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In der Zahnmedizin gehoren bakteriell verursachte und entzundlich bedingte Erkrankungen wie Parodontitis zu den haufigsten oralen Erkrankungen. Die mechanische Entfernung des supra- und subgingivalen Biofilms und die Etablierung einer guten hauslichen Mundhygiene im Rahmen der antiinfektiosen Therapie sind daher wichtige Ziele der systematischen Parodontitistherapie und fur einen langfristigen Therapieerfolg ausschlaggebend. In der Regel reicht die mechanische Instrumentierung aus, um eine erfolgreiche Parodontitistherapie durchzufuhren. Dennoch konnen Falle vorkommen, in denen eine rein mechanische Therapie nicht zu zufriedenstellenden Ergebnissen fuhrt. In ausgewahlten Fallen kann der Einsatz eines lokalen Antibiotikums, ublicherweise in Kombination mit einer subgingivalen Instrumentierung, in Betracht gezogen werden.

Accurate imaging is essential for effective treatment planning in periodontology. The aim of this ex vivo study was to investigate the accuracy of cone beam computed tomography (CBCT) and digital periapical radiographs (PA) in imaging periodontal defects. Hypotheses are: 1. That CBCT is a more accurate method than PA concerning vertical measurements of periodontal bone defects2. That CBCT itself is an accurate method to describe vertical periodontal bone loss MATERIAL AND METHODS: In this study, 117 periodontal defects from 10 human cadavers were investigated radiographically by CBCT and PA by one calibrated observer. Afterwards the vertical bone loss was measured with a periodontal probe by the same calibrated observer. Differences between radiographic and clinical measurements were calculated and analyzed. Bland-Altmann plots including 95% limits of agreement were calculated.The 95% limits of agreement ranged from 3.29 to -3.27 mm between clinical measurements and measurements in PAs, and from 2.13 to -1.97 mm in CBCTs. The mean difference between clinical and radiographic measurements was 0.0009 mm for PA and 0.0835 mm for CBCT.When comparing the clinical measurements, CBCT had a higher agreement and less deviations than PAs, and CBCT seems to be an accurate method to describe vertical periodontal bone loss.Accurate description of defects is helpful for accurate treatment planning.

The cause of chronic inflammatory periodontitis, which leads to the destruction of periodontal ligament and alveolar bone, is multifactorial. An increasing number of studies have shown the clinical significance of NLRP3-mediated low-grade inflammation in degenerative disorders, but its causal linkage to age-related periodontitis has not yet been elucidated. In this study, we investigated the involvement of the NLRP3 inflammasome and the therapeutic potential of NLRP3 inhibition in age-related alveolar bone loss by using in vivo and in vitro models. The poor quality of alveolar bones in aged mice was correlated with caspase-1 activation by macrophages and elevated levels of IL-1β, which are mainly regulated by the NLRP3 inflammasome, in periodontal ligament and serum, respectively. Aged mice lacking Nlrp3 showed better bone mass than age-matched wild-type mice via a way that affects bone resorption rather than bone formation. In line with this finding, treatment with MCC950, a potent inhibitor of the NLRP3 inflammasome, significantly suppressed alveolar bone loss with reduced caspase-1 activation in aged mice but not in young mice. In addition, our in vitro studies showed that the addition of IL-1β encourages RANKL-induced osteoclastogenesis from bone marrow–derived macrophages and that treatment with MCC950 significantly suppresses osteoclastic differentiation directly, irrelevant to the inhibition of IL-1β production. Our results suggest that the NLRP3 inflammasome is a critical mediator in age-related alveolar bone loss and that targeting the NLRP3 inflammasome could be a novel option for controlling periodontal degenerative changes with age.

SETTING The Xpert(®) MTB/RIF assay is endorsed by the World Health Organization for the detection of rifampicin (RMP) resistant tuberculosis (TB). OBJECTIVE To evaluate Xpert for its diagnostic accuracy in detecting RMP-resistant TB and its impact on treatment outcomes. DESIGN Patients with available phenotypic drug susceptibility testing (DST) results and those in whom RMP-resistant pulmonary TB was diagnosed using Xpert were evaluated. The accuracy and turnaround time (TAT) of Xpert for determining RMP-resistant TB was calculated. The TATs for treatment between patients diagnosed with RMP-resistant TB using Xpert and those diagnosed without the assay (phenotypic DST group) were compared. RESULTS In 321 patients, when phenotypic DST was used as the gold standard, Xpert sensitivity and specificity for RMP resistance diagnosis was respectively 100% and 98.7%; the positive and negative predictive values were respectively 86.2% and 100%. The Xpert group had a much shorter interval from initial evaluation to commencing second-line anti-tuberculosis treatment (64 vs. 2 days, P < 0.001), and negative conversion of mycobacterial cultures (197 vs. 62.5 days, P < 0.001) than the phenotypic DST group. CONCLUSION Xpert was accurate at diagnosing RMP resistance in this setting with an intermediate TB burden and a low level of RMP resistance. Xpert might reduce disease transmission by reducing the sputum culture conversion times for patients with RMP-resistant TB.

For the prompt prescription of patients suffering from infectious diseases such as tuberculosis or bloodstream infection, a rapid antimicrobial susceptibility test (RAST) is highly necessary. This paper describe rapid antibiotic susceptibility test system composed of biochips and automated expert system, which can determine the antibiotic susceptibility of bacteria and mycobacteria derived from various parts of body. With RAST, antibiotic susceptibility was available in six hours, which was conventionally taking more than two days. Device design consideration, clinical verification, commercialization, and application of RAST system to infectious diseases are reviewed.

Background Living-donor liver transplantation (LDLT) has been accepted as feasible treatment for fulminant hepatic failure (FHF), although it has generated several debatable issues. In this study, we investigated the prognostic factors predicting fatal outcome after LDLT for FHF. Methods From April 1999 to April 2011, 60 patients underwent LT for acute liver failure, including 42 patients for FHF at Samsung Medical Center, Seoul, Korea. Among 42 patients, 30 patients underwent LDLT for FHF, and the database of these patients was analyzed retrospectively to investigate the prognostic factors after LDLT for FHF. Results Among 30 patients, 7 patients (23%) died during the in-hospital period within 6 months, and 23 patients (77%) survived until recently. In univariate analyses, donor age (>35 years), graft volume (GV)/standard liver volume (SLV) ( 120 minutes), hepatic encephalopathy (grade IV), hepato-renal syndrome (HRS), and history of ventilator care were associated with fatal outcome after LDLT for FHF. In multivariate analyses, HRS, GV/SLV ( 35 years) were significantly associated with fatal outcome. Although the statistical significance was not shown in this analysis ( P = .059), hepatic encephalopathy grade IV also appears to be a risk factor predicting fatal outcome. Conclusions The survival of patients with FHF undergoing LDLT was comparable to that in published data. In this study, HRS, GV/SLV 35 years are the independent poor prognostic factors.

The treatment of choice for combined hepatocellular and cholangiocarcinoma (cHCC-CC) is surgical resection. However, the efficacy of liver transplantation is not clear. We compared the surgical outcome of hepatic resection and liver transplantation for cHCC-CC.From 1995 to 2012, 89 patients were diagnosed with cHCC-CC after hepatic resection and 8 patients diagnosed with cHCC-CC after liver transplantation. We excluded 21 patients who were American Joint Committee on Cancer Staging Stage III or IV and lost to follow-up. The outcomes were reviewed retrospectively.The poor prognostic factors in cHCC-CC patients who underwent hepatectomy were large tumor size (5 cm), small safety margin (2 cm), and low preoperative albumin level. The disease-free survival (DFS) and overall survival (OS) between the hepatectomy group (n = 68) and the liver transplant group (n = 8) was not statistically different (5-year DFS: 26.2% vs 37.5%, P = .333; 5-year OS: 42.1% vs 50%, P = .591). In the small tumor subgroup (tumor size 5 cm), the DFS and OS between the 2 surgical procedures was not different, and in the adequate resection margin subgroup (safety margin2 cm), survival was comparable.In well-selected cases with small tumor size and with preserved liver function, liver resection should be considered when complete resection is possible.

The BK nephropathy (BKN) shows a 10% prevalence among cases of kidney transplantation (KT). We assessed the incidence of BK replication in KT recipients as well as our updated screening strategy and the impact of interventions on BK virus infections.Since September 2007, our screening protocol for BK virus included examination of urine cytology or BK virus DNA real-time polymerase chain reaction (PCR) detection on postoperative days 1, 5, 9, 16, 24, 36, 48 weeks up to 1 year. IR present, we tested urine BK virus DNA PCR quantitation. We applied the updated screening protocol from August 2010. It urine BK DNA PCR quantification was above 10(7) copies/mL, we checked regularly blood the BK virus DNA PCR quantification. In addition, if the blood BK virus DNA load was above 10(4) copies/mL and the serum creatinine elevated, we was performed an allograft biopsy. Between September 2007 and December 2011, the 58 recipients who showed BK viremia were enrolled in the present study in 2 groups according to the period of screening protocol (era I, era II).The time between kidney transplantation and BK viremia detection of era II was shorter than that of era I (16 vs 29 weeks; P = .001). Viremia clearance rate at 6 months in era II was significant higher than that of era I (82% vs 36.8%; P = .001) as well as at 12 months (100% vs 61.1%, P .001) after intervention. Interestingly, viremia clearance at 12 months after intervention was 100% in era II.An updated screening protocol for BK virus allowed early detection and accurate diagnosis of BKN. Early detection of BK virus infection enabled early intervention and improved viral clearance rate.

ZnCdO oxide thin films have been deposited by using the radiofrequency cosputtering method to prepare ozone sensors for room-temperature operation. The sensors were fabricated in the order: electrode/sensor/glass/illuminant. The mechanisms of photo-assisted oxidation and reduction on the surface of the ZnCdO ozone sensors were investigated. Free electrons and holes were generated by exposure of the surface of the ZnCdO ozone sensor to ultraviolet light, tending to enhance surface absorption of dissociated O2 molecules and dissociation of adsorbed oxygen ions, respectively. Thereby, the sensitivity of the ZnCdO ozone sensor was increased. This photon exposure method can replace the conventional heating mode used in ozone sensors. Moreover, 405-nm light from a light-emitting diode, corresponding to photon energy of 3.061 eV, was found to assist the processes of oxidation and reduction due to the chemical reaction of the ozone gas. We present a possible route for fabrication of portable ZnCdO ozone sensors for room-temperature operation.

The purpose of this study was to determine the changing pattern of Salmonella serotypes causing acute diarrhoea in humans in Gwangju area, Korea, during 2000-2009. A total of 596 Salmonella isolated from culture of 29,896 faecal samples of patients with acute diarrhoea were included in this study. Faecal samples were collected from local hospitals and clinics in Gwangju area during January 2000-December 2009. The mean annual frequency of isolates for the 10 years was 2.0% (range, 0.9-6.0). The isolates were serologically classified into 43 different serotypes. The 10 most common serotypes were Salmonella Enteritidis (47.9%), S. Typhimurium (20.4%), S. Braenderup (3.2%), S. Montevideo (2.9%), S. Paratyphi B (2.9%), S. London (2.3%), S. Bardo (1.7%), S. Virchow (1.7%), S. Infantis (1.5%) and S. Typhi (1.5%), accounting for 86% of all the isolates. Temporal variations were observed in the distribution of different Salmonella serotypes over the years, and only S. Enteritidis and S. Typhimurium were persistent throughout the study period. Although age specificity varied with serotypes, Salmonella was isolated most frequently from children below 5 years of age (179/596, 30.0%). A seasonal trend was apparent, and the highest rates were found in the summer months. This is the first report of the annual frequency of isolation of Salmonella serotypes, and seasonal and age-specific patterns of salmonellosis in humans in Gwangju area, Korea, over a decade-long period.

We grew modulated BeZnO layers by hybrid plasma-assisted molecular-beam epitaxy/electron-beam deposition. A wide band-gap investigation of the modulated BexZn1−xO by means of photocurrent (PC) spectroscopy was conducted. The band-gap energy was directly acquired from the wavelength of the PC peak, caused by the band-to-band transition. By increasing x, which was the rate of the Be elements, the optical band-gap energy was empirically fitted by EBeZnO(x) = 6.32(x–1)x + 7.305x + 3.295. We expect that this finding can open new possibilities for wide band-gap engineering of BeZnO layers, which can be utilized as barrier layers in active layers consisting of ZnO/BeZnO quantum well structures and solar-blind ultraviolet photodetectors.

Background : Inositol polyphosphate 5-phosphatase PIPP (INPP5J) has been identified as a suppressor of oncogenic PI3K/Akt signaling in breast cancer.INPP5J depletion increases transformation and accelerates oncogene-driven tumor growth in vivo, while paradoxically reducing cell migration, invasion, and metastasis. Therefore, we hypothesized that INPP5J gene expression in human breast cancer tissues would be prognostic in early breast cancer patients over long-term follow-up. Methods: A total of 478 breast cancer tissue samples collected between 2003 and 2008 was available for analysis. We measured INNPP5J mRNA using a TaqMan gene expression assay. PIK3CA mutation status was evaluated using a TaqMan mutation detection assay. We then investigated the correlations of clinicopathological factors and prognosis with levels of INPP5J mRNA and the PIK3CA mutation status. Results: INPP5J mRNA was expressed at a low level in 30.1% (144/478) and at a medium to high level in the remaining breast cancer samples. Low INPP5J mRNA correlated with larger tumor (p=0.015), high grade (p Conclusion: We shows that the level of INPP5J mRNA expression is prognostics in breast cancer patients and that its prognostic impact is affected by PIK3CA mutation status. Citation Format: Kondo N, Kim T-S, Wanifuchi Y, Hato Y, Hisada T, Nishimoto M, Nishikawa S, Toyama T. The prognostic impact of inositol polyphosphate 5-phosphatase PIPP (INPP5J) expression in breast cancer tissue [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-07-34.

Summary Aims: Prominent anxiety symptoms are related to poor clinical course and outcome in major depressive disorder (MDD). The aim of this randomised, open-label, controlled study is to compare the efficacy and tolerability of mirtazapine in the form of orally disintegrating tablets against paroxetine in treating MDD patients with anxiety symptoms. Methods: A total of 60 MDD patients with a score above 18 on the Hamilton Anxiety Rating Scale (HARS) were randomly assigned to 8 weeks of fixed dosing treatment with mirtazapine (15–30 mg/day) and paroxetine (10–20 mg/day). Efficacy was primarily assessed with the HARS and with the 17-item Hamilton Depression Rating Scale (HDRS) at weeks 1, 2, 4 and 8 after treatment. Tolerability was assessed from adverse events. Results: The generalised estimating equations (GEE) models showed that the rates of improvement in HDRS scores from baseline to week 8 were similar between mirtazapine and paroxetine groups. However, patients with mirtazapine exhibited earlier improvement in HARS scores at weeks 1 and 2. Week-by-week GEE models showed that these significant differences in improvement of HARS scores between the two treatment groups were detectable from the first evaluation after the treatment (week 1) and maintained through week 2. There was no difference in the overall frequency of adverse events experienced between the two treatment groups. The most common adverse event in the mirtazapine group was somnolence (n = 8), whereas that in the paroxetine group was gastrointestinal discomfort (n = 9). Conclusions: Mirtazapine and paroxetine were equally effective and well tolerated for the depressive symptoms in MDD patients with the high level of anxiety symptoms. Mirtazapine was, however, more effective in reducing the anxiety symptoms than paroxetine in the early weeks of treatment, suggesting that mirtazapine may have an earlier-onset action for the anxiety symptoms in MDD patients.

Twenty-five Tc/tw5 and 12 control mice were killed at different ages and radiographically and histologically examined. In addition, histochemical analysis was performed on muscles from four mutant and one control mouse. All Tc/tw5 mice were tailless and had a fluid-filled lumbar myelomeningocele. Radiographically, most animals had six instead of 10 lumbosacral vertebrae. Vertebral anomalies were common. The spinal cord was grossly abnormal: at the level of the plaque, it was replaced by patches of neural tissue intermingled with connective tissue and muscle. Affected skeletal muscles had small myofibers with centrally placed nuclei consistent with arrest of development at the myotubular stage secondary to denervation in early embryonic life. Abnormal nerves were smaller and had fewer axons. Tc/tw5 mice show features of neural tube and notochord dysplasia. These mutant mice may be useful as animal models of lumbosacral agenesis and myelomeningocele.

We investigated the safety and efficacy of a methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) combination regimen as second-line chemotherapy for patients with advanced or metastatic transitional cell carcinoma who failed first-line gemcitabine and cisplatin (GC) chemotherapy. Thirty patients who had progressed or relapsed after GC chemotherapy as first-line treatment were enrolled in this study. The major toxicities were neutropaenia and thrombocytopaenia. A grade 3 or 4 neutropaenia occurred in 19 (63.3%) and a grade 3 or 4 thrombocytopaenia developed in nine patients (30.0%). There were no life-threatening complications during the study. The overall response was 30%. A complete response was achieved in two patients (6.7%) and a partial response in seven (23.3%). The overall disease control rate was 50%. Seven out of 16 patients who had responded previously to GC responded to M-VAC, while 2 out of 14 who had not responded to GC responded to M-VAC. The median response duration was 3.9 months and the median progression-free survival was 5.3 months. The median overall survival was 10.9 months. M-VAC showed encouraging efficacy and reversible toxicities in patients who had progressed after GC chemotherapy and, especially, M-VAC appears to be a reasonable option as a sequential treatment regimen in patients who responded previously to GC chemotherapy.

This study investigated the influence of a family history of diabetes on the risk of subclinical coronary atherosclerosis according to coronary computed tomography angiography (CCTA) in asymptomatic individuals.A total of 6434 consecutive asymptomatic individuals with no prior history of coronary artery disease voluntarily underwent CCTA evaluation as part of a general health examination. Coronary atherosclerotic plaque and significant coronary artery stenosis (degree of stenosis ≥50%) on CCTA were assessed. Logistic regression analysis was used to determine the association between a family history of diabetes and atherosclerotic plaque or significant coronary artery stenosis according to the degree of diabetes (normal, prediabetic and diabetic).Mean age of study participants was 53.7±7.6 years, and 4694 (73.0%) were male. A total of 1593 (24.8%) participants had a family history of diabetes in a first-degree relative. Among the study participants, 1115 (17.3%), 3122 (48.5%) and 2197 (34.1%) were categorized as diabetic, prediabetic and normal, respectively. In diabetic participants, after stepwise adjustments for clinical and laboratory variables, a family history of diabetes was significantly associated with non-calcified plaque (P0.05 for all), but did not appear to be associated with either calcified or mixed plaques or with significant coronary artery stenosis (P0.05 for all). In prediabetic and normal participants, a family history of diabetes was not associated with either atherosclerotic plaque or significant coronary artery stenosis (P0.05 for all).In asymptomatic diabetic individuals, a family history of diabetes is consistently associated with non-calcified coronary plaque after adjusting for risk factors.

This study designed to develop a mower which can reach to side of a tractor or inclined road side and operate weeding. The prototype consists of 4 parts; the base and turning equipment, the boom, the arm, the weeder. The hydraulic actuators were divided into two operations, weeding and operation of boom and they were controlled by electrical equipment. Weeding was very effective when pressure set up at using weeding, as , 2,210rpm. Weeding range of flail mower was 1.1 to 2.6m from the center of turning equipment at a flat. In case of disk mower, it was 1.5 to 2m. As a result of operation test, flail mower was appropriate for weeding at fence and short weeds, disk mower was appropriate for long weeds.

This study aims to analyze operating performance of a micro gas turbine with the aid of detailed measurements of various system parameters. In addition to embedded measurements, parameters such as exhaust temperatures, engine inlet temperatures and fuel flow rates are measured. Variations in measured data and estimated performance parameters are analyzed. Those data are processed to calculate losses along the power transmission line and the net gas turbine performance (power and efficiency based on the gas turbine shaft end) is isolated from the overall system performance. A method to estimate characteristic parameters such as component efficiencies, based on the comparison between measured and predicted performance data, is suggested and exemplified for the full load condition.

In this paper, we performed the design study of a wide-band digital autocorrelation spectrometer for the observation study of an extra-galaxy's spectral lines and the survey research of the special radio sources in field of the radio astronomy observational research. The autocorrelation spectrometer designed in this paper can be used to their spectrometer of any system because this spectrometer has a wide dynamic power and frequency range properties. In this system we use the aliasing sampling method to minimize the band loss. For the output signal of the correlator we can increase the signal processing speed using by a special DSP chip, the integration and the FFT using hardware, so this spectrometer can support the newest developed technique for the radio astronomy observation so called ``On the fly" method.

Summary Nontuberculous mycobacteria (NTM) are ubiquitous organisms that are now seen as emerging human pathogens. NTM infections are very difficult to diagnose and treat, therefore a high index of clinical suspicion is needed for diagnosis. Cutaneous NTM infections have been primarily reported associated with previous invasive procedures. We report the case of a healthy 59-year-old woman who developed recurring abdominal skin lesions caused by Mycobacterium massiliense after she underwent noninvasive cupping therapy. We identified the pathogen using a PCR assay targeting the erm(41) gene of the bacterium. The patient was treated successfully by en bloc excision and long-term antibiotic treatment. This case shows that cutaneous infection with M. massiliense may occur in an immunocompetent person without an antecedent invasive procedure.

In this study, a model to simulate the dynamic operation of regenerative gas turbines is described and the transient behaviour of a small engine equipped with a stationary recuperator is presented. The mathematical model of each component consisted of unsteady one-dimensional governing equations and steady state component characteristics. The equation set derived was solved by using a fully implicit numerical method. A realistic control unit model for speed control was likewise introduced to simulate the operation of real engines. Special emphasis was given to the thermal inertia of the recuperator metal that governs the dynamic characteristics of the engine. The dynamic characteristics were examined for a couple of load change modes such as stepwise and periodic load variations. Characteristic transient responses were then investigated and the dependence of transient response on the frequency of load variation was demonstrated.

This work presents an analysis of the dynamic behaviour of a HRSG (heat recovery steam generator) during start-up. A calculation program based on a quasi-steady method is constructed. A typical high-pressure HRSG is designed conceptually and analysis is performed to examine the influence of the gas inlet condition of the HRSG on its start-up behaviour. Effects of the gas turbine operation mode and the gas bypass are analysed. In addition, the water level control during start-up, which is one of the most important facts in the real plant operation, is simulated. Through a parametric calculation, the effect of the control parameters on the start-up behaviour is analysed and examples of optimum control are demonstrated. Copyright © 2000 John Wiley & Sons, Ltd.

e114 PO-059 The Impact of Dialysis-Dependent Acute Kidney Injury on Mortality in Myeloma: Findings from England Hospital Episode Statistics Data M. Cook, F. Evison, J. Sangha, P. Yadav, S. Aung, D. Ray, A. Sharif, J. Pinney, M. Drayson, P. Cockwell Department of Haematology, University Hospital Birmingham, Birmingham, UK; School of Infection and Immunity, University of Birmingham, Birmingham, UK; Department of Informatics, University Hospital Birmingham, Birmingham, UK; Department of Renal Medicine, University Hospital Birmingham, Birmingham, UK

This paper demonstrates a favourable influence of turbine coolant modulation on the part load performance of gas turbines. A general simulation programme is developed, which is capable of accurately estimating the design and part load performance of modern heavy-duty gas turbines characterized by intensive turbine blade cooling Investigations are made for a typical gas turbine and two distinct load control schemes are considered: the fuel-only control and the variable compressor geometry control. Maintaining blade temperatures as high as possible whose purpose is to minimize coolant consumption is simulated. It is found that the coolant modulation makes the part load characteristics deviate from usual behaviours and creates a considerable enhancement of part load thermal efficiency. For the fuel-only control with coolant modulation, it is predicted that efficiency can be higher than design efficiency over a wide range of part load operation.

For combined cycle plants that consist of heavy-duty gas turbine and single-pressure heat recovery steam generator, the effect of gas turbine coolant modulation on plant performance is analysed. Two distinct schemes for gas turbine load control are adopted (the fuel-only control and the variable compressor geometry control), based on the gas turbine calculation in Part 1 of this series of papers. Models for heat recovery steam generator and steam turbine are combined with the gas turbine models of Part 1 to result in a complete analysis routine for combined cycles. The purpose of gas turbine coolant modulation is to minimize coolant consumption by maintaining the turbine blade temperatures as high as possible. It is found that the coolant modulation leads to reduction in heat recovery capacity, which decreases steam cycle power. However, since the benefit of coolant modulation for the gas turbine cycle is large enough, the combine cycle efficiency is improved.

Using simulated noisy sequences of respiration and heart rate, we assessed the accuracy of the respiratory sinus arrhythmia transfer function (RSATF) estimation under three kinds of spontaneous breathing patterns: regular or tidal breathing, periodic breathing with apnea, and broadband breathing. Estimation employing the cross-power and autopower spectra of the simulated data produced RSATF estimates that were generally more variable than those computed with an autoregressive modeling approach. Variability and bias errors in the RSATF estimates became larger as respiratory bandwidth decreased when the breathing pattern changed from broadband to periodic to regular breathing. However, between frequencies of 0.1 and 0.3 Hz, these errors fell within 12% in all breathing patterns. Error in the RSATF estimates was only slightly increased, with reductions in data length to as low as 90 s. The results suggest the feasibility of obtaining accurate estimates of RSATF between 0.1 and 0.8 Hz from a wide variety of conditions, such as in different sleep-wake states where voluntary control of breathing is not possible and the ventilatory pattern may vary substantially.

Introduction We studied the incidence of vesicoureteral reflux (VUR) in the graft kidney and its effect on the occurrence of urinary tract infection (UTI) and long-term graft function. Methods We performed a retrospective analysis of 64 adult kidney transplant recipients based upon voiding cystourethrography at 12 months post-transplantation. Patients underwent analysis of survival, incidence of UTIs beyond 1 year, and graft function. Results Thirty-seven male and 27 female patients in the study populations showed a mean age 42 years. VUR in the transplanted kidney at 12 months post-transplant occurred among 78.1% (50/64) of subjects: grade I ( n = 6), grade II ( n = 30), or grade III ( n = 14) reflux. Patients followed for a median 61 months (range 44–74s) showed 11 cases of UTIs in 9 subjects. There were no significant differences in clinical characteristics or incidence of, UTIs according to the presence or severity of VUR ( P = .81) or the Serum creatinine and estimated glomerular filtration rate values at 12, 36, 48, or 60 months post-transplantation. Conclusions VUR present in 78.1% of patients after kidney transplantation affected neither graft functions or graft survival. The incidence of UTI did not differ according to the presence of VUR.

Successful arterial reconstruction is essential for liver transplantation. In the case of inadequate arterial inflow, an arterial conduit from the aorta using artery graft or re-establishment of arterial flow through other arteries such as the splenic artery, gastroepiploic, or sigmoid artery is considered. Herein we report our experience of 27 cases of hepatic artery reconstruction using alternative methods. The most common cause of hepatic artery reconstruction requiring alternative methods was intimal dissection for which we usually used the gastroepiploic artery. Many patients had a previous operation or transarterial chemoembolization history. Among these cases, hepatic artery reconstruction using the jejunal artery was performed for 2 cases of living donor liver transplantation due to the absence of suitable alternatives. These patients have been followed up with patent hepatic arterial flow until now. Thus, the jejunal artery can be a useful option for arterial reconstruction in living donor liver transplantation when suitable arterial inflow is absent.

Introduction Anatomic variants of the hepatic vasculature are common, so precise preoperative donor evaluation, including variations in the vasculature, is essential. We analyzed the anatomic similarity according to the donor–recipient relationship. Methods Among the cases who underwent living donor liver transplantations from September 2008 to January 2011 we selected 104 cases with clearly defined hepatic artery and portal vein on preoperative computed tomography. They were classified according to Hiatt et al for the hepatic artery and Cheng for the portal vein. We categorized the 104 cases into three groups: parents–child (n = 40), sibling (n = 24) and no-relation (n = 40), for analysis of the concordance of the hepatic artery and portal vein. Result Anatomic variations were observed in 25% of donors and 23.1% of recipients in the hepatic artery and 6.7% of donors and 10.6% of recipients in the portal vein. There was no significant difference in the distribution of the type of hepatic vasculature. Identical anatomic variations between donors and recipients were observed in 62.5% of the parent–child; 66.7% of the sibling and 52.5% of no-related group ( P = .493) in the hepatic artery and 92.5%, 100%, and 77.5% ( P = .014) in the portal vein respectively. Conclusion There was no similarity in the anatomic variations of the hepatic artery according to the donor–recipient relationship, but a similarity in portal venous anatomy according to the donor–recipient relationship.

The capability of modulating power and heat productions by steam injection in a recuperative cycle gas turbine was investigated. A combined heat and power system using a current state-of-the-art recuperative cycle gas turbine was modeled. Variations in engine performance characteristics due to steam injection were examined. A full off-design analysis was carried out to investigate not only the performance change but also the variation in engine operation caused by the steam injection. Impact of injecting steam at different locations (recuperator and combustor) was investigated. A special attention was given to the change in the compressor surge margin, and a couple of operations that secures a minimum surge margin were comparatively analyzed. Bypass of turbine exhaust gas around the recuperator to increase steam generation was simulated and its usefulness in controlling heat to power ratio was demonstrated. Variations in electric power and thermal energy productions in response to the modulations of injection ratio and gas bypass were presented for a wide ambient temperature range.

The ITER vacuum vessel (VV) is a double walled torus structure and one of the most critical components in the fusion reactor. The design and fabrication of the VV as nuclear equipment shall be consisted with the RCC-MR code based on French fast breeder reactor. The VV is a heavy welded structure with 60 mm thick shells, 40 mm ribs and flexible housing of 275 mm diameter. The welding distortion should be controlled since the total welding length is over 1500 m. To satisfy the design requirement, the electron beam welding (EBW) and narrow gap gas tungsten arc welding (GTAW) techniques are to be applied and developed through the fabrication of mock-ups. The fabrication design has been developed to manufacture the main vessel and port structures in accordance with the RCC-MR code. All fabrication sequences including welding methods are also established to meet the demanding tolerance and inspection requirement by HHI as a supplier.Copyright © 2011 by ASME

The purpose of this study was to evaluate the high-resolution computed tomographic (HRCT) findings of five adult patients (either immunocompromised or immunocompetent) with herpes simplex virus (HSV) pneumonia. We retrospectively assessed HRCT images of 5 patients (all male patients, age range 39-70 years; mean 62 years) with HSV pneumonia. The specific pathological findings that allowed for a definite diagnosis of HSV pneumonia included the presence of intranuclear inclusion bodies on haematoxylin and eosin staining, or positive immunohistochemical staining. High-resolution CT scans (HiSpeed Advantage or LightSpeed QX/i, GE Healthcare) using 1- or 1.25-mm collimation at 10-mm intervals without intravenous contrast medium injection were assessed, in particular for the presence and distribution of parenchymal abnormalities including ground-glass attenuation, airspace consolidation, nodules and interlobular septal thickening. In two patients, pathological specimens were obtained from open lung biopsy or bronchoscopic biopsy, and were correlated with HRCT findings. Three HRCT patterns of pulmonary abnormalities were identified in our series of HSV pneumonia: predominant areas of diffuse or multifocal ground-glass attenuation, predominant areas of multifocal peribronchial consolidations, and a mixed pattern of both. Histopathologically, areas of ground-glass attenuation seen on HRCT corresponded to diffuse alveolar damage in one patient who underwent open lung biopsy. No specific differences in HRCT findings were seen between the immunocompromised and the immunocompetent patients. In patients suspected of having an acute lower respiratory infection, whether immunocompromised or immunocompetent, a possibility of HSV pneumonia can be included in differential diagnoses when diffuse or multifocal areas of ground-glass attenuation and/or consolidations are seen on HRCT.

As design rules and corresponding logic standard cell layouts continue to shrink node-on-node in accordance with Moore's law, complex 2D interactions, both intra-cell and between cells, become much more prominent. For example, in lithography, lack of scaling of λ/NA implies aggressive use of resolution enhancement techniques to meet logic scaling requirements-resulting in adverse effects such as 'forbidden pitches'-and also implies an increasing range of optical influence relative to cell size. These adverse effects are therefore expected to extend well beyond the cell boundary, leading to lithographic marginalities that occur only when a given cell is placed "in context" with other neighboring cells in a variable design environment [1]. This context dependence is greatly exacerbated by increased use of strain engineering techniques such as SiGe and dual-stress liners (DSL) to enhance transistor performance, both of which also have interaction lengths on the order of microns. The use of these techniques also breaks the formerly straightforward connection between lithographic 'shapes' and end-of-line electrical performance, thus making the formulation of design rules that are robust to process variations and complex 2D interactions more difficult. To address these issues, we have developed a first-principles-based simulation flow to study contextdependent electrical effects in layout, arising not only from lithography, but also from stress and interconnect parasitic effects. This flow is novel in that it can be applied to relatively large layout clips- required for context-dependent analysis-without relying on semi-empirical or 'black-box' models for the fundamental electrical effects. The first-principles-based approach is ideal for understanding contextdependent effects early in the design phase, so that they can be mitigated through restrictive design rules. The lithographic simulations have been discussed elsewhere [1] and will not be presented in detail. The stress calculations are based on a finite-element method, extrapolated to mobility using internal algorithms. While these types of calculations are common in '1D' TCAD space, we have modified them to handle ~10 μm X 10 μm clips in reasonable runtime based on advances in software and optimization of computing resources, structural representations and simulation grids. In this paper, we discuss development and validation of the simulation flow, and show representative results of applying this flow to analyze context-dependent problems in a 32-nm low-power CMOS process. Validation of the flow was accomplished using a well-characterized 40/45-nm CMOS process incorporating both DSL and SiGe. We demonstrate the utility of this approach not only to establishing restrictive design rules for avoiding catastrophic context-dependent effects, but also to flag individual cells and identify cell design practices that exhibit unacceptable levels of context-dependent variability. We further show how understanding the sources of stress variation is vital to appropriately anchoring SPICE models to capture the impact of context-dependent electrical effects. We corroborate these simulations with data from electrical test structures specifically targeted to elucidate these effects.

A windowed nonlinear energy operator (wNEO)-based algorithm is proposed to detect the first-arrival pulse of ultrasound transmission computed tomography (UTCT). In UTCT, the detection of first-arrival pulse is critical to derive imaging indices such as attenuation coefficients and time-of-flight (TOF). Currently, various algorithms utilizing a threshold, maximum, wavelet, etc. have been tested for the detection of the pulse, but each technique suffers from its own intrinsic limitations, failing in detecting the first-arrival pulse reliably. Especially the most widely used wavelet technique, which is also considered as the most effective technique to handle frequency-dependent attenuation, dispersion, and noise of ultrasound, often fails to detect the first-arrival pulse due to the inconsistency of ultrasound pulse shapes with respect to a best mother wavelet. Furthermore, the wavelet technique is impractical for real-time processing. In this work, we propose the use of wNEO for the first time to detect the first-arrival pulse and show its outperforming results in comparison to those conventional techniques through simulation and experimental data with a pair of 5MHz ultrasound transmitreceive transducers.

A new strategy to register each slice of the postmortem brain to anatomically corresponding in-vivo MRI slices is presented. The approach relies on a recursive reslicing of the FVIRI volume using non-linear polynomial transformations. Simulation studies to validate the approach and results using real data are presented. The results suggest the feasibility and practicability of second- and third-order polynomials to register postmortem images on a slice-by-slice basis to corresponding MRI sections. Using this method, it is possible to investigate the pathology of a disease through routinely acquired MRIs and postmortem brain images.

A rare case of carotid cavernous fistula occurring during endovascular embolization of the left carotid cave aneurysm in a 48-year-old female is reported. It was thought to be caused by the tear of a small branch derived from the intracavernous internal carotid artery while the guidewire was passing the sharp posterior bend of the intracavernous internal carotid artery. The left carotid cave aneurysm was completely occluded with five Guglielmi detachable coils assisted by neck plasty technique. It was decided to follow-up the carotid cavernous fistula since it was asymptomatic. Follow-up angiogram performed two weeks later revealed spontaneous obliteration of the carotid cavernous fistula.

We have studied the use of tertiarybutylarsine (t‐BuAsH2) for organometallic vapor phase epitaxy (OMVPE) growth of AlGaAs/GaAs heterojunction bipolar transistors (HBTs). Good dc characteristics were achieved with t‐BuAsH2‐grown HBT structures, including common‐emitter current gains higher than 200 and 1000 for n‐p‐n and p‐n‐p structures, respectively. Near‐ideal current gain dependence on the collector current density was observed, indicating that the quality of AlGaAs was suitable for high‐performance HBTs. The microwave characteristics were also comparable to those of arsine‐grown HBTs. These results demonstrate that t‐BuAsH2 can successfully replace arsine for OMVPE growth of AlGaAs/GaAs HBT structures.

With the introduction of a new cardiac prosthesis, it behooves surgeons and cardiologists to carefully monitor its performance. The ATS Medical prosthetic valve has been used at Guro Hospital in Korea since 1994.