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In a model of asymmetric small for gestational age (SGA) fetal growth retardation, we have previously found that glucose transport is decreased in lung (an organ whose growth is restricted) and unaffected in brain (growth is normal). The SGA model alters a number of physiological and metabolic factors that may decrease glucose transport, thereby causing growth retardation. Specifically, insulin and insulin-like growth factor-I (IGF-I) concentrations are diminished in SGA fetuses. We hypothesized that the specific modulation by these factors of gene expression of a glucose transporter, Glut-1, is impaired. We performed bilateral uterine arterial ligation in pregnant rats on day 19 of gestation (term = 21.5 days) and obtained fetal brain, lung, and skeletal muscle on day 20. Lung and muscle explants and monolayers of glial cells and type II pneumocytes were cultured in the presence or absence of insulin or IGF-I for 24 h. Glucose uptake and levels of Glut-1 protein and mRNA were similar in brains of SGA and control fetuses and were not affected by treatment with insulin or IGF-I. Treatment with insulin or IGF-I increased glucose uptake and levels of Glut-1 protein and mRNA in a dose-dependent manner in lung and muscle from control fetuses. However, the response in SGA lung was not as great as that in controls. SGA muscle demonstrated no significant response to either hormone. These findings suggest that changes in glucose transport modulation might contribute to the development of asymmetric growth retardation, and that maintenance of normal transporter function and expression in brain may play a role in sparing its growth.

A new classification technique was proposed from the viewpoint of memory saving, as well as intensive processing time reduction, to meet the strong requirement for easier operation on a personal computer. To carry out this process efficiently, some neighbouring pixels were lumped into a cell. This idea is based on the fact that changes of the CCT counts in the sea area are monotone, that is histograms are symmetrical, and that cell by cell classification is, therefore, sufficient. First, a cell distance was denned by extending the concept of the Mahalano-bis' distance, which is the statistical difference between a cell and a cluster. The classification results agree well with those of the conventional Maximum Likelihood Method. We define this method as CDM (Cell Distance Method). Secondly, an alternative concept which indicates the degree of similarity between two cells was proposed. It was found that this concept, defined as HOM (Histogram Overlay Method), not only improves the speed of processi...

OBJECTIVE To determine whether the additional costs of preconception care are balanced by the savings from averted complications. Several studies have demonstrated the efficacy of preconception care in reducing congenital anomalies in infants born of mothers with pre-existing diabetes mellitus. RESEARCH DESIGN AND METHODS This study used literature review, consensus development among an expert panel of physicians, and surveys of medical care personnel to obtain information about the costs and consequences of preconception plus prenatal care compared with prenatal care only for women with established diabetes. Preconception care involves close interaction between the patient and an interdisciplinary health-care team as well as intensified evaluation, follow-up, testing, and monitoring. The outcome measures assessed in this study are the medical costs of preconception care versus prenatal care only and the benefit-cost ratio. RESULTS The costs of preconception plus prenatal care are $17,519/delivery, whereas the costs of prenatal care only are $13,843/delivery. Taking into account maternal and neonatal adverse outcomes, the net savings of preconception care are $1720/enrollee over prenatal care only and the benefit-cost ratio is 1.86. The preconception care program remained cost saving across a wide range of assumptions regarding incidence of adverse outcomes and program cost components. CONCLUSIONS Despite significantly higher per delivery costs for participants in a hypothetical preconception care program, intensive medical care before conception resulted in cost savings compared with prenatal care only. Third-party payers can expect to realize cost savings by reimbursing preconception care in this high-risk population.

Insulin-like growth factors (IGFs) are important regulators of somatic growth in childhood and circulate in association with specific binding proteins (IGFBPs). Insulin is important for the regulation of IGFs and IGFBPs in postnatal life and is required for normal growth in utero. We asked whether alterations in the availability of IGFs and/or their BPs may contribute to impaired fetal growth 24 h after bilateral uterine artery ligation when circulating levels of insulin are low and fetuses are small for gestational age (SGA). Bilateral uterine arterial ligation or sham surgery was performed on maternal rats on day 19 of gestation (term = 21.5 days). One day after ligation, fetuses were SGA compared to shams (2.9 +/- 0.1 vs. 3.5 +/- 0.1 g/fetus, respectively; P < 0.001), and liver weight was reduced (242 +/- 9 vs. 300 +/- 6 mg/liver; P < 0.001). Serum levels of both insulin and IGF-I were reduced approximately 50% in SGA litters compared to those in shams (P < 0.001) and correlated with each other (P < 0.02). IGF-I levels also correlated with fetal body and liver weights (P < 0.005 for each) even after controlling for the effects of insulin. Insulin levels correlated with body and liver weights (P < 0.02 and P < 0.03, respectively), but these relationships were not significant after controlling for the effects of IGF-I. Serum levels of IGF-II were not significantly reduced in SGA and did not correlate with fetal weight or insulin or IGF-I levels. [125I]IGF-I binding assay demonstrated that the availability of IGFBPs was increased in SGA serum, and Western ligand blotting indicated that circulating levels of 32K IGFBPs were increased in SGA fetuses compared to shams. Densitometric analysis indicated that levels of 32K IGFBPs were 4-fold greater in SGA litters (P < 0.001 vs. shams), and the level of 32K IGFBPs correlated with fetal body and liver weights (P < 0.05 for each) and with levels of both insulin and IGF-I (P < 0.001 for each), but not with levels of IGF-II. Immunoblotting with newly developed antiserum against rat IGFBP-1 confirmed that levels of immunoreactive 32K IGFBP-1 are increased in SGA serum, and immunoprecipitation studies confirmed that IGFBP-1 accounted for the rise in 32K IGFBPs in SGA serum.(ABSTRACT TRUNCATED AT 400 WORDS)

The ruggedness of SiC pn diode was investigated. The SiC pn diode was confirmed to operate at over 800°C, a higher temperature than Si device's destruction temperature, and to endure a large current of over 1000A (2000A/cm2) per one chip. The resistance of the diode showed a positive temperature coefficient until its destruction. This was different from the destruction of Si pn diodes.

We studied the effects of short and long durations of insulin-induced maternal hypoglycemia upon in viro glucose utilization of several fetal tissues in the rat. Osmotic minipumps filled with insulin were implanted in pregnant rats on d 15 or 18 of gestation (term 21.5 d), and radiolabeled 2-deoxyglucose was used to measure relative glucose utilization rates (rGU) of fetal liver, lung, muscle, kidney, heart, placenta, and brain on d 20 of gestation after 2 or 5 d of hypoglycemia. Maternal plasma glucose concentrations decreased within 24 h of pump placement and remained less than controls throughout gestation. Fetal plasma glucose and insulin concentrations on d 20 were equally reduced after 2 and 5 d of hypoglycemia. Both 2 and 5 d of hypoglycemia were associated with significant reductions in the rGU of fetal liver, lung, and muscle. Reductions in fetal kidney rGU also occurred after 2 and 5 d of hypoglycemia but to a smaller degree. rGU of fetal heart was reduced after 2 d of hypoglycemia, but was normal after 5 d of hypoglycemia. Both 2 and 5 d of hypoglycemia were associated with increased rGU of fetal brain. Five d, but not 2 d of hypoglycemia resulted in decreased fetal weight on d 20 of gestation. However, at term, newborn pups delivered of hypoglycemic mothers weighed significantly less than controls regardless of the timing of minipump placement. Liver, lung, and carcass of these growth-retarded pups weighed less than control tissues, whereas kidney, heart, and brain weights were not affected. We speculate that fetal tissue growth and glucose utilization are influenced by common mechanisms and that glucose utilization may be an important determinant of fetal tissue growth.

A new concept of a compact microbeam formation system is proposed and being constructed by slightly modifying an existing 400 keV ion accelerator at ULVAC. In this system, an object slit is placed on the high voltage terminal and the acceleration tube incorporated with a quadrupole doublet forms the reduced image on the sample position. The beam acceleration between the object and image results in the image size reduction which is profitably used in this design. The effects of the lens action at the entrance of the acceleration tube are discussed based on the beam optics calculation by using the standard matrix formalism.

A 81-year-old man was referred to our department for the acute onset of dyspnea. Chest radiograph suggested a bowel shadow containing gases in the right chest. Computed tomography (CT) scan revealed the dislocation of the liver and the transverse colon in the right pleural cavity. Although the patient had no history of a blunt trauma, he had undergone the right nephrectomy for the renal cancer 3 years before. An emergency operation revealed the right lobe of the liver and the transverse colon profoundly entering into the right pleural cavity. The dislodged organs were gently restored through a dual approach, and the defect of the diaphragm was repaired with a prosthesis. The postoperative course was satisfactory. A diaphragmatic hernia sometimes occurs acutely and often shows life-threatening symptoms. The occurrence of the diaphragmatic hernia associated with previous surgery must be taken into account, when the procedure involved the diaphragm.

High overload inverters were developed by using SiC devices for the first time, although its realization by using Si devices had been difficult because of Si's low maximum Tj. The newly developed 100 kVA overload SiC inverter provides an overload capability rate of 200 % and can supply 300 kVA for up to 3 seconds. Moreover, the volume was downsized to 1/7.5 of the previous inverter and the 150 hour continuous inverter operation test at 110 kVA was performed successfully.

We have suggested that altered maternal metabolism may affect the subsequent anthropometrie and neuropsychological development of children who were in utero during disturbances in maternal fuel economy. This study reports the physical growth through 8 yr of age and the neuropsychological development through 4 yr of age in offspring of diabetic mothers (ODM). At birth, 50% of infants had weights >90th percentile for gestational age. By 12 mo, length and weight were similar to the general population. Height remained normal until 7 yr of age, when it became slightly greater than average. After 5 yr of age, relative weight increased dramatically, and by 8 yr of age, half of the ODM had weights >90th percentile. This childhood obesity in ODM is correlated with maternal prepregnant weight and independently with amniotic fluid insulin at 32–38 wk gestation. The Brazelton Neonatal Behavioral Assessment Scale (BNBAS) was administered to 185 newborn ODM. Significant correlations were found between poorer second- and third-trimester glycemie regulation and lower scores in three of four newborn BNBAS dimensions. The Stanford-Binet Intelligence Scale was measured in 102 ODM at 4 yr of age. We found an inverse correlation between childhood IQ and second- and third-trimester maternal lipid metabolism (serum free fatty acids and β-hydroxybutyrate). This correlation is not explained by adverse perinatal events, socioeconomic status, maternal IQ, ethnicity, or diabetes type. These long-range associations between altered maternal metabolism and childhood growth and development continue to support Freinkel's hypothesis of fuel-mediated teratogenesis.

A new genetic variant apolipoprotein (apo), A-I Yame, was discovered during screening for apoA-I genetic variants with isoelectric focusing gel electrophoresis. To investigate the structural abnormality of apoA-I Yame, we amplified the apoA-I gene isolated from the proband's peripheral blood leukocytes with the polymerase chain reaction (PCR) method and directly sequenced these PCR fragments. ApoA-I Yame was found to have aspartic acid (GAC) substituted by tyrosine (TAC) at residue 13. We also identified this substitution by an automated DNA sequencer. This substitution was confirmed with amino acid sequencing of the isolated apoA-I Yame by Immobiline gel electrophoresis. This combined method, direct PCR from genomic DNA-derived individual peripheral blood leukocytes and subsequent direct sequencing, can be used to identify the entire sequence of apoA-I in a short period of time. Furthermore, with this method, it is possible to identify both alleles in heterozygous individuals.

The sea features on half-closed bays and coastal areas were investigated by satellite remote sensing. The turbidity on the Kanmon area and Hiroshima Bay was estimated by using a new classification technique with the aid of the sea truth data. The performance of this method on a personal computer was examined for comparison with the most likelihood method (MLM) in the course of the investigation. It has been found that this method is more stable against noise and fluctuation of system parameters in addition to the improved computing time than the MLM, and that the classified results are almost same as those of the MLM. This technique was extended and applied to the environmental researches on the coastal areas of the southernmost Korea which face the Sea of Japan and the industrialization has been emphasized there. The data used in the present study are LANDSAT MSS and TM, NOAA AVHRR and MOS-1 MESSR.

OBJECTIVES. The primary objective of this study was to determine whether widespread use of nitric oxide after Food and Drug Administration approval decreased admissions to a neonatal referral center for extracorporeal membrane oxygenation evaluation. We also sought to determine whether antecedent treatment delayed eventual transfer, resulting in sicker patients, increased mortality, increased extracorporeal membrane oxygenation application, and higher direct costs of care.METHODS. This was a retrospective cohort study of all of the patients transferred to a neonatal referral center for extracorporeal membrane oxygenation evaluation before (1995–1999) and after (2000–2005) Food and Drug Administration approval of nitric oxide. Patients were divided into “congenital diaphragmatic hernia” and “persistent pulmonary hypertension” (all other diagnoses) for additional analysis.RESULTS. Admission rates for extracorporeal membrane oxygenation evaluation decreased in the nitric oxide era, and eventual transfer was not delayed. Persistent pulmonary hypertension patients had improved oxygen indexes, a trend toward decreased mortality, decreased extracorporeal membrane oxygenation use, and decreased direct costs. Congenital diaphragmatic hernia patients had unchanged physiologic measurements, mortality, and extracorporeal membrane oxygenation use with increased direct costs of care. As a whole, outcomes for patients transferred for extracorporeal membrane oxygenation evaluation improved, whereas direct costs were unchanged.CONCLUSIONS. Persistent pulmonary hypertension patients had improved outcomes with decreased costs, whereas congenital diaphragmatic hernia patients had unchanged outcomes with increased costs. Overall, patients admitted to this NICU because of the presence of extracorporeal membrane oxygenation services had improved outcomes without increased costs in the nitric oxide era.

4.5 kV 1000 A class high heat resistive SiC pn diode modules of both a resin mold package type using a new mold resin, Nanotec-resin KA 500, and a ceramic flat package type using a new ACTSG technique were developed for the first time. The resin mold module has a much smaller trr and Qrr in addition to higher Tj (max) of 300 degC as compared with Si pn diodes.

High resistive SiC pin diodes with heavy electron irradiation are proposed for the turn-on snubber circuit as an alternative to the conventional resistor and diode. The inverter circuit was greatly miniaturized by mounting the high resistive SiC pin diode in a SiCGT (SiC commutated gate turn-off thyristor) module and using no heat sink for the resistor. Using this inverter circuit, stable 100 kVA inverter operation for 150 hours was demonstrated with stable forward characteristics of the high resistive SiC pin diode. Furthermore, the high resistive SiC pin diode was demonstrated to be useable in the high output 200 kVA class power inverter.

We studied the effects of maternal uterine artery ligation on fetal rat tissue glucose utilization (GU). Unilateral uterine artery ligations were performed on the 19th d of gestation (term 21.5 d) and 2-[3H]deoxy-D-glucose was used to measure GU of placenta, liver, brain, muscle, kidney, and heart from fetuses in the ligated (IUGR) and nonligated (control) uterine horns 24 and 48 h after the procedure. At both periods, IUGR fetuses weighed significantly less and had lower fetal/maternal plasma glucose ratios than controls. Twenty-four h after ligation, placenta, liver, brain, and muscle from IUGR fetuses had lower relative GU rates than corresponding tissues from control fetuses (p less than 0.01-0.05). However, at 48 h, IUGR liver, muscle, kidney, and heart had higher relative GU rates than control tissues (p less than 0.01-0.05). The lower GU of IUGR fetal tissues observed at 24 h postligation was likely related to the acute decrease in fetal glucose availability. Other factors, such as hypoxemia and acidosis, that affect cellular metabolism may also have led to lower GU rates. The increase in GU by IUGR tissues at 48 h occurred despite a persistence of low fetal glucose concentrations and can be explained by either: 1) an attempt by IUGR fetal tissues to compensate for the persistently low plasma glucose; 2) an increased demand for metabolic fuel for repair processes; or 3) a less efficient use of glucose due to alterations in cellular respiration. We speculate that this increase in fetal tissue GU may be partially responsible for the supranormal glucose requirements seen in small-for-gestational-age newborns.

Experimental study of fluidization and current flow characteristics was conducted. The result shows that the pressure overshoot at the incipient fluidization under electric field was slightly influenced by applied electric potential, while a significant influence on the minimum fluidization velocity was observed. The process of the initiating fluidization was also analyzed through axial pressure drop profiles.

SiC whisker (SiCw)/silica glass composites were prepared from tetramethylorthosilicate, silica fine powder and SiCw by the sol-gel method. An optimum condition for the gel preparation and the following HIP sintering was investigated. Employment of the optimum sol composition and aging of the resultant gel made it possible to obtain crack-free SiCw/SiO2 gel in which SiCw was dispersed homogeneously. HIP sintering under the condition of 1, 000°C, 30 MPa, 2 h was optimum since the crystallization of the glass matrix to cristobalite could be avoided. Theoretically dense composites were obtained up to 15 vol % SiCw. A maximum fracture toughness of 2.3 MPa m1/2 was obtained.

A newly developed worldwide video tape recorder with a digital television standards converter is described. The recorder can record and playback all VHS formats corresponding to each of the world's TV standards, such as NTSC, PAL, and SECAM. >

We determined the extent to which ligating both maternal uterine arteries affects fetal hepatic energy and redox states in the fetal rat. Bilateral maternal uterine artery ligation on d 18 of the rat's 21.5-d gestation significantly inhibits fetal growth; sham surgery limits growth to a lesser extent. Within 12 h of surgery and persisting to d 19, small-for-gestational age (SGA) fetuses had significantly diminished ATP/ADP and adenylate charge ratios, whereas sham fetuses had values intermediate between SGA and normal. Hepatic mitochondrial redox state demonstrated similar changes. Cytosolic redox state in SGA fetuses at 12 and 24 h after surgery was significantly elevated. SGA fetuses had significantly diminished plasma insulin and elevated glucagon concentrations. On d 19 and 20, hepatic ATP/ADP and cytosolic NAD+/NADH correlated directly for sham and normal but not SGA fetuses. Alterations in glucose, insulin, and glucagon availability and hypoxia were responsible for the changes in energy and redox states. They may also have disassociated hepatic cytosolic from mitochondrial redox states and altered the equilibrium between adenine and nicotinamide nucleotides. These altered cellular functions retarded fetal growth. Newborn SGA, sham, and normal rat pups had similar hepatic ATP/ADP, cytosolic, and mitochondrial redox states at 10 and 240 min after delivery suggesting that the hypoglycemia which developed in SGA pups was not attributable to alterations in these variables.

A novel phenomena of VF degradation reduction, TEDREC phenomena, was found, which can reduce the degradation by increasing SiC device temperature. To realize safe and repeatable operation of degraded SiC devices and to achieve a drastic reduction in their cost, TEDREC method was developed by using the phenomena. A 180 kVA class SiC inverter was also developed by using the method, which is the largest one among the reported SiC inverters.

A new measurement method of Tj (junction temperature ), TjDM, of a SiC device installed and operated in a circuit is proposed. Tj of a SiC device has been related to the turn-off waveforms and estimated by the time in the turn-off process. TjS of developed SiCGTs ( SiC Commutated Gate turn-off Thyristors ) under the high voltage half bridge inverter operation at 2 kHz are measured, and are confirmed to be greater than 300degC. It is demonstrated that the SiCGTs can operate in the half bridge inverter at the high voltage of 2 kV and high temperature of 315degC. Furthermore, it is shown to be able to measure real time Tj and pick up higher Tj of SiCGT compared with normal devices in the 3 phase inverter.

To achieve an ultra low flying height, a multi-functional PFPE lubricant was synthesized. The molecule was achieved by combining several PFPE unit molecules. The novel lubricant contains extra polar functional-groups in the middle of the molecule. These functional-groups enhance the lubricant and substrate interaction, which results in reduction of the lubricant monolayer thickness. Through this molecular designing, we were able to reduce the monolayer thickness by 30% compared with the commercially available lubricants. The reduction of lubricant monolayer thickness would provide an ultra low flying height.

Gasless laparoscopic surgery using the abdominal wall lifting (AWL) method was first developed in Japan and has been used in various surgical fields. The AWL method allows the use of conventional reusable surgical instruments. The purpose of this study was to compare the cost-effectiveness of laparoscopic cholecystectomy (LSC) using the AWL method in relation to that using pneumoperitoneum (P) method.Retrospective analysis of 431 LSC procedures between 1991 and 2004 was performed. The two surgical groups consisted of consecutively operated patients with a diagnosis of cholecystolithiasis or gallbladder polyps. One group consisted of 224 LSC procedures performed using the P method from 1992 to 1998 and the other group comprised 207 LSC performed using the AWL method from 1998 to 2004. All instruments used in the P method were disposable, whereas trocars, scissors, dissectors, graspers and L-hook electrodes (excluding clips) used in the AWL method were reusable. Hospital expenses, length of hospital admission and complication rates were analyzed.Mean hospital cost per case for LSC using the AWL method (dollars 6743) was 7% less expensive than that using the P method (dolars 7215). Costs of operative equipment contributed to the difference (mean dollars 912 per case) in total cost. Conversion to open cholecystectomy occurred in 6 cases (2.9%) using the AWL method and 7 cases (3.1%) using the P method. There were no significant differences in length of hospital admission or complication rates between the two groups.LSC using AWL method was less expensive than that using P method. This is mainly due to the use of reusable instruments in the AWL method. If LSC is performed using the AWL method instead of using disposable equipment, considerable savings can be achieved without compromising patient safety.

4.5 kV 120 A SICGT with a chip size of 8 mm times 8 mm and a new high heat resistive resin capable of 400 degC operations were developed. The SICGT coated with the resin has a low leakage current of less than 5 times 106 A/cm2 at both 4.5 kV and 250 degC, a low VF of 5.0 V at 120 A, and short turn-on and turn-off times of 0.3 mus and 1.7 mus respectively. A SICGT module was built by mounting one SICGT and two 6mm times 6mm SiC pn diodes in a metal can package, and a 110 kVA PWM 3 phase inverter was developed by using six of the SICGT modules. The electric power capabilities of both the developed SICGT and the 3 phase inverter are the largest ones among the reported SiC switching devices and SiC inverters, respectively

Environmental and health concerns with Pb have led to development of lead-free solders to replace commercial Sn-Pb solders in electronic packaging applications. Sn-3Ag-0.5Cu solder is one of the solders applied to both the reflow soldering process and the wave soldering process. However, its melting temperature is about 30 K higher than that of Sn-Pb eutectic, so the temperature on the soldering process becomes higher. With regards to protecting electronic components from heat, the soldering process in low temperature is desirable. Therefore, Sn-Zn system solders are expected as the candidate solders able to produce PWBs in lower temperature soldering process. Sn-8Zn-3Bi solder is practically used for the reflow soldering process. However, the wave soldering process using Sn-Zn solders has scarcely been investigated. So, the study of the influences of Cu addition on wave soldering before is investigated. In this study, the influence of several kinds of impurity on the properties of wave soldering for Sn-Zn system solder is discussed by using small sized wave soldering equipment. As a result, it was found that the solderabilities of Sn-Zn solder became worse by the addition of Cu, especially in solder bridging. It is thought that this is because of the rise of liquidus line on Sn-9Zn alloy to the addition of Cu. Therefore, the impurity level of Cu on Sn-9Zn solder should control under the content of 0.1%

Background Selective transarterial chemoembolization (TACE) and portal vein embolization (PVE) could improve the rate of hypertrophy of the future liver remnant (FLR) in patients with chronic liver disease. This study evaluated the feasibility and efficacy of this combined procedure. Methods Between November 1998 and October 2004, 36 patients with cirrhosis and hepatocellular carcinoma underwent right hepatectomy after PVE. Additional TACE preceded PVE by 3–4 weeks in 18 patients (TACE + PVE group) and the remaining 18 patients had PVE alone (PVE group). Results PVE was well tolerated in all patients. The mean increase in percentage FLR volume was significantly higher in the TACE + PVE group than in the PVE group (mean(s.d.) 12(5) versus 8(4) per cent; P = 0·022). The rate of hypertrophy was more than 10 per cent in 12 patients in the TACE + PVE group and in five who had PVE alone (P = 0·044). Duration of surgery, blood loss, incidence of liver failure and mortality (two patients in each group) were similar in the two groups. None of the 17 patients with an increase in FLR volume of more than 10 per cent died, whereas there were four deaths among 19 patients with a smaller increase. The incidence of complete tumour necrosis was significantly higher in the TACE + PVE group (15 of 18 versus one of 18; P < 0·001), with a higher 5-year disease-free survival rate (37 versus 19 per cent; P = 0·041). Conclusion Sequential TACE and PVE before operation increases the rate of hypertrophy of the FLR and leads to a high rate of complete tumour necrosis associated with longer recurrence-free survival.

Background: Idiosyncratic terminology and frameworks in the study of patient safety have been tolerated but are increasingly problematic. Agreement on standard language and frameworks is needed for optimal improvement and dissemination of knowledge about patient safety. Methods: Patient safety events were assessed using critical incident analysis, a method used to classify risks that has been more recently applied to medicine. Clinician interviews and clinician reports to a web based reporting system were used for analysis of hospital based and ambulatory care events, respectively. Events were classified independently by three investigators. Results: A pediatric patient safety taxonomy, relevant to both hospital based and ambulatory pediatric care, was developed from the analysis of 122 hospital based and 144 ambulatory care events. It is composed of four main categories: (1) problem type; (2) domain of medicine; (3) contributing factors in the patient (child-specific), environment (latent conditions) and care providers (human factors); and (4) outcome or result of the event and level of harm. A classification of preventive mechanisms was also developed. Inter-rater reliability of classifications ranged from 72% to 86% for sub-categories of the taxonomy. Conclusions: This patient safety taxonomy reflects the nature of events that occur in both pediatric hospital based and ambulatory care settings. It is flexible in its construction, permits analysis to begin at any point, and depicts the relationships and interactions of elements of an event.

Multi-context FPGAs (MC-FPGAs) have multiple memory bits per configuration bit forming configuration planes for fast switching between contexts. The additional memory planes cause significant overhead in area and power consumption. To overcome the overhead, a fine-grained MC-FPGA architecture using a floating-gate-MOS functional pass gate (FGFP) is presented which merges threshold operation and storage function on a single floating-gate MOS transistor. The transistor count of the proposed multi-context switch (MC-switch) is reduced to 10% in comparison with SRAM-based one. The transistor count of the proposed MC-switch is also reduced to 20% in comparison with the MC-switch that uses floating-gate MOS transistors just as storage device. The test chip is designed using a 0.35mum EPROM technology, and the area of the proposed MC-FPGA is reduced to about 50% of that of a conventional MC-FPGA

Intracystic fluid pressure is thought to be involved in odontogenic cyst growth. In this study, we investigated the effects of positive pressure on the expression of interleukin-1α (IL-1α), matrix metalloproteinases (MMPs), and prostaglandin E2 (PGE2) in odontogenic keratocysts to determine whether this pressure stimulates inflammatory cytokine production and signaling of osteoclastogenic events. Positive pressure enhanced the expression of IL-1α mRNA and protein in odontogenic keratocyst epithelial cells, and increased the secretion of MMP-1, MMP-2, MMP-3, and PGE2 in a co-culture of odontogenic keratocyst fibroblasts and the epithelial cells. The pressure-induced secretions were inhibited by an interleukin-1 receptor antagonist. Recombinant human interleukin-1α (rhIL-1α) increased the secretion of MMP-1, MMP-2, MMP-3, and PGE2 in the fibroblasts. Furthermore, in the fibroblasts, rhIL-1α enhanced the expression of macrophage colony-stimulating factor (M-CSF) mRNA, and rhIL-1α-induced PGE2 increased the expression of nuclear factor κB ligand (RANKL) mRNA. Thus, positive pressure may play a crucial role in odontogenic keratocyst growth via stimulating the expression of IL-1α in epithelial cells.

The Gamma-ray Large Area Space Telescope (GLAST) Balloon Flight Engineering Model (BFEM) represents one of the 16 towers that compose the Large Area Telescope (LAT) instrument to be launched in March 2006. In low earth orbit and at balloon altitude, background generated by cosmic-ray interactions is known to dominate over the astronomical gamma ray signal in its rate. A Geant4 based simulation program has been developed to study this cosmic-ray background. Although the program is intended primarily for the BFEM, the cosmic-ray generator producing primary and secondary cosmic-ray fluxes is adaptable to most balloon and satellite experiments at any geomagnetic latitude and solar modulation cycle. The balloon was successfully launched on August 4, 2001 at Palestine, Texas. We well reproduced the observed trigger rate in our simulator, and a detailed comparison between the data and simulation is underway.

We obtain high density recording, 263 Mbpi/sup 2/, using metal evaporated tape and a new automatic equalizer, which consists of a new analog detector and a new analog delay circuit. We also describe how to decide the optimum recording current to satisfy the electromagnetic characteristics; output level, overwrite ratio and waveform asymmetry (a special problem of metal evaporated tape). >

4.5kV 60A SICGT of 6mm times 6mm chip size has been developed, which has the largest electric power handling capability among the reported SiC switching devices. Due to the fast turn-on time of 0.08mus and the fast turn-off time of 2.3mus at 250degC, SICGT can realize a low power loss as compared with 4.5kV Si GTOs and 4.5W Si IGBTs. A PWM half bridge inverter was built by using a couple of SICGT modules. Each module consists of one SICGT and two SiC pn diodes in a TO3 type package. The inverter achieved an output power of 20 kVA at V DC of 2kV and carrier frequency of 2kHz, This represents the largest output power among the reported SiC inverters

Background The remnant left liver after right hepatectomy tends to rotate spontaneously into the right subphrenic space. This rotation might induce venous outflow impairment. The aim of this study was to assess immediate venous outflow in the left hepatic vein by intraoperative Doppler ultrasound (US) according to the position of the remnant liver. Methods From August 2003 to February 2004, assessment of left hepatic venous outflow was systematically performed in 44 consecutive right hepatic resections by Doppler US in spontaneous and anatomical positions. The anatomical position was defined as the position in which the falciform ligament was in its strict median position. Results The placement of the left liver from the spontaneous position to the anatomical position resulted in a significant increase in left hepatic venous outflow (20·1 ± 5·7 versus 8·5 ± 4·4 cm/s; P < 0·0001). In the spontaneous position, the decrease in left hepatic venous outflow persisted even without division of the left triangular ligament (10·2 ± 5·4 versus 21·7 ± 5·3 cm/s in the anatomical position) or removal of the middle hepatic vein (8·4 ± 3·4 versus 21·3 ± 5·8 cm/s). Conclusion Results of this study strongly suggest that after right hepatectomy the remnant left liver should always be fixed in the anatomical position.

This report concerns 2 cases with blunt traumatic hernia of the diaphragm. The diagnosis of these cases had been delayed by 1 month and 6 years, respectively. The former was a left sided case, which had suddenly suffered severe dyspnea. An emergency operation revealed the dislocated stomach into the left thoracic cavity. The latter was a right sided case, which was discovered by chance during the laparoscopic cholecystectomy. The right lobe of the liver dislocated into the right thoracic cavity. The delayed case of traumatic diaphragmatic hernia tends to be overlooked without suspicion. In all patients with thoracoabdominal blunt injury, a rupture of the diaphragm must be suspected.

The present study aims to obtain a measure to evaluate the quality of raw limestone. As a macroscopic approach, we employ a remotely sensed satellite image with high spatial resolution which provides a birds-eye view of the limestone mine and spectral properties of the naked limestone rocks surface. The second approach uses a commercial digital camera and we attempt to grade the sample limestone samples materials of different quality for screening the limestone powders used as coating materials for printing papers. The statistical quantities on the sample images and their fractal dimensions are applied for the evaluation of the quality.

We analyze hourly-based tidal data acquired at the Izu Islands and the Kii Peninsula to investigate the behaviors of the Kuroshio's flow axis because it has a remarkable effect on the tidal fluctuation when its flow axis approaches the southern coasts of Honshu Island. The time-frequency analysis by a wavelet transform and the nonlinear time series analysis are employed to demonstrate the effects of Kuroshio an the tide. The present study aims to reveal the tidal behaviors under the influences of Kuroshio through the visual illustrations of the results by the wavelet transform. In addition, the phase trajectories of the time series also disclose a plausible direction of the Kuroshio's flow axis.

This paper describes the design and implementation of a handy terminal for the telehealth care support system. The telehealth care life support modeling is proposed. The system is able to set up automatically the communication channel among the client, nursing staff and clinician. To construct the telehealth care life support modeling, the analysis of task and information for health care is discussed. The structure of the proposed telehealth care life support model is based on the feedback control system. The clinician and nursing staff play the role as a controller and the client as a controlled object in the model. The role of information technology plays in supporting the model is discussed. The design and implementation of collaboration among the client, clinician and comedical including the family and establishment of communication channels are explained using an actual example based on the proposed telehealth care life support model. The software is designed to work on cellular phone.

A 3 kV 600 A 4H-SiC high temperature diode module has been developed for use in electricity supply applications, which utilizes a pressure contact flat package type module and includes five 6 mm/spl times/6 mm SiC diode chips. The diode module does not get oxidized in the air even at 500/spl deg/C and has excellent electrical performances at high temperature.

In parameters estimation for stereo-based vehicle detection, it is important to estimate the three-dimensional geometrical relationship between a stereo camera and a road surface. However, vehicles' existence in a field of view sometimes has a bad influence upon the accuracy of road surface estimation. Therefore, we propose a method for road surface estimation robust against vehicles' existence in a field of view. This method considers the difference between the distribution of feature points from a road surface and those from a vehicle in the spatio-disparity space. Therefore, road surface estimation can be done using those mostly from a road surface. We also confirm its effectiveness by experiments on field images.

For the purpose of traffic measurement, it is necessary to recognize various vehicles, including those vehicles that are partly overlapped. A new stereo-based image processing vehicle recognition method which is robust against vehicles' overlapping, is proposed. A stereo-based method is selected because of its robustness to environmental changes. The proposed method overcomes the problem by three key points: 1) feature extraction based on a size-changeable feature extraction window; 2) camera calibration using environmental information; and 3) model matching with various overlapped vehicles' models. The effectiveness of the proposed method has been confirmed by experiments on real images. An average recognition accuracy rate above 95% was obtained for images of frequently overlapped vehicles.

To examine the practicality of applying the chip-on-glass packaging technique to liquid-crystal-display (LCD) panels, the authors investigate how reliability is affected by different types of glass substrates and sealing resins, using 63% Sn-Pb solder for the bump contacts of a flip-chip. The results suggest that packaging failure can be reduced even when 63% Sn-Pb solder bump contacts are used as long as the glass substrate is properly selected. It is also confirmed that service life can be prolonged beyond that of a bare chip by proper materials selection and that expansion coefficient and longitudinal elastic constant are the most important factors in selecting the resin material. >