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Ductal adenocarcinoma is a variant of prostatic adenocarcinoma, originating from the epithelial lining of the primary and secondary ducts of the prostate. We report a 63-year-old male with prostatic ductal adenocarcinoma, presenting as urinary retention and a prostate-specific antigen (PSA) level of 11.71 ng/mL and biopsy-proven prostate cancer (Gleason score 3 + 3). MRI showed 2 hemorrhagic, multilocular cysts projecting into the bladder side from the prostatic inner gland and between the prostate and the right seminal vesicle. The prostate inner gland showed high signal intensity on the T2-weighted image and included tiny hyperintense spots on the fat-suppression T1-weighted image. In the part of the border of the hemorrhagic, multilocular cyst, a solid portion showing slight low intensity on T1-weigthed imaging and markedly restricted diffusion was observed, suggesting prostate cancer. He underwent total prostatectomy, and ductal adenocarcinoma (Gleason score 4 + 4) in the prostate inner gland and multilocular cysts was pathologically diagnosed. After the operation, his PSA level gradually increased, and MRI 8 months after the operation showed a vesical multilocular cyst, suggesting local recurrence. After he underwent radiation therapy and hormonal therapy, PSA level decreased, and no re-recurrence was observed during 8 years. We suggest its inclusion in the differential diagnosis of cases of prostatic ductal adenocarcinoma’s multiloculated cystic formation around the prostate and the bladder.

This study describes the Ku -band 70- and 30-W-class internally matched gallium nitride (GaN) power amplifiers (PAs) for multi-carrier satellite communications (SatComs). The GaN PAs maintain low third-order intermodulation distortion (IMD3) over a wide offset frequency range of up to 400 MHz, whereas in the Ku -band, one PA can deliver a high peak output power of approximately 70 W and the other PA, a peak output power of higher than 30 W. To realize a wide offset frequency operation, our proposed output-matching circuit includes three different types of difference-frequency short circuits, two of which are embedded into a tournament-shaped output-matching circuit inside the PA package and the rest is embedded into the drain bias feed placed outside the package. To verify the short-circuit design and its effectiveness, two different power classes (70 and 30 W), Ku -band GaN PAs, were designed and fabricated, and then, their output transfer characteristics focusing on IMD3 were measured. The measurements show that the 70-W-class GaN PA achieves a peak output power of 48.6 dBm while maintaining a linear output power of over 40 dBm and an IMD3 of less than −26 dBc over wide offset frequencies ranging from 1 to 400 MHz. The 30-W-class GaN PA maintains a linear output power of over 36.3 dBm and an IMD3 of less than −27 dBc over wide offset frequencies of up to approximately 600 MHz. To the best of the authors’ knowledge, these PAs have a record output power level over a wide frequency range of 1–400 MHz or higher under the condition of a low IMD3 of less than −25 dBc, compared to previously reported Ku -band GaN PAs used for multi-carrier SatComs.

Treatment-related neuroendocrine-differentiated prostate cancer (NEPC) is a rare tumor entity that transdifferentiates from adenocarcinoma as an adaptive response to androgen receptor pathway inhibition. We report a 79-year-old male with treatment-related NEPC, presenting as rectal bleeding after hormonal therapy. MRI showed a 51 × 52 × 65 mm tumor occupying almost the whole prostate gland and invading the seminal vesicle and rectum as moderately heterogeneous hypointensity on T2-weighted image, restricted diffusion on apparent diffusion coefficient map and diffusion-weighted imaging, and heterogeneous enhancement on Gd-enhanced T1-weighted image. FDG-PET/CT showed strong FDG uptake of the prostate tumor, and somatostatin receptor scintigraphy (SRS) showed mild uptake of the prostate tumor. The surgically resected specimen revealed NEPC. If prostate cancer worsens despite conventional therapy, treatment-related NEPC should be considered, and the benefit of imaging examinations including prostate MRI, FDG-PET/CT, and SRS is in localizing lesions with neuroendocrine differentiation.

Autoimmune hemolytic anemia (AIHA) is a rare comorbidity in colorectal cancer (CRC) and has an unknown etiology. Previously, we described an AIHA case secondary to CRC with ectopic band 3 expression. Herein, we investigated ectopic band 3 expression and erythrocyte membrane-bound IgG in a CRC cohort. Between September 2016 and August 2018, 50 patients with CRC and 26 healthy controls were enrolled in the present study. The expression of band 3 and SLC4A1 mRNA was observed in 97% of CRC surgical specimens. Although clinical AIHA was not observed in any patient with CRC, a direct antiglobulin test was positive in 10 of the patients in the CRC group (p = 0.01). Flow cytometry revealed significantly increased erythrocyte membrane-bound IgG among patients with CRC compared to healthy controls (mean ± standard deviation; 38.8 ± 4.7 vs. 29.9 ± 15.6, p = 0.012). Normocytic anemia was observed, including in cases negative for fecal occult blood, suggesting a shortened erythrocyte life-span due to increased membrane-bound IgG. Immunoprecipitation revealed increased anti-band 3 autoantibodies in patients' sera. Mouse experiments recapitulated this phenomenon. We also confirmed that band 3 expression is controlled by 5' AMP-activated protein kinase under hypoxic conditions. These findings increase our understanding of the etiology of cancer-related anemia.

Multiple-system atrophy is an adult-onset progressive neurodegenerative disease affecting the central nervous system, including the spinal cord. There has been no perioperative guideline of the muscle relaxants used in multiple-system atrophy, although a recent article recommends anesthesiologists to use shorter-acting drugs at the lowest possible doses in the patients. Here, we document the first case with multiple-system atrophy undergoing surgery managed with a combination of rocuronium and sugammadex. The recovery time to the train-of-four count 2 after intravenous rocuronium 0.6 mg / kg, or the time from the start of sugammadex 2 mg / kg intravenously to the train-of-four ratio over 0.9 was prolonged in our case more than 20 and 2 minutes compared with those in healthy subjects, respectively. Neuromuscular monitoring, in addition to the careful vigilance in the perioperative period, seems mandatory in the patients. J. Med. Invest. 68 : 381-382, August, 2021.

Background Ectopic pancreas is basically a benign disease and is not always necessary to be removed. However, all types of neoplasms occurring in the normal pancreas such as ductal adenocarcinomas and intraductal papillary mucinous neoplasms (IPMNs) may develop even within ectopic pancreas. We recently encountered an extremely rare case of ectopic pancreas in the gastric antrum associated with IPMN possessing a GNAS mutation. Case presentation A 71-year-old Japanese woman complained of epigastric pain. Computed tomography and upper gastrointestinal endoscopy showed an intramural cystic mass in the antrum of the stomach. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) biopsy did not give a definitive diagnosis, and the patient underwent resection of the lesion. Histology of the resected specimen showed that the gastric intramural lesion was ectopic pancreas. Moreover, the lesion contained dilated duct components with tubulo-villous epithelial proliferation consistent with pancreatic IPMN. Since the covering epithelial cells had highly atypical nuclei, the lesion was diagnosed as IPMN with high grade dysplasia. Immunohistochemistry showed that the IPMN component showed to be MUC2-, MUC5AC-, and CDX2-positive but MUC1- and MUC6-negative. Mutational analyses using genomic DNA revealed that the IPMN component had a mutation of GNAS at exon 8 (Arg201Cys). Conclusion We finally diagnosed this case as gastric ectopic pancreas accompanied by intestinal type IPMN with high grade dysplasia possessing GNAS mutation. Although there were 17 cases of ectopic pancreas with IPMN including 6 cases of gastric ones reported in the English literature, this is the first case of ectopic pancreas with IPMN which was proved to have GNAS mutation. Intimate preoperative examinations including imaging analyses and EUS-FNA biopsy/cytology are recommended to decide whether the lesion has to be resected or not even if they are not effective for getting the right diagnosis.

A 66-year-old man was diagnosed with a gastric submucosal tumor. Endoscopic ultrasound (EUS) revealed an iso/hypoechoic mass in the third layer. No malignant cells were detected in a histological examination. Yearly follow-up endoscopy and EUS showed the slow growth of the tumor. Endoscopic submucosal dissection (ESD) was performed and a glistening tumor was resected. The lesion showed a multinodular plexiform growth pattern consisting of spindle cells with an abundant fibromyxoid stroma that was rich in small vessels. The tumor was diagnosed as plexiform fibromyxoma (PF) by immunohistochemistry. Although difficulties are associated with reaching a diagnosis preoperatively, chronological changes on EUS may contribute to the diagnosis of PF. ESD may also be useful in the diagnosis and treatment of PF.

We report the case of a 62-year-old woman with a history of bilateral hearing impairment, who developed mitochondrial cardiomyopathy after chemotherapy. The patient underwent postoperative cisplatin chemotherapy after the surgical treatment of cervical cancer. The systolic function of her left ventricle decreased significantly. A tissue examination of the left ventricle revealed mitochondrial cardiomyopathy. Genetic testing revealed mutations in mitochondrial 3,243 A→G. Nine hundred fifty-five individual mutations were identified by next-generation sequencing. Since cardiovascular complications are the second leading cause of morbidity and mortality in patients undergoing cancer treatment, mitochondrial cardiomyopathy should be considered a potential cause of heart failure.

The aim of this paper is to clarify how natural disasters influence the stock prices of property-liability insurance companies. Examining a series of typhoons that made landfall in Japan, this paper shows that the stock prices of property-liability insurers, on average, increase around typhoon landfalls. However, cross-sectional results indicate that specific insurer or typhoon characteristics can temper the increase. First, a property-liability insurer’s stock price reacts more positively around typhoons of greater scale and more negatively around typhoons with longer intervals from the previous typhoon landfall, with longer times to landfall, or that cause more serious residential damage. Second, a property-liability insurer’s stock price reacts according to its profitability or business structure. In addition, insurers with a larger capital buffer or of greater financial soundness are evaluated relatively higher around typhoon landfall since the deregulation of the insurance industry.

We herein examined the immunohistochemical expression of 2 hepatocyte-specific transporters (bile salt export pump [BSEP] and multidrug-resistance protein 3 [MDR3]) in hepatocellular carcinomas (HCCs, n=54), intrahepatic cholangiocarcinomas (n=34), combined hepatocellular and cholangiocarcinomas (n=23), and hepatoid carcinomas originated from extrahepatic organs (n=27) to compare their diagnostic values with those of arginase-1 (ARG1) and hepatocyte paraffin-1 (HepPar-1). BSEP was expressed in 91% of HCCs and MDR3 in 83%. Although their sensitivities were slightly lower than those of ARG1 (96%) and HepPar-1 (93%), the 2 transporters appeared to be more specific for HCCs. ARG1 and HepPar-1 were expressed in intrahepatic cholangiocarcinomas (9% and 6%) and hepatoid carcinomas (22% and 44%, respectively), whereas BSEP and MDR3 were entirely negative in these neoplasms, except for 1 case of BSEP-positive hepatoid carcinoma of the esophagus. The highly specific expression of BSEP and MDR3 in hepatocytes was recapitulated in additional examinations of combined hepatocellular and cholangiocarcinomas, in which the expression of the transporters was restricted to morphologically hepatocellular areas. In contrast, ARG1 and HepPar-1 were also variably positive in areas of biliary or indeterminate differentiation. We also applied BSEP and MDR3 immunohistochemistry to 8 biopsy cases of poorly differentiated primary liver cancer, in which the original diagnosis was not conclusive. The diagnosis of HCC was retrospectively suggested in 2 cases expressing both BSEP and MDR3. In conclusion, given the highly specific expression of BSEP and MDR3 in HCCs, immunohistochemistry for these transporters will be useful not only for determining hepatocellular differentiation in primary liver cancers but also for discriminating HCCs from hepatoid carcinomas.

Preventing pressure ulcers is important in patients undergoing procedures in the park-bench position. We hypothesized that the microclimate around the skin is a significant risk factor for developing pressure ulcers. This research continuously assessed factors of the microclimate in terms of skin temperature and perspiration as well as the interface pressure in order to determine whether the microclimate is an independent risk factor for the development of park-bench position-related pressure ulcers (PBP-PUs). A prospective observational study was conducted among patients undergoing elective surgery in the park-bench position at a general hospital in the metropolitan area of Japan between April and November 2014. Factors of the microclimate, including skin temperature and perspiration, in addition to the interface pressure were continuously measured throughout surgery. Twenty-nine patients were analyzed (mean age 44.4 ± 13.2 years, male 44.8%). Of these 29 patients, seven (24.1%) developed Category I PBP-PUs. The change in skin temperature from baseline to the end of surgery (2.7 ± 0.3 °C vs. 1.9 ± 0.8 °C) and the average peak pressure (119.1 ± 36.8 mmHg vs. 94.5 ± 23.1 mmHg) were significantly higher in the patients with PBP-PUs than in those without PBP-PUs. There were no significant differences in the amount of perspiration between the two groups. A hierarchical logistic regression analysis showed that the change in skin temperature was significantly related to the development of PBP-PUs (unit = 0.1 °C: odds ratio 1.44, 95% confidential interval 1.09-2.33) when adjusted for the average peak pressure and length of surgery. Our results suggest that a change in skin temperature toward a higher value is an independent risk factor for the development of PBP-PUs. Proper intraoperative management of skin temperature may therefore be a promising candidate as a preventive method against PBP-PU development.

Suprasellar and third ventricular region cavernous malformations originating from the floor of the third ventricle are extremely rare. We report a case of third ventricular cavernous malformation arising from the ventricle floor in a 24-year-old woman who presented with short-term memory loss and disorientation. Computed tomography revealed a suprasellar mass with calcification in the posterior chiasmatic region. T2-weighted magnetic resonance imaging revealed a mass with heterogeneous intensity and without hydrocephalus. The mass was slightly enhanced subsequent to gadolinium infusion. Using a basal interhemispheric translamina terminalis approach and a neuroendoscope, we confirmed that the tumor was located at the floor of the third ventricle and removed it. Histopathological examination confirmed the diagnosis of cavernous malformation. The postoperative course was uneventful, but the patient's short-term memory loss persisted. Despite its rarity, cavernous malformation should be suspected when a tumor is detected in the vicinity of the third ventricle floor. It is treatable through surgical resection.

Patients undergoing surgery in the park-bench position are at high risk of developing intraoperatively acquired pressure ulcers (IAPUs). The purpose was to examine retrospectively risk factors associated with IAPUs in the park-bench position. This study was conducted at a general hospital during the period of September 2010 to September 2012. Twenty-one potential risk factors were evaluated using data obtained from the hospital database. IAPUs developed in 30 of 277 patients (11%). Perspiration was statistically found to be independently associated with IAPUs [OR 3·09, 95% confidence interval (Cl) 1.07-8·58, P = 0·037]. A length of surgery of more than 6 hours was identified to be likely associated with IAPUs (OR 2·64, 95% Cl 0·84-9·08, P = 0·095) compared with less than 6 hours. Furthermore, there was an interaction between the length of surgery and the core temperature; that is, when the length of surgery was more than 6 hours, a core temperature of more than 38·1°C at the end of surgery had a higher odds ratio (8·45, 95% Cl 3·04-27·46, P < 0·001) than that at a lower core temperature (3·20, 95% Cl 1·23-8·78, P = 0·017). These results suggest that perspiration and core temperature are preventable causative factors of pressure ulcers, even under conditions of prolonged surgery in the park-bench position.

Radiological findings of pulmonary infarction have been well characterized mainly in established infarction. However, the early course CT appearance of patients who develop pulmonary infarction has not yet been fully elucidated. A 50-year-old female with a history of postmenopausal hormone replacement therapy (HRT) presented with dry cough and high-resolution computed tomography (HRCT) findings of fan-shaped segmental ground-glass opacity (GGO) in the right lower lobe. As the parenchymal density in the GGO gradually enlarged over a period of 4 weeks in spite of antibiotic treatment, the patient was referred to our hospital on clinical suspicion of bronchioloalveolar cell carcinoma. However, the pathological findings of a transbronchial biopsy of the lesion were compatible with pulmonary infarction. After an endoscopic examination, the typical CT appearance of established pulmonary infarction was observed. Moreover, enhanced CT detected an intraluminal filling defect in the right lower lobe artery suggesting peripheral pulmonary emboli. Our case was a peripheral pulmonary infarction probably induced by HRT, and suggested that fan-shaped GGO may be a premonitory sign of pulmonary infarction.

BACKGROUND AND OBJECTIVES To explore whether lymphocytes in sentinel lymph nodes (SLNs) are highly exposed to tumor neoantigens and thus express high level of programmed death 1 (PD-1), we examined PD-1 expression in SLNs and non-sentinel regional lymph nodes (non-SLNs) in breast cancer. METHODS We performed PD-1 immunohistochemistry in two cohorts: 40 metastasis-negative SLNs including 10 patients for each subtype (luminal A-like, luminal B-like, HER2, and triple negative breast cancer [TNBC]); and 25 pairs of metastasis-positive SLNs and non-SLNs (10 luminal A-like, 10 luminal B-like, and 5 TNBC). RESULTS Among 40 metastasis-negative SLNs, 34 and 6 samples were PD-1 intensity grade 1 (low) and 2 (high), respectively. PD-1 intensity correlated with PD-1-positive lymphocyte numbers (P = 0.005); TNBC had the highest PD-1 lymphocyte numbers among all subtypes. The median PD-1-positive lymphocyte number was higher in SLNs than non-SLNs. In most cases, more lymphocytes in SLNs expressed PD-1 than those in non-SLNs (P

The patient was a 15-year-old girl with severe acute hepatitis. A liver biopsy showed the typical findings of autoimmune hepatitis (AIH). Subsequently, two lineages of cytopenia were found in the patient's peripheral blood. Hemophagocytosis by macrophages was observed in the bone marrow. Virus-, drug- and lymphoma-associated hemophagocytic syndrome (HPS) was ruled out. Therefore, the patient was diagnosed with autoimmune-associated HPS (AAHS). Following the administration of combination therapy with prednisolone and cyclosporine A, both the AAHS and AIH improved. This is the first report of AAHS originating from AIH. The patient was followed up for five years after treatment, and no disease recurrence was detected.

We report on a seasonal pattern that has persisted in the Japanese stock market for more than half a century: Mean stock returns are significantly positive for months during the first half of the calendar year and significantly negative for months during the second half. Dubbed the Dekansho‐bushi effect, this seasonality is independent of other known calendar anomalies, such as the so‐called January effect. The Dekansho‐bushi effect should be distinguished from the ‘sell in May effect,’ because Japanese stocks perform well in June and poorly in November and December. The Dekansho‐bushi effect varies in magnitude among firms and is particularly significant among small firms with high book‐to‐market ratios. Nonetheless, the effect exists, regardless of a company's size or book‐to‐market ratio.

The Great East Japan Earthquake of March 11, 2011, incurred huge damages to Japan. This paper investigates how this earthquake influenced the value of Japanese insurance companies, especially non-life insurance companies. Our findings are as follows. (1) The stock prices of insurance companies decreased right after the earthquake. The spread of this decrease was less for the stock prices of non-life insurance companies than for those of life insurance companies. (2) The more capital buffer a non-life insurance company had, the higher the stock return. (3) The Earthquake Insurance System on Dwelling Risks in Japan not only indemnifies seismic losses but also functions as a Japanese stock market stabilizer.

Semiconductor spintronics is an extensively studied field toward next generation devices. For room temperature operation of semiconductor spintronics, high temperature ferromagnetic semiconductor is needed. This paper reviews recent progress of one of the high temperature ferromagnetic semiconductors, ferromagnetic oxide semiconductor, mainly Co-doped TiO2.

This paper proposes a method for generating an adaptive knowledge base (AKB) involving two knowledge representations: rule and case. Combining rules and cases makes it possible to solve problems accurately and quickly, and to acquire new cases from problem-solving results. In general case-based problem-solving methods, the similarity metric must be defined for each problem domain. In previous work using rules and cases, a threshold of negative case applications had to be adjusted. The proposed AKB does not require manual adjustment of the threshold and the similarity metric.

Cronkhite–Canada syndrome (CCS) is a rare nonhereditary syndrome characterized by gastrointestinal polyposis and ectodermal changes [1]. Although several treatments, such as steroids, are available, the prognosis is poor, with a 5-year mortality rate of 55% [2]. A 57-year-old man, who suffered from alopecia, anorexia, severe diarrhea, dystrophic nail changes, and pigmentation on the hands, presented to our hospital. Colonoscopy revealed numerous polyps throughout the colon (●" Fig.1a). Gastroscopy and small-bowel series also showed severe gastric and small-bowel polyposis, and histology showed juvenile-like polyps with mild inflammation. On the basis of these findings, the patient was diagnosed with CCS. He was treated with medications including corticosteroids, antiplasmin agents, and azathioprine; however, the symptoms persisted. He developed intussusception 7 years after diagnosis (●" Fig.1b) and underwent ileocecal resection. As he continued to suffer from frequent relapses, with diarrhea and malnutrition with severe hypoalbuminemia, a different therapeutic strategy was needed to control the disease progression. Supported by a single report finding of high levels of tumor necrosis factor alpha (TNF-α) in tissue affected by CCS [3], implying that antiTNF-α therapy could be useful for CCS patients, the patient was administered infliximab at 200mg every 2 weeks. His general condition improved, and colonoscopy performed 20 months after induction of anti-TNF therapy showed complete remission with the disappearance of polyposis (●" Fig.1c). He now receives 200mg of infliximab every 8 weeks, and has been symptom free for 3 years since the initial administration. There is one report that described strong TNF-α expression in intestinal mucosa affected by CCS, implicating the potential usefulness of anti-TNF-α antibody for patients with CCS. However, to the best of our knowledge, this treatment has not been tested until now [3]. Although we could not detect TNF-α expression in the polyps of this patient by immunohistochemistry (●" Fig.2), given the patient’s dramatic response to therapy, it can be assumed that TNF plays an important role in disease development, perhaps upstream of polyp formation. This case indicates that further basic and clinical research is warranted, and that anti-TNF therapy could be an important new strategy for treatment of CCS.

The preventive effect of vitamin E (Vit. E)-containing liposome instillation on cataract progression was examined in 12-month-old Wistar rats fed a 25% galactose diet. Vit. E-containing liposomes prepared with dipalmitoylphosphatidylcholine and dioleoylphosphatidylcholine (7:3 w/w) were instilled into both eyes twice a day. Lenses of galactose-fed rats showed suture accentuation at 6 months of feeding and opacities in the cortex and nuclei at 8 months. Two months of Vit. E-containing liposome instillation, starting at 6 months of galactose feeding, retarded this cataract progression. Lenses of galactose-fed rats had increased Vit. E, lipid peroxide (LPO), galactitol, and water contents and decreased reduced glutathione (GSH) content at 6 months of feeding; increased LPO, galactitol, and water contents and decreased GSH content at 8 months. Sera of galactose-fed rats had increased Vit. E and cholesterol concentrations at 6 months of feeding. The liposome instillation increased lens Vit. E content with attenuation of the increased lens LPO content and the decreased lens GSH content but did not affect the changes in lens galactitol and water contents and serum Vit. E and cholesterol concentrations. These results indicate that instilled Vit. E-containing liposomes retard cataract progression in 12-month-old rats fed a 25% galactose diet, mainly by the antioxidative and membrane-stabilizing actions of Vit. E contained in the liposomes.

Emissive behaviors from the systems with the sizes of the order of visible wavelength are described. Control of electrically-pumped emission from thin-film electroluminescent devices by use of one-dimensional planer cavities is demonstrated. Photoluminescence behaviors from organic dielectric stacks with buried emissive centers prepared by vacuum-vapor deposition were examined. Photoluminescence from self-organized three-dimensional ordered arrays of polystyrene small particles with luminescent dyes is also studied. In both systems, inhibition of spontaneous emission due to photonic gaps were observed.

This study examines wealth effects of mergers and acquisitions in developing mergers and acquisitions market by using data of both domestic and cross-border acquisitions by Japanese firms. Although Japan had the second largest GDP in the world during the analyzed period, active market for corporate control in Japan started recently. The results indicate that M&A by Japanese firms enhance shareholder wealth. We also show that larger synergy realized in horizontal acquisitions with full control of target firms. Existence of outside directors and monitoring by shareholders contribute the post-acquisition performance. We provide evidence that acquisitions by Japanese firms play similar role as those in the US and the UK.

This paper aims to introduce new evidence of consistently negative impacts on enterprise value when corporations increase real estate holdings. Adopting a different approach from previous studies, our data analysis shows that corporate real estate portfolios and enterprise value share an inverse relationship. Surprisingly, this trend was seen during the Japanese real estate bubble in the late 1980' s. Previous reports from the United States and Singapore show that only in the retail sector do increases in corporate real estate holdings have a positive influence on stock performance. However, our research indicates that the stock performance of Japanese firms in the retail sector was negative across the board for firms in other sectors.

子宮摘出術症例10例で麻酔導入時の高濃度イソフルラン吸入による循環動態変動に対するフェンタニル導入2分前投与の効果と,麻酔導入前後の血中カテコラミン濃度の変化を検討した。チアミラールおよびベクロニウムを静注,100%酸素およびイソフルラン5%とし,調節呼吸を5分間継続後気管内挿管を行った。脈拍数は,イソフルラン5%吸入群(I群)では導入後有意に増大したが,フェンタニル2μg/kg前投与群(F群)ではこの脈拍数の上昇は有意に抑制された。導入時,平均動脈圧には群間の差はなかった。I群およびF群とも,血中ノルエピネフリン濃度は導入後有意に増大したが群間の差はなかった。また,エピネフリン濃度にも群内,群間の差はなかった。本研究結果から,高濃度イソフルラン吸入時の頻脈抑制にフェンタニル前投与は有効であるが,この抑制作用は血中カテコラミン遊離抑制によらないものと考えられた。

We test whether Japanese leading CEOs are optimistic and miscalibrated using 50 years of survey data conducted by the Nihon Keizai Newspaper on New Year’s Day. In a sense, this study is a complement to Ben-David, Graham and Harvey (2010), who find U.S. executives are severely miscalibrated using the 10 years of survey data. Our unique Japanese data provide an opportunity to examine CEO miscalibration under a different setting over a longer period of time. Though we use a completely different data set, our results are similar to Ben-David, Graham and Harvey (2010). However, we find several important differences. One of the interesting findings is the clear contrast of forecasts by CEOs between two different periods of Japanese economy: more conservative during the high growth period and more optimistic during the low growth period. Contrary to US CFOs, Japanese CEOs predict current trend would reverse. We also find Japanese CEOs are more optimistic and less miscalibrated than their U.S. counterparts. Corporate investment does not seem to increase with either optimism or miscalibration unlike the U.S. The performance of the portfolio based on CEOs’ recommendation is not better than the market average.

術前2週間以内のかぜ既往,および,術直前のかぜ症状の有無が術中・術後の合併症に与える影響を検討した。7歳以下の小児306例を,里吉らのかぜスコアを用いて,Ia群:かぜ既往があり,術直前のかぜスコアが3点以上,Ib群:かぜ既往があり,術直前のかぜスコアが2点以下,II群:かぜ既往がなく,かぜスコアが2点以下の3群に分類した。対象手術は主に外科の鼠径ヘルニア,形成外科の体表の手術であった。Ia, Ib群はII群より術中呼吸器系合併症が多かった。術後合併症はIa群で他の2群より有意に発生頻度が高かったが,Ib, II群間に有意差はなかった。以上の結果より,術前にかぜ既往がある場合,術直前のかぜ症状が顕著であれば予定手術は延期すべきである。しかし,かぜ既往があっても,かぜ症状がないか,軽度である場合は,必ずしも延期する必要はなく,総合的な判断が望ましい。

The hyperresponsiveness of cardiac tissue to histamine following treatment with reserpine was pharmacologically characterized. Guinea pig hearts were isolated 24 hours after intraperitoneal administration of 5 mg/kg reserpine. This treatment resulted in a complete depletion of tissue norepinephrine. Reserpine treatment potentiated the positive inotropic response of isolated perfused hearts to histamine at doses ranging from 0.3 to 3 micrograms (23 to 57% increase for reserpine-treated animals vs. 14 to 32% increase for control animals). Isolated left ventricular papillary muscle of reserpine-treated guinea pig hearts also showed hyperresponsiveness to histamine at concentrations of 0.1 microM or greater. The hyperresponsiveness of the papillary muscle contraction of the reserpine-treated animals to histamine was abolished in the presence of 1 microM cimetidine, but not attenuated in the presence of 1 microM diphenhydramine. This hyperresponsiveness was not modified by 1 microM bunazosin or 1 microM propranolol. The results suggest that H2-receptor mediated action plays a role in the hyperresponsiveness of cardiac muscles to histamine.

This paper describes a high efficiency and high output power GaN power amplifier for C-band space applications. The amplifier uses on-chip harmonic tuned FETs to improve dc-to-rf conversion efficiency. A 2nd harmonic input tuning circuit is incorporated into each unit on-chip FET cell and realizes high precise control of 2nd harmonic input impedance. In addition, 2nd and 3rd harmonic output impedances are optimized with external output matching circuits. A 100 W power amplifier with 4-chips achieves a 67.0% PAE (72.4% drain efficiency) at 3.7 GHz under CW operating conditions. To the best of our knowledge, this is the highest efficiency of C-band power amplifiers ever reported with over 100 W output power.

This study was undertaken to examine the effect of sevoflurane on right ventricular function, the safety of sevoflurane for one-lung ventilation and the effects of PEEP (positive end-expiratory pressure) to the dependent lung in this model using 12 open-chest sheep. Haemodynamic variables, including cardiac output, mean arterial blood pressure, right ventricular pressure and pulmonary arterial pressure, and right ventricular segment shortening (sonomicrometry) were measured. First, animals received 2.0, 3.0 or 4.0% sevoflurane for 20 min each, respectively, during two-lung ventilation to measure the dose-dependent haemodynamic effects of sevoflurane. Then one-lung ventilation was performed with a randomized sequence of 0 (ZEEP), 5 and 10 cm H2O PEEP to the dependent lung under 2.0% sevoflurane anaesthesia after one-hour stabilization. A decrease in systolic segment shortening along with increases in both the end-diastolic and end-systolic lengths of the right ventricle were observed at 3.0 and 4.0% sevoflurane, while global right ventricular function remained substantially unchanged during two-lung ventilation. During one-lung ventilation the PaO2 was greater with 5 cm H2O PEEP 198 mmHg (+/- 25 SEM) than with ZEEP 138 mmHg (+/- 22) or with 10 cm H2O PEEP 153 mmHg (+/- 23) (P < 0.05). No differences in haemodynamic variables or segment shortening between ZEEP and PEEPs during one-lung ventilation were observed. We conclude that although sevoflurane causes a dose-dependent depression of right ventricular function, sevoflurane anaesthesia can be safely applied to one-lung ventilation, and that 5 cm H2O PEEP to the dependent lung can improve arterial oxygenation without causing changes in right ventricular function.

A subset of lung cancers harbours the fusion gene echinoderm microtubule-associated protein-like-4-anaplastic lymphoma kinase (EML4-ALK). Recently, immunohistochemistry for ALK has shown sensitivity for the detection of EML4-ALK-positive lung adenocarcinoma almost equal to that of the fluorescence in situ hybridisation (FISH) assay.To study the clinicopathological features of EML4-ALK-positive lung adenocarcinoma in a large number of surgically resected samples using immunohistochemistry, in order to establish a useful screening method for EML4-ALK-positive lung adenocarcinoma.Immunohistochemistry for ALK was used to screen for EML4-ALK-positive lung adenocarcinomas in 254 cases of surgically resected samples.EML4-ALK-positive cases were detected in 3.1% of lung adenocarcinomas (8/254). EML4-ALK-positive lung adenocarcinomas showed significant associations with intra- and/or extra-cytoplasmic mucin (p=0.0001), and cribriform pattern with excessive extracytoplasmic mucin (p0.0001). Signet-ring cell appearance alone lacked significance (p=0.149).EML4-ALK-positive lung adenocarcinoma has a tendency to express a characteristic morphological pattern. The combined use of morphological feature analysis and immunohistochemistry may be a useful and cost effective screening method for EML4-ALK lung adenocarcinoma.

This paper describes a high efficiency (68%), high output power (100W), high reliability GaN HEMT amplifier for C-band space applications. The high efficiency is achieved by 2nd-harmonic frequency (2f o ) tuning circuits in the input and output matching circuits. The input circuit uses open-ended stubs located nearby FET gate terminals for setting the 2f o reflection-phase at the optimum phase. In the output circuit, the optimum 2f o reflection phase is realized using three transmission-line transformers while matching loss is kept low at fundamental frequency. In addition, a 3000 hour's RF overdrive life test reveals that an estimated mean time to failure (MTTF) is 1×107 hours at 150°C channel temperature, proving that the amplifier has sufficient reliability for space applications. To the best of our knowledge, the efficiency of 68% is the highest of 100-W class C-band amplifiers ever reported, and is also comparable to that of commercially available traveling wave tube amplifiers.

Periodic dielectric structures, consisting of hexagonally closed-packed arrays of silica microspheres with the diameter of 550 nm, were incorporated into organic light-emitting devices with a conventional two-layer structure made with vacuum-sublimation. The arrays acted as a two-dimensional diffraction lattice which behaved as a light scattering medium for the light propagated in waveguiding modes within the device. Strongly scattered light emission through the front surface of the devices was observed. An increase in the device coupling-out factor for electroluminescent efficiency by using the scattering structure is demonstrated.

Spontaneous emission from dye molecules embedded in periodic dielectric structures was investigated. The structures consist of close-packed arrays of dye-doped polystyrene microspheres. Periodic arrays of polystyrene spheres with a submicrometer diameter were shown to provide a nonoverlapping gap or pseudogap in the visible spectral region. The modification of the spontaneous emission from inside the pseudogap structure was observed as a deep dip in the photoluminescence spectra. The alteration in the emission spectra is explained in terms of the partial suppression of radiation modes due to the periodic dielectric structures.

The preventive action of vitamin E (Vit. E)-containing liposomes on cataractogenesis was examined in male Wistar rats (five weeks old) fed a 25% galactose diet. Vit. E-containing liposomes prepared with dipalmitoylphosphatidylcholine were instilled into both eyes three times a day over a 45-day period. Cataract appeared at 18-day galactose feeding and developed gradually thereafter. Simultaneous Vit. E-containing liposome instillation delayed this cataractogenesis. Lenses of 18-day galactose-fed rats showed decreases in Vit. E and reduced glutathione (GSH) contents and Na+, K(+)-ATPase activity and increases in lipid peroxide (LPO), galactitol, and water contents. Lenses of 45-day galactose fed rats showed decreases in GSH content and Na+,K(+)-ATPase activity and increases in Vit. E, LPO, galactitol, and water contents. Serum Vit. E and cholesterol levels decreased in 18-day galactose-fed rats, while both levels increased in 45-day galactose-fed rats. Simultaneous Vit. E-containing liposome instillation prevented these changes except for the changes of lenticular galactitol and water contents and serum Vit. E and cholesterol levels. These results indicate that simultaneously instilled Vit. E-containing liposomes can delay cataractogenesis in young adult rats fed a 25% galactose diet mainly by the antioxidative action of Vit. E contained in the instilled liposomes.

Room-temperature ferromagnetic oxide semiconductor Co-doped TiO2 films are grown on glass substrates by sputtering method. Conducting films are ferromagnetic at room temperature that is consistent with the carrier-mediated nature of the ferromagnetism. Nearly full-polarized magnetization, large magneto-optical effect, and anomalous Hall effect are observed at room temperature. The magneto-optical effect shows nearly fourfold enhancement in a one-dimensional magnetophotonic crystal structure with a standard dielectric multilayer (SiO2/TiO2).

Two-dimensional ordered arrays of SiO2 (silica) microspheres, as a semi-two-dimensional photonic crystal, with large surface area were fabricated by using a newly developed self-organization method. We observed strong light scattering and hexagonal diffraction patterns for the hexagonally close-packed array of spheres with submicrometer size. Dips in the transmission spectra due to coupling between incident light and electromagnetic bound states of the photonic bands within the array were observed. From the transmission spectra, we determined the photonic band structure of the two-dimensional arrays of microspheres.