period of time. ILe-SI in the large intestine requires an understanding of potential adverse events and complications, as well as fully informed consent from the patient. ILu-SI has been reported to be an effective treatment for the management of strictures in various regions. To the best of our knowledge, however, this is the first report to document the treatment of an anastomotic stricture of the colorectum by ILu-SI. Conclusion Transanal decompression therapy combined with local steroid local treatment might promptly improve anastomotic strictures occurring after colectomy.

We report a case of Morgagni hernia in which the patient underwent laparoscopic mesh repair. A 65-year-old woman presented with an abnormal shadow in the right lower lung field on a routine medical checkup. CT showed that the transverse colon passed between the liver and abdominal wall, and herniated into the thoracic cavity. Simple closure was precluded by the large hernial orifice. We therefore performed laparoscopic repair using a Parietex Optimized Composite Mesh. The double-crown technique was used to fix the margin of the mesh to the region around the hernial orifice. Our procedure for repair of a Morgagni hernia with a large hernial orifice is safe and minimally invasive, and it may effectively prevent recurrence.

Shave-off depth profiling uses a Ga focused ion beam micro-machining process to provide highly precise depth profiles with nanometer-scale resolution. This method is a very unique process for acquiring a depth profile using the shave-off scan mode, in which the primary ion beam perpendicular to the direction of depth irradiates the sample. In our previous study, we confirmed by molecular dynamics simulation that the shave-off scan mode has a low mixing effect compared with the conventional scan mode, which uses the normal incident angle. However, the current understanding of measurement using the shave-off scan mode is insufficient. In this study, in order to estimate the sample damage in the shave-off scan mode, we investigated the degree of mixing effects after the primary ion bombardment under shave-off conditions using atom probe tomography. To evaluate the mixing effects, the intermixing of silicon isotope multilayers induced by ion beam irradiation was investigated. The depth of the damage from the sample surface caused by Ga focused ion beams was analyzed for both the shave-off scan mode and the conventional scan mode using the normal incident angle. Results showed that the shave-off scan mode has a significantly smaller mixing effect thanthe conventionalscanmode. Inaddition, results showed that the attenuations of the damage and the Ga concentration exhibited almost the same tendency. Copyright © 2014 John Wiley & Sons, Ltd.

To avoid high temperatures and long curing times, both of which are impractical in the manufacture of flexible printed electronic devices, we fabricated new electrically conductive adhesives using vinyl ester resin and silver micro-flakes and introduced an intense pulse of light to cure the adhesives under an ambient atmosphere at room temperature. The electrically conductive vinyl ester resin–silver micro-flake adhesives can absorb intense pulsed light, which initializes the double bonds in the resin to successfully achieve crosslinking and curing. This curing process, known as photonic curing, can be completed within a second under an ambient atmosphere at room temperature, over a large area. A typical curing time was 140 ms without any photosensitizers or photoinitiators in the adhesives. The cured conductive adhesives had low bulk resistivity, e.g., 7.54 × 10−6 Ω cm and high bonding strength, e.g., 6.75 MPa. Thus, the combination of photonic curing and electrically conductive vinyl ester resin–silver micro-flake adhesives has great potential for printed electronics, which require low temperature and fast processes based on flexible devices.

A new detector module for positron emission tomography using multi-pixel photon counters (MPPCs) was developed. The detection area is 40 mm × 40 mm using an 8 × 8 MPPC array. The active area of each MPPC is 3 mm × 3 mm. The detector module contains preamplifiers, digital-to-analog converters for setting the bias offset, a 2D resistor network for position encoding, a high-voltage module, a temperature sensor, and embedded microprocessor units. Since the MPPC gain depends on temperature, compensation was performed by varying the bias voltage. Two kinds of flood images of an 8 × 8 array (5-mm pitch) and a 32 × 32 (1.25-mm pitch) array were acquired and examined. The timing resolution and the effect of dark counts were evaluated. With a reference detector consisting of a BaF2 crystal coupled to a PMT, the timing resolution was 354 ps when a single 5 mm × 5 mm × 20 mm LYSO scintillator was coupled to one MPPC channel. However, the time resolution of the array deteriorated because of the increase in dark counts.

Nerve growth factor (NGF) has been recently proposed as one of the key factors responsible not only for promotion of nerve fiber growth but also for the onset and maintenance of pain in a variety of diseases. The aim of this study was to investigate the role of NGF in the pelvic pain associated with endometriosis. Tissue and peritoneal fluid samples were collected from 95 women with laparoscopically and histopathologically confirmed endometriosis and 59 control women without endometriosis. Expression levels of NGF mRNA and protein were examined using real-time RT-PCR and immunohistochemistry, respectively. Concentration of NGF in the peritoneal fluid (PF-NGF) was measured using ELISA. The degree of dyspareunia and dysmenorrhea was evaluated using a verbal rating scale. Real-time RT-PCR analysis revealed that NGF mRNA was significantly more abundant in the ovarian endometriomas and peritoneal endometriosis than in the normal control endometrium. Immunohistochemical analyses demonstrated that NGF was prominently expressed and preferentially localized to the glands of the ovarian endometriomas and peritoneal endometriosis, whereas it was only weakly detectable in the normal endometrium. Although PF-NGF was undetectable in some normal subjects and endometriosis patients, elevated PF-NGF in the peritoneal fluid was more frequently observed in endometriosis patients with severe pain than in those with less severe pain. Our results suggest that NGF produced locally in the peritoneal cavity may be involved in the generation of endometriosis-associated pelvic pain.

In this study, the growth of (111)-oriented epitaxial and textured YO1.5-HfO2 (0.07:0.93 ratio) films using the pulsed laser deposition method is presented. Epitaxial films were prepared on ITO//(111)yttria-stabilized zirconia (YSZ) substrates (ITO: Sn-doped In2O3; YSZ: yttria-stabilized zirconia), while textured films were prepared on (111)Pt/TiOx/SiO2//Si substrates with and without an ITO buffer layer via the grain on grain coherent growth. Inserting an ITO layer increased the volume fraction of the ferroelectric orthorhombic phase. Both the epitaxial and uniaxially textured films exhibited similar ferroelectricity with a remanent polarization of around 10 μC/cm2 and a coercive field of 1.9 to 2.0 MV/cm. These results present us with a way of obtaining stable and uniform ferroelectric properties for each grain and device cells consisting of a small number of grains. This opens the door for ultimately miniaturized ferroelectric devices, such as ferroelectric field effect transistors with small gate leng...

Cervical pregnancy is a rare form of ectopic pregnancy (Parente et al. 1983), with an incidence of 0.15%. This disease sometimes results in life-threatening condition due to massive or unrelenting ...

FUNDAMENTO: A necessidade de melhorar a acurácia do teste de esforço, determinou o desenvolvimento de escores, cuja aplicabilidade já foi amplamente reconhecida. OBJETIVO: Avaliação prognóstica do coronariopata estável através de um novo escore simplificado. MÉTODOS: Um novo escore foi aplicado em 372 coronariopatas multiarteriais e função ventricular preservada, 71,8% homens, idade média 59,5 (± 9,07) anos, randomizados para angioplastia, revascularização cirúrgica e tratamento clínico, acompanhados por 5 anos. Óbito cardiovascular foi o desfecho primário. Infarto do miocárdio não-fatal, óbito e re-intervenção formaram o desfecho combinado secundário. O escore baseou-se numa equação previamente validada resultante da soma de 1 ponto para: sexo masculino, história de infarto, angina, diabete, uso de insulina e ainda 1 ponto para cada década de vida a partir dos 40 anos. Teste positivo adicionou 1 ponto. RESULTADOS: Ocorreram 36 óbitos (10 no grupo angioplastia, 15 no grupo revascularização e 11 no grupo clínico), p = 0,61. Observou-se 93 eventos combinados: 37 no grupo angioplastia, 23 no grupo revascularização e 33 no grupo clínico (p = 0,058). 247 pacientes apresentaram escore clínico > 5 pontos e 216 > 6 pontos. O valor de corte > 5 ou > 6 pontos identificou maior risco, com p = 0,015 e p = 0,012, respectivamente. A curva de sobrevida mostrou uma incidência de óbito após a randomização diferente naqueles com escore > 6 pontos (p = 0,07), e uma incidência de eventos combinados diferente entre pacientes com escore < 6 e > 6 pontos (p = 0,02). CONCLUSÃO: O novo escore demonstrou consistência na avaliação prognóstica do coronariopata estável multiarterial. BACKGROUND: The need to improve the exercise testing accuracy, pushed the development of scores, whose applicability was already broadly recognized. OBJECTIVE: Prognostic evaluation of stable coronary disease through a new simplified score. METHODS: A new score was applied in 372 multivessel coronary patients with preserved ventricular function, 71.8% male, age: 59.5 (± 9.07) years old, randomized to medical treatment, surgery (CABG) or angioplasty (PTCA), with 5 years of follow-up. Cardiovascular death was considered the primary endpoint. Non-fatal myocardial infarction, death and re-intervention were considered for a combined secondary endpoint. The score was based on an equation previously validated, resulting from a sum of one point for: male gender, infarction history, angina, diabetes, insulin use and one point for each decade of life after 40 years old. Positive exercise testing summed one additional point. RESULTS: Thirty six deaths was observed (10 in group PTCA, 15 in CABG and 11 in the clinical group), p = 0.61. We observed 93 combined events: 37 in PTCA group, 23 in CABG and 33 in the clinical group (p = 0.058). 247 patients presented clinical score > 5 points and 216 > 6 points. The cutoff point > 5 or > 6 points identified higher risk, p = 0.015 and p = 0.012, respectively. The survival curve showed a different death incidence after the randomization when score reached 06 points or more (p = 0.07), and a distinct incidence of combined events between the patients with score < 6 and > 6 points (p = 0.02). CONCLUSION: The new score was consistent for multiarterial stable coronary disease risk stratification. FUNDAMENTO: La necesidad de mejorar la exactitud de las pruebas de estrés, determinó el desarrollo de los puntajes, cuya aplicación fue ampliamente reconocida. OBJETIVO: La evaluación pronóstica del coronariópata estable a través de un nuevo score simplificado. MÉTODOS: Un nuevo score se aplicó en 372 coronariópatas multiarteriales y función ventricular preservada, el 71,8% varones, edad media de 59,5 (± 9,07) años, randomizados para angioplastia, revascularización quirúrgica y tratamiento clínico, seguidos de cinco años. Muerte cardiovascular fue el resultado primario. El infarto de miocardio no fatal, la muerte y la re-intervención formaron el desenlace combinado secundario. El score se basó en una ecuación previamente validada resultante de la suma de 1 punto a: sexo masculino, antecedentes de infarto, angina, diabetes, uso de insulina y todavía un punto por cada década de vida después de 40 años. Prueba positiva añadida 1 punto. RESULTADOS: Hubo 36 muertes (10 en el grupo de angioplastia, 15 en el grupo de revascularización y 11 en el grupo clínico), p = 0,61. Se observó 93 eventos combinados: 37 en el grupo angioplastia, 23 en el grupo revascularización y 33 en el grupo clínico (p = 0,058). Presentaron score clínico > 5 puntos y 216 > 6 puntos 247 pacientes. El valor de corte > 5 o > 6 puntos identificó un mayor riesgo, con p = 0,015 y p = 0,012, respectivamente. La curva de sobrevida mostró una incidencia de muerte después de la aleatorización que aquellos con score > 6 puntos (p = 0,07), y una incidencia de eventos combinados diferentes entre los pacientes con score < 6 y > 6 puntos (p = 0,02). CONCLUSIÓN: El nuevo score demostró consistencia en la evaluación pronóstica del coronariópata estable multiarterial. (Arq Bras Cardiol 2011;96(5):411-419)

Several publications considering anatomical, histological, pathological, electrocardiographic, vectorcardiographic, and electrophysiologic studies have shown that the left bundle branch splits into three fascicles or in a "fan-like interconnected network" in the vast majority of human hearts. The left His system is trifascicular with a left anterior, a left posterior, and a left septal fascicle (LSF). Consequently, the classic term "hemiblock," to describe the block of one of the fascicles, established several decades ago by the Rosembaum's school, should be updated. Electrovectorcardiographic changes resulting from conduction abnormalities of the left anterior and left posterior fascicles are commonly diagnosed, mainly by their changes in the frontal plane. However, the existence of conduction defects of the LSF remains controversial. The ECG/VCG hallmark of LSF block is prominent anterior QRS forces (PAF) on the horizontal plane. This ECG/VCG phenomena should be distinguished from other conditions that also produce anterior QRS shift in the HP as: normal variants, right ventricular enlargement, misplaced precordial leads, lateral myocardial infarction, right bundle branch block, Wolff-Parkinson-White, obstructive and nonobstructive forms of hypertrophic cardiomyopahty, diastolic left ventricular enlargement, endomiocardial fibrosis, Duchenne muscular dystrophy, and dextroposition. The two highly frequent etiologies of LSFB are ischemia (coronary artery disease (CAD) with critical proximal obstruction of the left anterior descending coronary artery) and, in Latin America, Chagas' cardiomyopathy. The aims of this review are to revise the evidence of the existence of a trifascicular left Hissian system and to help in the ECG/VCG recognition of the LSFB.

Leucine-rich repeat-containing G protein-coupled receptor 5 (LGR5) is a 7-transmembrane receptor reportedly expressed in stem cells of the intestinal crypts and hair follicles of mice. Overexpression of LGR5 is observed in some types of cancer; however, there has been no specific assessment in colorectal tumorigenesis. We performed quantitative RT-PCR for LGR5 expression in 37 representative cancer cell lines, and showed that LGR5 mRNA was frequently overexpressed in colon cancer cell lines. Moreover, LGR5 expression was higher in colon cancer cell lines derived from metastatic tumors compared with those from primary tumors. In clinical specimens, there was significant overexpression of LGR5 in 35 of 50 colorectal cancers (CRCs), and in seven of seven sporadic colonic adenomas, compared with matched normal mucosa. This suggests up-regulation of LGR5 from the early stage of colorectal tumorigenesis. LGR5 expression showed marked variation among CRC cases and correlated significantly with lymphatic invasion, vascular invasion, tumor depth, lymph node metastasis, and tumor stage (IIIC vs. IIIB). In addition to cancer cells, crypt base columnar cells of the small intestine and colon were shown by in situ hybridization to express LGR5. This is the first report suggesting the involvement of LGR5, not only in early events but also in late events in colorectal tumorigenesis.

O teste ergométrico é um exame já bem estabelecido e vem sendo adotado na práticaclínica por várias décadas. Ele é geralmente seguro, mas deve ser considerado de formajudiciosa, indicando-se de forma apropriada qual o tipo de paciente que deve ser submetidoao exame. A interpretação do teste ergomético inclui capacidade funcional, aspectos clínicos,hemodinâmicos e a resposta eletrocardiográfica.

Wellens syndrome is a clinical-electrocardiographic entity also referred to as left anterior descending (LAD) coronary T-wave syndrome or acute coronary T-wave syndrome. It is a complex of symptoms and signals indicating the existence of an undesirable condition secondary to critical high-grade proximal stenosis of the LAD coronary artery characterized by the association of prior history of acute coronary syndrome with little or no elevation of markers of myocardial damage (unstable angina) and characteristic electrocardiographic changes consistent with subepicardial anterior ischemic pattern (persistently symmetrical, deep negative and broad-based T waves) or plus-minus T waves with inversion of the terminal portion in the LAD coronary artery territory (V1 through V5 or V6). We present a case of a variant of Wellens syndrome that reveals association and, transitorily, the criteria described in literature for left septal fascicular block.

The specific surface reaction rates of Breasol coal and styrene–divinylbenzene resin particles in sub and supercritical water with O 2 were investigated in the temperature range of 300 – 450 ∘ C at 25 MPa by observing the size change using a shadowgraph method. The rates were approximately proportional to the O 2 concentration and non-linearly dependent on the flow rate. The rate obeyed the Arrhenius law at lower temperatures, but became gradually independent on the temperature above 400 ∘ C , which indicated that the overall reaction is controlled by a certain mass transfer process at the higher temperatures. Compared with the case of coal and activated carbon, much smaller amount of O 2 is enough to result in the rapid size decrease rate in the resin particle.

We sought to determine the value of dobutamine versus adenosine real-time myocardial perfusion (MP) echocardiography for detecting coronary artery disease and the value of quantitative analysis of MP over electrocardiography, wall motion, and qualitative MP. We studied 54 patients by real-time MP echocardiography and coronary angiography. Replenishment velocity (beta) and an index of myocardial blood flow (A(n)xbeta) were derived from quantitative MP. During dobutamine stress, beta (1.7 +/- 0.7 vs 2.7 +/- 1.2; P.001) and A(n)xbeta (2.2 +/- 1.0 vs 3.5 +/- 1.6; P.001) reserves were lower in patients with coronary artery disease. The same was observed with adenosine for beta (1.7 +/- 0.8 vs 2.5 +/- 1.1; P.001) and A(n)xbeta (1.9 +/- 0.7 vs 3.2 +/- 1.4; P.001) reserves. Accuracy of electrocardiography, wall motion, qualitative MP, and quantitative MP were 61%, 76%, 76%, and 80% for dobutamine and 70%, 70%, 76%, and 80% for adenosine, respectively. Quantitative MP had incremental diagnostic value over other variables during dobutamine (chi(2) 23.7-38.4; P.001) and adenosine (chi(2) 26.7-59.4; P.001). In conclusion, dobutamine and adenosine real-time MP echocardiography hold similar accuracy for detecting coronary artery disease. Quantitative MP provides incremental diagnostic information over other variables.

OBJECTIVE Ischemic preconditioning is an increased tolerance to myocardial ischemia during the second of two consecutive exercise tests. ATP-sensitive K(+) channel blockers, such as glinides and sulfonylurea drugs, can induce loss of ischemic preconditioning. This study aimed to investigate the effects of repaglinide, a hypoglycemic agent with an affinity for myocardial ATP-sensitive K (+)channels, on the results of consecutive exercise tests in patients with diabetes and multivessel coronary artery disease. METHODS Forty-two patients with type 2 diabetes and chronic stable angina pectoris, and two-vessel or three-vessel disease participated in this study. The patients underwent two consecutive treadmill exercise tests (phase 1). On the day after these exercise tests, 2 mg of oral repaglinide was given to the patients. One week later, two exercise tests were repeated consecutively (phase 2). RESULTS All patients achieved 1.0-mm ST-segment depression during the four exercise tests (T1, T2, T3, and T4). In phase 2, seven patients improved in time to onset of 1.0-mm ST-segment depression. The worsening of the time to onset of 1.0-mm ST-segment depression in phase 2 demonstrated ischemic preconditioning block in 83.3% of patients (P=0.0001). Even the postexercise electrocardiographic parameters (ST-segment depression morphology and magnitude and arrhythmias) were significantly different between the groups with and without pharmacologic ischemic preconditioning block (P=0.031). CONCLUSIONS Repaglinide, an oral hypoglycemic agent with ATP-sensitive K(+) channel-blocker activity, eliminated the myocardial ischemic preconditioning in patients with coronary disease and diabetes.

当施設において2003年1月から2004年3月の間に施行された腹部大動脈瘤 (AAA) 手術患者の周術期経過に関して, 全身麻酔単独症例 (全麻単独群) 8例と硬膜外麻酔併用全身麻酔・術後鎮痛症例 (硬麻併用群) 11例の周術期経過を後向きに検討した. その結果, 術直後の白血球数, 術後3日目までの補助鎮痛薬の使用回数は両群間で有意差を認め, 術後最初の腸管ガス排出までの時間, 手術後在院日数は硬麻併用群で短い傾向が認められた. これらの結果は硬膜外併用全身麻酔・術後鎮痛法によって周術期経過が改善される可能性を示しており, 硬膜外併用全身麻酔の有用性を示唆するものである.

Trismus is an early symptom of tetanus and commonly associated with maxillofacial injuries. A careful differential diagnosis is thus required for patients who have trismus after facial injuries. In this report, we present a case of tetanus with trismus after a facial injury.A 62-year-old man sustained facial injury on April, 200X. On May, he consulted a surgeon because the trismus had worsened since May. After debridement and the administration of tetanus antitoxin to prevent tetanus, he was referred to our hospital and admitted for nutritional management. The first clinical diagnosis was facial injuries with traumatic arthritis of TMJ; the imaging findings revealed no maxillofacial fractures or head and neck phlegmon. On the next day, tetanus was diagnosed on the basis of progressive trismus, and tetanus antitoxin was administered. On May, he was transferred to Osaka Prefectural Senri Critical Care Medical Center, and artificial ventilation was instituted under sedation. His condition improved with intravenous administration of antibiotics and by controlling tonic convulsions. On June I, he revisited our hospital for rehabilitation. Finally, he was discharged on July.It is important to consider the possibility of tetanus when examining patients with trismus, particularly after injury.

A new detector for PET using multi-pixel photon counters (MPPCs) was developed for MRI compatible applications. This module has an 8 × 8 MPPC array, each segment has a 3 mm × 3 mm active area, and the pitch of the array is 4.1 mm in both directions. A temperature sensor is attached to the back of the array for temperature compensation. The MPPC array is connected to the front-end circuit with a detachable flexible printed circuit cable (FPC), which provides flexibility for detector arrangement. The front-end circuit consists of preamplifiers, a register network, buffer amplifiers, a built-in high voltage (HV) unit, and an embedded microprocessor unit. The HV unit is a down-regulator and requires an external HV supply. The preamplifier also has a sum output, which can be used for timing pick-off and energy discrimination. With LYSOs, the timing performance was evaluated using flexible printed cables of two different lengths. Set in a copper shield box, energy spectra and flood images were evaluated with a 3T-MRI Very little interference was observed during simultaneous MRI measurements.

Background There is increasing evidence to suggest that not all individuals with type 2 diabetes mellitus (T2DM) have equal risk for developing cardiovascular disease. We sought to compare the yield of testing for pre-clinical atherosclerosis with various approaches. Methods 98 asymptomatic individuals with T2DM without known coronary artery disease (CAD) were enrolled in a prospective study and underwent carotid ultrasound, exercise treadmill testing (ETT), coronary artery calcium (CAC) scoring, and coronary computed tomography angiography (CTA). Results Of 98 subjects (average age 55 ± 6, 64 % female), 43 (44 %) had coronary plaque detectable on CTA, and 38 (39 %) had CAC score >0. By CTA, 16 (16 %) had coronary stenosis ≥50 %, including three subjects with CAC = 0. Subjects with coronary plaque had greater prevalence of carotid plaque (58 % vs. 38 %, p = 0.01) and greater carotid intima media thickness (0.80 ± 0.20 mm vs. 0.70 ± 0.11 mm, p = 0.02). Notably, 18 of 55 subjects (33 %) with normal CTA had carotid plaque. Eight subjects had a positive ETT, of whom five had ≥ 50 % coronary stenosis, two had

In this paper, a new vibration isolator using origami-based foldable structures is proposed and the performance of the isolator is numerically evaluated to prevent structural vibration. Next, the prototype of the isolator is introduced. It has been known that the origami-based foldable structures based on torsional buckling pattern provide the bistable folding motions under the given conditions. We propose to apply additional linear springs to this structure. It is numerically confirmed that the structure with additional linear springs can work as a vibration isolator around the region that the total spring stiffness of the whole structure reaches the relative minimum value that is close to zero. The prototype of the isolator consists of metallic components. The structure is adequately simplified from the above-mentioned conceptual foldable structure, still maintaining the bi-stability.

Transparent conductors (TCs) based on metal nanowires have emerged as an outstanding alternative of indium tin oxide (ITO) film in particular for wearable sensors, solar cells and other flexible devices. Copper nanowire (CuNW) TCs featured by low-cost and high conductivity have attracted much attention in these days. The fabrication of CuNW TCs is usually complicated by sintering process involving high temperature and reducing atmosphere, and multi-step transfer methods. Here, a fast high intensity pulse light sintering technique was applied to achieve CuNW TCs with high conductivity of 2.54 ohm/sq on polyurethane (PU) substrates. Importantly, the CuNWs-PU TCs exhibited excellent stretchability with resistance increase of only 4.3 times after 20% strain for 100 cycles.

Background The influence of diabetes mellitus on myocardial ischemic preconditioning is not clearly defined. Experimental studies are conflicting and human studies are scarce and inconclusive. Objectives Identify whether diabetes mellitus intervenes on ischemic preconditioning in symptomatic coronary artery disease patients. Methods Symptomatic multivessel coronary artery disease patients with preserved systolic ventricular function and a positive exercise test underwent two sequential exercise tests to demonstrate ischemic preconditioning. Ischemic parameters were compared among patients with and without type 2 diabetes mellitus. Ischemic preconditioning was considered present when the time to 1.0 mm ST deviation and rate pressure-product were greater in the second of 2 exercise tests. Sequential exercise tests were analyzed by 2 independent cardiologists. Results Of the 2,140 consecutive coronary artery disease patients screened, 361 met inclusion criteria, and 174 patients (64.2 ± 7.6 years) completed the study protocol. Of these, 86 had the diagnosis of type 2 diabetes. Among diabetic patients, 62 (72 %) manifested an improvement in ischemic parameters consistent with ischemic preconditioning, whereas among nondiabetic patients, 60 (68 %) manifested ischemic preconditioning (p = 0.62). The analysis of patients who demonstrated ischemic preconditioning showed similar improvement in the time to 1.0 mm ST deviation between diabetic and nondiabetic groups (79.4 ± 47.6 vs 65.5 ± 36.4 s, respectively, p = 0.12). Regarding rate pressure-product, the improvement was greater in diabetic compared to nondiabetic patients (3011 ± 2430 vs 2081 ± 2139 bpm x mmHg, respectively, p = 0.01). Conclusions In this study, diabetes mellitus was not associated with impairment in ischemic preconditioning in symptomatic coronary artery disease patients. Furthermore, diabetic patients experienced an improvement in this significant mechanism of myocardial protection.

The 2005 Fukuoka-ken Seiho-oki earthquake caused heavy damage to residential areas at the Genkai-jima Island. A field survey was carried out to investigate the damage of retaining walls in the residential areas. From the survey of 218 retaining walls, it appeared that 83% of the retaining walls were damaged and 61% of the whole lost their functions (collapsed or distorted/cracked). Especially in masonry retaining walls using natural rocks and boulders, the damage was serious. The damage features of dry masonry retaining walls (collapsed: 62%) and wet masonry retaining walls (collapsed: 25%) were different, and the difference in the earthquake-resistant capacity between the two retaining walls became obvious. Moreover, it appeared that most of the residential houses are built on transitions of cut slopes and fill embankments. It seems that this condition is one of a great factor which causes the heavy damage. Only 17% of the retaining walls escaped from any damage. Furthermore, to evaluate the collapse mechanism of masonry retaining walls during earthquake, a theoretical model based on the earth pressure theory was proposed. Through the theoretical considerations, it became possible to quantitatively evaluate the stability of the masonry retaining walls.

Study Design. An experimental study, in which spinal fusion in rats was conducted using a hydroxyapatite fiber mesh (HAM) as a carrier for recombinant human bone morphogenetic protein (rhBMP)-2. Objectives. To study the usefulness of the HAM as a carrier and seek the possibility of clinical application in spinal fusion. Summary of Background Data. Several biomaterials have been used as a carrier for BMP to achieve spine fusion, however, to our knowledge, the most effective carrier has not been established. Methods. In experiment No. 1, HAMs and the controls (commercially available hydroxyapatite ceramic body), loaded with rhBMP-2, were immersed in phosphate-buffered saline to evaluate the time course of the release of rhBMP-2. In experiment No. 2, posterolateral fusion was conducted in rats using HAM and the control loaded with rhBMP-2. The fusion status was evaluated radiologically and histologically after surgery. Results. In experiment No. 1, HAMs released a larger amount of rhBMP-2 for up to 28 days than the controls (49.5% vs 7.8%). In experiment No. 2, the fusion rate was significantly higher in the HAM group (>80%) than in the control group (20%). Dense new bone formed close to the spine, and the HAMs were markedly absorbed compared with the controls. Conclusion. HAM provided more solid fusion mass than the control, suggesting that HAM is an efficient carrier for BMP.

It is reported that the sound of a car door closing is one of the main factors to determine the overall impression of the car. Much effort has been made to improve the quality of this sound. In this study, sounds of the closing of the doors of various passenger cars were recorded and presented via headphones in a sound-proof room. Based on these sounds, German and Japanese groups of participants formed mental images of the cars involved. They were also asked to evaluate the quality of the sounds. Generally speaking, though there were some differences, similar results were obtained with both groups of participants. It was found that the impressions of the sound quality varied considerably and that there was a correlation between the impression of the sound and the mental image of the car. It was suggested that the image of a car is related to the sound of the car.

Background: The warm-up phenomenon observed after the second of two sequential exercise tests is characterized by an increased time to ischemia and ischemic threshold, and the latter is related to ischemic preconditioning. Previous studies have demonstrated that a single dose of glibenctamide, a cardiac ATP-sensitive K (K A T P ) channel blocker, prevents ischemic preconditioning. This study aimed to investigate the effects of chronic treatment with glibenclamide during two sequential exercise tests. Methods: Forty patients with angina pectoris were divided into three groups: 20 nondiabetics (NDM), 10 patients with diabetes in treatment with glibenclamide (DMG) and 10 diabetic patients with other treatments (DM0). All patients underwent two consecutive exercise tests. Results: Heart rate and rate-pressure product at 1.0 mm ST-segment depression significantly increased during the second exercise test in NDM group (121.3 ′ 16.5 vs 127.3 ′ 15.3 beats/min, P < 0.001, and 216.7 + 43.1 vs 232.1 ′ 43.0 beats.min - 1 .mmniHg.10 2 , P < 0.001), and in DM0 group (114.1 ′ 19.6 vs 119.6 ′ 18.1 beats/min, P = 0.001, and 199.8 ′ 36.6 vs 222.2 ′ 29.2 beats.min - 1 .mmHg.10 2 , P = 0.019), but it did not change in patients in DMG group (130.7 ′ 14.5 vs 132.1 ′14.7 beats/min, P = ns, and 251.7 ′ 47.2 vs 250.3 ′ 42.8 beats.min - 1 .mmHg.10 2 , P = ns). In the three groups, NDM, DMO, and DMG, the time to 1.0 mm ST-segment depression during the second exercise test was greater than during the first (225.0 ′ 112.5 vs 267.0 ′ 122.3 seconds, P = 0.006; 187.5 ′ 54.0 vs 226.5 ′ 74.6 seconds, P = 0.029 and 150.0 ′ 78.7 vs 186.0 ′ 81.9 seconds, P < 0.001). Conclusion: The chronic use of glibenclamide may have mediated the loss of preconditioning benefits in the warm-up phenomenon, probably through its KATP channel-blocker activity, but without acting upon the tolerance to exercise.