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A search for solar axions has been performed using an axion helioscope which is equipped with a 2.3m-long 4T superconducting magnet, a gas container to hold dispersion-matching gas, PIN-photodiode X-ray detectors, and a telescope mount mechanism to track the sun. A mass region around m_a = 1eV was newly explored. From the absence of any evidence, analysis sets a limit on axion-photon coupling constant to be g < 5.6-13.4x10^{-10} GeV^{-1} for the axion mass of 0.84, Comment: 13 pages, 6 figures, to be published in PLB

Introduction Recently developed radiochromic films can easily measure the absorbed doses by using a flat-bed scanner. However, in a GAFCHROMIC EBT3 (EBT3) radiochromic film, the precision of the measurement was compromised because of the change in density caused by the scan timing of image acquisition using a flat-bed scanner. Purpose The purpose of this study was to investigate the temporal light source change of a flat-bed scanner affecting the density of EBT3. Materials and methods EBT3 without irradiation was used to remove non-uniformity error caused by irradiation. EBT3 was scanned every hour (0–6 h) from power activation to investigate the temporal light source change of a flat-bed scanner (EPSON ES-10000G). In addition, five consecutive scans were performed every hour. Scan parameters were RGB (48 bit) mode, 100 dpi, the reflection mode. Image data of EBT3 was divided into R, G, and B modes, and the R (16 bit) mode was used. The region of interest has a diameter of 75 pixels in the center of the EBT3 sheet. Results The density gradually decreases after power activation and became the plateau 5 h later. After the first scan, a low density is observed: the density was stable after the third scan. Conclusion To improve repeatability of EBT3, the scan must be performed only after 5 h power activation. In addition, the image data obtained after the third consecutive scan must be used. Disclosure We have no disclosure and financial support.

As the performance of each node becomes higher, it is expected that the ad hoc network is used for the community network in which a few thousands of mobile nodes exist. In such a network, the number of hops between a source node and a destination node also becomes longer. However, as the route becomes longer, it is difficult to provide the robust and reliable route for mobile ad hoc networks since the multiple route breaks occur at the same time due to the topology change. Therefore, this paper proposes a route-split routing with resiliency to simultaneous failure (RSR). RSR sets up multiple subroute management nodes (SMN's) on the route and each SMN manages the subroute between the SMN and the neighboring SMN. When the multiple route breaks occur at the same time, each subroute is repaired by the SMN. Consequently, RSR can reduce the number of control packets used for the route repair and mitigate the network congestion even in case that the number of nodes in the network becomes very larger.

From January 1995 to May 2003, 36 patients with dialysis-dependent renal failure underwent coronary artery bypass grafting. We performed the operation with cardiopulmonary bypass (group On) in 17 cases and without cardiopulmonary bypass (group Off) in 19 patients [off-pump coronary artery bypass grafting (OPCAB) 15, minimally invasive direct coronary artery bypass (MIDCAB) 4]. There were no statistical differences regarding mean age, sex, duration of dialysis, preoperative hypertension, diabetes and peripheral and cerebral vascular diseases. Mean operation time and the number of bypass grafts were 315 +/- 53 minutes, 2.8 +/- 0.8 grafts in group On and 284 +/- 78 minutes, 2.4 +/- 1.1 grafts in group Off, respectively (not significant). Seventeen patients (100%) of group On and 12 patients (63%) needed blood transfusion. Hospital stay after operation was significantly longer in group On (40 days) of group Off than that in group Off (26 days). After the operation, continuous hemodiafiltration (CHDF) was used in 10 cases (59%) in group On and 3 cases (16%) in group Off. In coronary artery bypass grafting (CABG) on dialysis patient, it is very effective to have various operation techniques, such as off-pump bypass and on-pump beating bypass. Also control of water-electrolyte balance using early postoperative CHDF is useful. However, off-pump cases could be controlled by conventional hemodialysis.

A 68-year-old man was admitted to our hospital because of ischemia in the upper and lower extremities with rest pain. Aortography revealed complete bilateral subclavian artery occlusion and left femoral artery occlusion. We planned simultaneous revascularization of upper and lower extremities. Ascending aorta to biaxillar and left femoral artery bypass was performed. The postoperative course was uneventful and he was discharged on the 18th day after operation. This procedure was useful for patient with upper and lower limb ischemia.

Phase-matching technique by the artificial anisotropic structure and its application to mode converter are proposed for the millimeter-wave dielectric circuitry. Phase-matched dielectric planar waveguide is designed and mode conversion characteristics are studied. Mode conversion experiment is successfully performed.

GaInAsP surfaces were investigated by contact angle measurement of a water droplet to estimate their hydrophilicity. The most hydrophilic surface of GaInAsP was obtained by the O/sub 2/ plasma activation process. Wafer direct bonding was successfully achieved between O/sub 2/ plasma activated GaInAsP and garnet crystals.

In Fukuoka whose population is approximately five million inhabitants, surveys on the accuracy of laboratory data have been performed by the Fukuoka Prefecture Medical Association for the last 30 years. We have been attempting to evaluate the data for routine use since 1988, and it has become possible to share laboratory data between all institutions in Fukuoka prefectures. As a result, reference intervals for 23 clinical chemistry analytes were established in 1995, to which were added in 1996 five serum protein constituents that have been utilized for clinical examinations. Methods for documentations and monitorings the data obtained in the prefecture were also established, standardization of the above analytes extended to 97% of the institutions in the prefecture. Results for 14 of the 23 clinical chemistry analytes have become highly reliable and clinically useful as differences between institutions in terms of results have narrowed. Standardization of other analytes is now in progress.

5-Fluorouracil (5-FU) is a commonly used adjuvant therapeutic drug in treating breast cancer. 5-FU is metabolically converted to 5-fluorouracil-2'-deoxyuridine-5'-monophosphate-(FdUMP) which is believed to inhibit DNA synthesis in neoplastic cells by forming a tightly bound ternary complex with thymidylate synthase (TS). In the present study, we examined the possible relationship between TS levels and clinico-pathologic and prognostic features in breast disease. Mean TS levels of 2.9 pmol/g, 6.1 pmol/g, and 23.1 pmol/g were obtained in cases of benign breast disease (3 cases), primary breast cancer (115 cases), and recurrent tumors (4 cases), respectively. In breast cancer, mean TS levels significantly correlated with S-phase fraction (SPF), DNA polymerase a and lymphatic invasion. Thus, TS levels in breast cancer significantly reflected cell proliferation and malignancy. Regarding the survival rate, patients with TS values above 10 pmol/g showed an unfavorable prognosis. The effectiveness of adjuvant 5-FU derivatives chemotherapy was reflected in a higher disease-free survival rate in node (+) cases showing TS levels between 5 and 10 pmol/g (p0.1), but not in node (-) cases. In conclusion, TS levels in neoplastic tissues of the breast were highest in recurrent tumors, followed by those in primary cancer, benign breast disease and in breast cancer which reflected proliferative activity. Breast cancers with extremely high TS levels were accompanied by an unfavorable prognosis; however, those with moderately high TS levels tended to respond to adjuvant chemotherapy with 5-FU derivatives.

The 5q- syndrome is a myelodysplastic disorder characterized by macrocytic anemia, hypolobulated micromegakaryocytic hyperplasia, and an interstitial deletion of chromosome 5 as a solitary cytogenetic abnormality. The majority of patients with this syndrome are elderly women exhibiting red blood cell transfusion-dependent refractory anemia with a normal-to-increased number of platelets and modest granulocytopenia. The prognosis is relatively favorable with a low incidence of leukemic transformation. We report on a patient with 5q- syndrome associated with autoimmune hemolytic anemia (AHIA) and severe erythroid hypoplasia mimicking pure red cell aplasia (PRCA). A 65-year-old woman was admitted because of severe anemia. Elevated serum levels of LDH and indirect bilirubin, and a positive direct Coombs' test suggested AIHA associated with a huge ovarian dermoid cyst. However, lack of peripheral reticulocytes and bone marrow eryhroblasts, characteristic megakaryocytic morphology, and solitary 5q- anomaly favored a diagnosis of 5q- syndrome complicated by PRCA-like feature. Underlying immunological abnormalities ascribed to aberrant lymphoid clones intrinsic to MDS may be responsible for red cell aplasia and autoantibodies against red blood cells.

A study was performed on 28 cases of ischemic colitis. The patients were divided into three groups: Group A (9 cases with bloody stool detected within 2 hours after the onset of abdominal pain), Group B (7 cases with bloody stool detected in 2 to 6 hours), and Group C (12 cases with bloody stool detected after more than 6 hours). These cases were comparatively studied. Variables used were as follows: (1) age, (2) sex, (3) constipation, (4) vomiting, (5) peak value of WBC count (/microliter) after admission, (6) peak value of log CRP (microgram/dl), (7) presence of ulcerative lesion in endoscopic findings in acute stage. Using Group A B and C as classification variables, canonical discriminant analysis was performed. As a result, clear linearity was recognized in Group A--B--C, and the values (5), (6) and (7) were extracted as the corresponding variables. For these variables, significant difference was also noted in multivariate analysis of covariance. These results suggest that it is possible to predict the severity of the disease to some extent as represented by objective markers of inflammation by finding the time from onset of abdominal pain to detection of bloody stool.

We assessed the clinical efficacy and determined the effective dose of erythropoietin (EPO) in 48 children scheduled for open heart surgery without blood transfusion. The children were divided into three groups: group 1 (n=21) was treated with 300 U/kg of EPO; group 2 (n=11) was treated with 150 U/kg of EPO; and group 3 (n=16) was not treated with EPO. EPO was administered on the day of hospital admission (6 to 7 days prior to surgery), on the following day, immediately after surgery, and on the following day. Immediately after surgery, the hemoglobin concentration in groups 1 and 2 was significantly higher than that in group 3. The reticulocyte count in groups 1 and 2 was significantly higher than that in group 3. Open heart surgery was completed without transfusion in all 21 patients in group 1 (100%), 10 of 11 in group 2 (90.9%), and 11 of 16 in group 3 (68.8%). EPO caused no adverse reactions. In conclusion, EPO was effective as an adjuvant therapy for open heart surgery without blood transfusion in children. Administration of a relatively high dose of EPO (300 U/kg) seems to be effective for pediatric patients.

Extended calcification of the total aorta and arch vessels may make coronary revascularization with cardiopulmonary bypass impossible. We report the left thoracotomy approach for a case of a 70-years diabetic man who was revascularized without cardiopulmonary bypass because of porcelain aorta extended into abdominal aorta, the arch vessels and femoral arteries. He had had prior anterior wall infarction. Cardiac catheterization showed poor ventricular function with an EF of 25% and there was a 60% occlusion of left main trunk, 90% occlusion of circumflex coronary. Through a left thoracotomy, saphenous vein grafting was performed without cardiopulmonary bypass from the noncalcified left subclavian artery to the circumflex coronary artery. During distal anastomosis, distal perfusion of coronary artery was carried out to support the heart up. Intraoperatively, hemodynamic remained stable with no electrocardiographic change. This technique may offer a practical solution to this problem.

The prognoses of T4 lung cancer patients treated surgically were investigated in 76 patients. Extended resection was performed in 21 patients, palliative resection in 21 and exploratory thoracotomy in 34. Although the five-year survival of the extended resection group did not differ significantly from that obtained in the exploratory thoracotomy group, the mean survival time of the extended resection group was 3.1 months longer than that of the exploratory thoracotomy group. Two patients who had undergone resection for left atrial involvement, survived for two years or more, and a T4N0 patient with squamous cell carcinoma, in whom resection for aortic involvement was carried out, died from an unrelated disease after 15 months. Two patients with pleural dissemination, who underwent panpleuropneumonectomy, survived for two years. Surgical intervention did not improve the prognosis of patients with N2-squamous cell carcinoma, those with malignant effusion or those with multiple organ involvement.

Chordal replacement with expanded polytetrafluorethylene suture has become a procedure of choice for repairing anterior leaflet prolapse among certain surgeons. However, most surgeons believe that the chordal replacement is too complicated and not reproducible. This report introduces a new method of chordal replacement using intraoperative epicardial and transesophageal echocardiography. Three dogs underwent the following procedures. One major marginal chorda of an anterior mitral leaflet was resected during cardiopulmonary bypass. A specially designed 3-0 polytetrafluoroethylene suture, having straight needles, was attached to the anterior leaflet by a mattress suture. Then the needles were brought from the root of the anterior papillary muscle to the outside of the left ventricle. After the bypass flow was reduced, both ends of the polytetrafluoroethylene suture were pulled under echocardiographic guidance until valve competence was achieved. At that point, the suture was temporarily tied. When cardiopulmonary bypass was discontinued, competence was again confirmed and the suture was tied permanently. When the procedures were completed, echocardiography showed trivial regurgitation and good pliability of the anterior leaflets in all animals. Left atrial pressures were sufficiently decreased. It appears that this new technique is reproducible for all surgeons because the optimal length of polytetrafluoroethylene chordae is determined with the valve functioning.

62-year-old female, who had been under observation for an indolent myeloma for six years without therapy, was admitted because of left flank pain. Various imaging modalities disclosed left pleural effusion, and a huge abdominal tumor involving the left crus of the diaphragm, spleen, stomach, pancreatic tail, left adrenal gland, left kidney and left posterior abdominal wall. Morphological and immunological examinations revealed extensive proliferation of more anaplastic myeloma cells within the tumor and in the pleural effusion than those in bone marrow on admission or at the beginning of the period of observation. Chemotherapy reduced serum M-protein, but LDH, the volume of the pleural effusion, and the size of the tumor increased. She died of pancreatitis associated with massive bleeding from the gastric tumor. Renal function was well preserved until her terminal phase. The clinical course showed the progression of indolent myeloma into an aggressive one without chemotherapeutic intervention, implying a rare subtype in terms of the natural history of multiple myeloma.

We have developed the protocol for selective cerebral perfusion (SCP) and pharmacological cerebral protection, and used it successfully in cases of aortic arch aneurysm. The subjects of the present study were 34 patients (28 males, 6 females) whose aortic arch aneurysm were surgically treated. Preoperative brain CT and brain scintigram showed high incidence of brain ischemia. However only 4 patients experienced a neurological episode. We conclude that our SCP technique and pharmacological cerebral protection are useful component to surgery of the aortic arch.

A case of Mycoplasma pneumonia complicated with severe hemolytic anemia, which occurred as a result of a high titer of cold agglutinin is presented. A 49 year-old male was admitted because of fever, jaundice and dyspnea. Chest x-ray showed diffuse small nodular infiltrates throughout both lung fields. Laboratory studies disclosed the following values: Hb 4.6 g/dl, Ht 13.9%, reticulocyte 11.5%, direct and indirect Coombs' test positive, haptoglobin 38 mg/dl, ESR 145 mm/hr, cold agglutinin titer 1:2,048 mycoplasma antibody titer 1:640, PPD negative. The diagnosis of autoimmune hemolytic anemia associated with Mycoplasma pneumonia was made, and treatment with minocycline and prednisolone observed striking clinical improvement. It was suggested that the cold exposure was possibly a major factor in the pathogenesis of hemolysis in this patient.

We analyzed the outcome for 18 patients with prosthetic valve endocarditis (PVE) treated between 1965 and 1990, 17 of whom had undergone valve replacement with mechanical prosthetic valves and one of whom had a bioprosthesis. Two patients developed infection within 60 days after surgery, and 16 thereafter. Fifteen patients received combined medical and surgical therapy and three medical therapy. In 14 patients, surgery had been performed during active infection. Mortality rate of those who had received combined medical and surgical therapy was 27%, and that of those who had received medical therapy was 67%. At operation, para-annular abscess was around the mitral prosthesis was found in three patients and around the aortic prosthesis in eight. Seven patients required reoperation for postoperative paravalvular leakage, in six, para-annular abscess had been found at the operation for PVE, and in one para-annular abscess had been noted. One patient who had undergone reoperation had developed reinfection after the first surgery and died due to multiple organ failure after the second operation (Danielson's translocation technique). In one patient who had complete loss of supporting tissue because of severe para-annular abscess, we had performed aortic valve replacement by implanting the aortic valve prosthesis into the left ventricle with Dacron felt-supported sutures placed in the mitral annulus and the muscles of the left ventricular outflow tract. This patient showed no postoperative infection or no paravalvular leakage.(ABSTRACT TRUNCATED AT 250 WORDS)

The nuclear DNA content was determined by flow cytometry (FCM) in 155 resected specimens (122 paraffin-embedded and 33 fresh frozen specimens) of primary adenocarcinoma of the lung obtained at our department during the 8 years from 1982 to July, 1990. Aneuploid patterns were observed in 106 specimens (68.4%), and the diploid patterns in 49 (31.6%). No difference was observed in the age, sex, or clinical stage between the two groups. As for the relationship of the presence or absence of vascular infiltration with the DNA index (DI) and the heterogeneity index score (HIS), the percent positivity of vascular infiltration was 38.1% in the group with 1 less than or equal to DI less than 1.5 but nearly twice higher at 63.6% in the group with 1.5 less than or equal to DI. The percent positivity of vascular infiltration was 29.4% in the group with HIS less than 100 but 62.5% in the group with 100 less than or equal to HIS. Concerning the relationship between the ploidy pattern and outcome, the 5-year survival rate was 28.0% in the aneuploidy group and 65.1% in the diploid group, the outcome being significantly poorer in the first group. Concerning the relationship between DI and outcome, the 5-year survival rate was 14.9% in the group with 1.5 less than or equal to DI as compared with 55.4% in the group with 1.0 less than or equal to DI less than 1.5. DNA analysis was made also in bronchoscopic brushing specimens to examine the possibility of preoperative evaluation of the prognosis of lung cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

We experienced twelve cases of non-small cell carcinoma of the lung of the so-called "galloping type" small size carcinoma (less than or equal to 2 cm). Ten cases presented with mediastinal lymph node metastasis and two cases with distant metastasis. Solitary lymph node metastasis observed in almost half of the cases and lymph node metastasis in peculiar lymphatic regions (#3 a) seen in two cases, were the prominent characteristics of the lymphatic pathway dissemination showed by this type of cancer in advanced clinical stage. The prognosis was good, with 3 years and 5 years survival rate of 72.2% and 54.1% respectively. According to these results, we consider that, if the clinical stage is favorable, the surgical treatment must be indicated in all cases of these advanced small size carcinoma of the lung.

"Postoperative erythroderma", the pathogenesis of this disease have solved as graft-versus-host disease (GVHD) due to blood transfusion, is fatal and impossible to cure for the time being. Therefore the prevention against the disease is very important. One woman and three men who underwent an operation and blood transfusion at our department died of this disease. They fell into high fever on 11-13 days, erythroderma on 12-16 days, liver dysfunction on 14 days, and leukocytopenia on 17-19 days, after surgery and transfusion. Eventually, they all suffered from thrombocytopenia, diarrhea, renal dysfunction, and sepsis which led to death. The clinical course, macroscopic and microscopic findings of them coincided with those of GVHD. Since 1989, we have tried following methods for prevention of postoperative erythroderma: Reducing blood transfusion, especially fresh blood and fresh thrombocyte plasma, by using predeposited autologous blood, autologous washed erythrocytes collected from the operative area before and after extracorporeal circulation (ECC), concentrated residual blood from the ECC using a hemoconcentrater, and 1,500 rad of cobalt-irradiation of fresh blood, fresh thrombocyte plasma, and blood collected within 7 days prior to the transfusion. Postoperative erythroderma has not been experienced by introduction of these methods since 1989.

A case of autoimmune hemolytic anemia (AIHA) and bullous pemphigoid (BP)-like skin lesion combined with Idiopathic thrombocytopenic purpura (ITP) is reported. A 25-years-old male, who had been diagnosed as ITP and treated at another hospital, was admitted in this hospital recently complaining of disseminated bullous-vesicular eruptions on the whole body and autoimmune hemolytic anemia. Examinations, disclosed that RBC was 364 X 10(4)/microliters, reticulocyte 40, platelet 3000/microliters, direct and indirect Coombs test positive, and platelet Coombs consumption test was positive leading to the diagnosis of AIHA and ITP, known as "Evans syndrome." Vesicular biopsy-findings and immunofluorescence study showed suspicion of BP, but clinical course and blister was not improved though the administration of prednisolone was performed. Reports of cases of BP complicated by Evans syndrome are very few. AIHA, ITP and BP are considered to have autoimmune disorders and their pathogenetic mechanism are discussed. This patient consulted another hospital one year later, when we heard that skin eruptions already had disappeared.

A novel spot-size converter based on a vertical ridge waveguide taper for super-high-Δ silica waveguides is demonstrated. This structure can be formed with a simple fabrication process. The coupling loss between a singlemode fibre and a 2.5%-Δ silica waveguide was reduced to 0.31 dB/point compared to 2.7 dB/point for conventional straight waveguides.