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Background: \ud Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial.\ud \ud Methods: \ud NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy.\ud \ud Findings: \ud Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk of recurrent ischaemic stroke between rivaroxaban and aspirin (hazard ratio [HR] 0·54; 95% CI 0·22–1·36), and the risk was similar for those without known PFO (1·06; 0·84–1·33; pinteraction=0·18). The risks of major bleeding with rivaroxaban versus aspirin were similar in patients with PFO detected (HR 2·05; 95% CI 0·51–8·18) and in those without PFO detected (HR 2·82; 95% CI 1·69–4·70; pinteraction=0·68). The random-effects meta-analysis combined data from NAVIGATE ESUS with data from two previous trials (PICSS and CLOSE) and yielded a summary odds ratio of 0·48 (95% CI 0·24–0·96; p=0·04) for ischaemic stroke in favour of anticoagulation, without evidence of heterogeneity.\ud \ud Interpretation: \ud Among patients with ESUS who have PFO, anticoagulation might reduce the risk of recurrent stroke by about half, although substantial imprecision remains. Dedicated trials of anticoagulation versus antiplatelet therapy or PFO closure, or both, are warranted.\ud \ud Funding: \ud Bayer and Janssen.

Autonomous robots, like living systems, must be adaptive in nature if we want them to preserve their integrity while completing their mission. The challenge to survive in their environment is better accomplished if they are open systems, interacting with the environment by exchanging matter, energy, information, and so on. The roboticle framework, presented here forth, is an attempt to model how the autonomous robot control unit works. It borrows from living systems the idea that sensing and acting on the environment can be recognized as a mechanism exchanging energy with the environment in order to maintain an highly organized internal control structure to resist to external applied perturbations. The necessary energy balancing is provided by an autopoietic loop which is fed by the energy entering the robot through its sensor devices and it is dissipated by its effectors for properly acting in the environment. The autopoietic loop is also responsible of the adaptive properties of the robot.

Novel ternary Mn-containing compound MnGeP2 has been grown on GaAs and InP substrates using molecular beam epitaxy, in which Mn and Ge were supplied from solid sources and P from a gas source. The films obtained showed XRD pattern characteristic of MnGeP2. Lattice constants were determined using reciprocal lattice mapping analysis. Films directly grown on GaAs substrate showed three-dimensional grain-growth. By

Growth conditions for MnGeP2 thin films have been investigated by using molecular beam epitaxy (MBE) method. Mn and Ge were evaporated by K-cells, and P2 was supplied by decomposing tertialybutylphosphine (TBP). GaAs (001) and InP (001) single crystals were used as substrates. An X-ray diffraction peak, which can be assigned to (008) peak of MnGeP2, was observed at nearly the same position as the (004) peak of GaAs. The lattice constant of the MnGeP2 thin film was determined to be 1.13 nm assuming its crystal structure is a c-axis oriented chalcopyrite type structure. Secondary phases such as GeP, MnGe x and MnP were observed for beam fluxes of Mn and Ge as high as 1×10−8 Torr.

Novel ternary compound MnGeP2 thin films have been prepared on InP(0 0 1) substrates by molecular beam epitaxy (MBE), in which Mn and Ge were supplied from solid sources using Knudsen cells and P2 from a gas source by decomposing tertiary butyl phosphine (TBP). From an X-ray analysis the crystal structure was determined to be tetragonal with lattice constants a ¼ 0:569 nm and c ¼ 1:130 nm; with the c-axis perpendicular to the InP(0 0 1) plane. Optimal conditions to suppress GeP and MnP extraneous phases are discussed.

Background Both herpes zoster (HZ) and malignancies have been reported in patients treated with TNF blockers such as etanercept (ETN). In Japanese patients with RA, information regarding the incidence of HZ and malignancy following long-term treatment with TNF blockers is limited. Objectives The objective of this study was to analyse the incidence rates (IR) of HZ and malignancy in Japanese patients with RA treated with ETN in order to expand the safety data set available for this patient population. Methods Data were pooled from 4 clinical trials of ETN in Japanese patients with RA. Two studies were double-blind trials of 10 and 25 mg ETN vs placebo (study 202) or methotrexate (study 315-JA), and were of 12 and 52 weeks duration, respectively. The other 2 studies were open-label, long-term trials of ETN (studies 310-JA and 313-JA) and were of 183 and 134 weeks duration, respectively. Crude IR for HZ and malignancy per 100 patient-years, with 95% confidence intervals (95% CI), were calculated and the rates were stratified by age and time of symptom development. Results A total of 521 patients with RA were included in this analysis. Mean age was 51.9 years and 81.6% of patients were female. Mean and standard deviation (SD) duration of RA was 5.2 ± 6.5 years, and the mean (SD) disease activity score 28-erythrocyte sedimentation rate was 6.15 ± 1.20. Following ETN treatment, 18 incidences of HZ in 17 patients were reported. The IR/100 years [95% CI] for the entire population was 2.5 [1.45, 4.00]. IR of HZ was highest in the 50–59 age bracket, followed by the 60–69 age bracket (Figure). IR [95% CI] was highest during the first 6 months of treatment with ETN (3.81/100 patient years [1.74, 7.23]) and subsequently declined with a stable cumulative IR seen up to 48 months of treatment (2.50/100 patient years [1.45, 4.00] across the entire treatment period). In addition, 4 incidences of malignancy in 4 patients were reported following treatment with ETN. There was 1 incidence of hypopharyngeal cancer which occurred in the first 6 months of treatment, 2 incidences of breast cancer, each occurring between Months 6–12 of treatment, and 1 incidence of liposarcoma, which occurred between Months 30–36 of treatment with ETN. IR/100 patient years [95% CI] for malignancy was 0.57 [0.15, 1.46]. Conclusions In Japanese patients with RA treated with ETN, increased IR of HZ in patients aged over 50 was observed. This trend is consistent with previous observations in the Japanese general population. IR of HZ was similar to that seen in a study of Japanese patients with RA treated with the IL-6 blocker tocilizumab (2.29/100 patient years), 1 and might be higher compared with a large cohort study of Japanese patients with RA (2005–2010) where only 3% of patients used a biological treatment for RA (0.91/100 patient years). 2 Malignancies occurred in a small number of patients with limited exposure, and there was no increase in the cumulative IR of malignancy during the treatment period. Tsutomu Takeuchi and Naonobu Sugiyama are equally credited first authors. References Nishimoto N, et al. Mod Rheumatol. 2010;20:222–32. Nakajima A, et al. Mod Rheumatol. 2015;25:558–61. Disclosure of Interest T. Takeuchi Grant/research support from: Astellas Pharma, Bristol–Myers K.K., Chugai Pharmaceutical Co, Ltd., Daiichi Sankyo Co., Ltd., Eisai Co., Ltd., Mitsubishi Tanabe Pharma Co., Pfizer Japan Inc., Santen Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Teijin Pharma Ltd., AbbVie GK, Asahikasei Pharma Corp., and Taisho Toyama Pharmaceutical Co., Ltd.,SymBio, Consultant for: Astra Zeneca K.K., Eli Lilly Japan K.K., Novartis Pharma K.K., Mitsubishi Tanabe Pharma Co., and Asahi Kasei Medical K.K.,abbivie GK, Daiichi Sankyo Co.,Ltd., Bristol–Myers K.K., Nipponkayaku Co.Ltd., Speakers bureau: AbbVie GK., Bristol–Myers K.K., Chugai Pharmaceutical Co,. Ltd., Eisai Co., Ltd., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Co., Pfizer Japan Inc., and Takeda Pharmaceutical Co., Ltd., Astellas Pharma, and Diaichi Sankyo Co.,Ltd., Celtrion, Nipponkayaku Co.Ltd, N. Sugiyama Shareholder of: Pfizer, Employee of: Pfizer, N. Miyasaka Grant/research support from: AbbVie, Astellas, Chugai, Eisai, Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Corporation and Takeda., Y. Morishima Shareholder of: Pfizer, Employee of: Pfizer, H. Yuasa Shareholder of: Pfizer, Employee of: Pfizer, N. Sugiyama Shareholder of: Pfizer, Employee of: Pfizer

Reliable power supply is considered more and more important for today's infrastructure. If power line faults occur, they could give damage to the facility that fail the power supply quality, so that the fault point must be located, investigated and repaired quickly as possible. Since the length of overhead transmission line is long, say several decades to hundreds kilometers, fault location system has been employed and utilized. J-Power Systems (JPS) has provided the fault location system for overhead power transmission line since early 1980s, which locates the fault point based on the distribution pattern of the induced current detected by the current sensors on the ground wire. By applying the combination of EMTP (Electro Magnetic Transients Program) simulation and the neural network pattern recognizing technology, the located fault point is achieved narrower than the sensor to sensor section. Typical fault location system consists of one Master Station (MS) which has a personal computer with fault location software and communication device to communicate with Local Stations (LS), several LS installed on tower which are driven by solar panel and battery, incorporate processing circuit boards and communication device to communicate with MS, and several current sensors which are installed on ground wire and whose signal cables are connected to LS. Except for few cases JPS has not provided the fault location system in overseas. Recently the authors achieved to apply the fault location system to Chinese power supply network, by studying and considering to make the system improved to adapt the local material, local telecommunication network, local installation procedure, and so on. This paper describes the fault location system for 220kV overhead power line in China, designed, manufactured and implemented by authors. (6 pages)

PURPOSE AND METHODS The major purpose of this study was to determine whether the survival rate in young lung cancer patients after surgical treatment differs from that in older patients. An analysis was performed for all patients with bronchogenic carcinoma who underwent surgery at Mie University Hospital from 1965 to 1990. RESULTS Of 803 patients, 24 (2.99%) were 33 to 39 years old. At the time of surgery, the disease was diagnosed as stage I in seven patients (29%), stage II in four (17%), stage IIIa in seven (29%), stage IIIb in two (8%), and stage IV in four (17%), while 46.3% of the patients older than 40 years of age had either stage IIIa, IIIb, or IV disease. All of the 24 patients less than 40 years of age underwent thoracotomy: curative resection in 14 cases, palliative resection in sex, and probe-thoracotomy in four. The 5-year survival rate for all stages of disease was 31.4% in these 24 patients, and 41.9% in 603 patients greater than 40 years of age. The 5-year survival rate for stage I disease was 35.7% in the seven younger patients and 78.0% in the 207 older patients; for stage II, it was 25.5% in the four younger patients and 40.6% in the 98 older patients; for stage III, it was 33.3% in the nine younger patients and 15.6% in the 250 older patients; and for stage IV, it was 25% in the four younger patients and 6.6% in the 48 older patients. There were no significant differences in survival rate between the two age groups for all patients or for those with each stage of disease. CONCLUSION Although younger patients tended to have more advanced disease, long-term survival in these patients did not differ from that of older patients.

We present two cases of Graves' disease whose initial thyroidal scintiscan with 99mTcO4- (Case 1) and 123I (Case 2) showed unilateral diffuse uptake of radioisotopes. Initial diagnosis was possibility of malignancy in Case 1 and Graves' disease or Plummer's disease in Case 2. Both cases underwent right hemithyroidectomy. Histopathology of the resected thyroid gland in both showed hyperplastic columnar epithelium and infiltrative lymphocytes which was compatible with Graves' disease. Twenty seven (Case 1) and eight months (Case 2) after operation, both presented with thyrotoxic symptoms associated with enlarged left lobe, increased serum free thyroid hormone concentrations, suppressed TSH concentration, increased thyroidal 123I uptake in the remaining left lobe, and positive thyrotropin receptor antibodies. Both cases were successfully treated with methimazole. It was concluded that initial radioisotope uptake as well as scintigram in rare subgroup of patients with Graves' disease could be similar with that of non-autoimmune autonomous goiter (Plummer's disease).

It is new possible experimentally to measure myocardial blood flow of the beating heart using a helium-neon (He-Ne) laser Doppler flowmeter. A myocardial probe was redesigned to reduce its size and weight, and a method devised of fixing the probe to the beating cardiac surface to allow its clinical application. This modified laser flowmeter was used on 36 patients with ischaemic heart disease to measure myocardial blood flow before and after revascularization. Flow was measured in the right and left ventricles while patients were in a haemodynamically stable state as determined by electrocardiography, heart rate, blood pressure and double product (heart rate × systolic blood pressure). No significant difference was found between the mean (s.e.m.) preoperative and postoperative flow volume at the anterior wall of the right ventricle (77(15) versus 81 (12) ml/min per 100g), which did not undergo revascularization, but mean (s.e.m.) myocardial blood flow at the ischaemic left ventricle increased significantly (from 68(15) to 88(13) ml/min per 100 g; P

SUMMARY The purpose of this study is to clarify vehicle dynamics effected by traction force distribution, not only between the front and rear wheels but also between the left and right wheels. Contribution of traction force distribution to vehicle turning performance was investigated using a mathematical simulation and an experimental vehicle. The results indicates that the control of traction control distribution between the left and right wheels greatly influences vehicle turning characteristics and improve the performance even in a marginal turning condition.

We examined the effects of endothelin-1 (ET-1) on pulmonary hemodynamic and transvascular fluid filtration and the conversion of big endothelin-1 (big ET-1), a precursor of ET-1, in isolated perfused rabbit lungs at constant vascular and airway pressures. Furthermore we examined whether ET-1 contributes to cyclooxygenase metabolism. The perfusate flow decreased significantly after bolus administration of 1 or 0.1 nmol of ET-1. Lung weight did not increase throughout the experimental period. Big ET-1- (1 nmol) induced decrease in the flow was slow in developing, although the maximum response was comparable to that induced by the same dose of ET-1. The concentration of bit ET-1 in the perfusate progressively decreased, while that of ET-1 increased in a time-dependent manner. Phosphoramidon, an inhibitor of metalloproteinase, suppressed the pressor effect of big ET-1 (P less than 0.01) and the increase in the concentration of ET-1 in the perfusate (P less than 0.05). The present findings provide the first evidence suggesting that the potent vasocontractile effect of big ET-1 in pulmonary circulation can be attributed to the production of ET-1 by the conversion from big ET-1 in the vascular bed. ET-1-induced perfusate flow changes were not affected by indomethacin, and the concentration of 6-ketoprostaglandin F1 alpha, a metabolite of prostacyclin, did not increase after ET-1 administration.

Knowing the predicted overpressure rate under anticipated operational occurrences (AOOs) is very important when evaluating the integrity of a BWR reactor pressure vessel. One of the factors that influence the overpressure rate is the wall condensing performance. Many condensing studies have been done under low-pressure conditions without vapor flow, but few condensing test results under BWR conditions have been reported. Therefore, the purposes of this study were to extend the vapor condensing data base for high-pressure, high-temperature conditions, to improve the heat transfer correlation and to evaluate the condensing effect on the overpressure rate. Condensation heat transfer tests have been performed with the pressure range from 0.5 to 8 MPa under upward and downward vapor flow. The test section consisted of a condensing tube and a water-cooling jacket. The condensing tube was a circular tube. The test results showed that the condensation heat transfer coefficient increased with the velocity of vapor flow due to enhancement of heat transfer caused by turbulence of the liquid film. We obtained a new correlation for condensation heat transfer that considered vapor shear force and condensate film Reynolds number. This new correlation agreed well with experimental data over a wide range of pressure. New correlation was incorporated into TRACG02modT1 code. When the condensation heat transfer tests were analyzed using this modified TRACG02modT1 code, the calculated condensation heat transfer coefficients were found to be in considerable agreement with the measured data. Furthermore, when the main steam isolation valve AOO (safety relief valve capacity design) of the BWR plant was evaluated by this modified TRACG02modT1 code, we found that the vapor condensation effect appeared under relatively high-pressure conditions and the pressure with improved condensation model was lower than that without vapor condensation. In summary, the condensation heat transfer model of TRACG02modT1 code has been improved based on high-pressure, high-temperature condensation test data with vapor flow. The vapor condensation effect was found to be strong, especially in the pressure increase AOO of the actual plant.Copyright © 2008 by ASME

R24, a mouse IgG3 mAb against GD3 ganglioside, was shown to bind to itself in a homophilic manner. This was demonstrated by augmented binding of 125I-labeled R24 to the cell surface of GD3+ cells by unlabeled R24 and by direct binding of biotinylated R24 to R24 adsorbed on solid phase. Although homophilic binding was evident when R24 was bound to solid phase, R24-R24 aggregates could not be detected in solution under otherwise identical conditions. R24 bound to four other mAb (two IgG3, one IgG2a, one IgM) directed against GD3 but did not bind to a panel of 21 other mAb including other IgG3 mAb and mAb directed against non-GD3 ganglioside. Evidence implicating the GD3-binding site of R24 in homophilic binding included the following observations: 1) F(ab')2 fragments of R24 could bind to R24, 2) an antiidiotypic mAb against the GD3-binding site of R24 inhibited R24 homophilic binding, 3) an IgM anti-GD3 mAb also demonstrated homophilic binding to R24, and 4) homophilic binding was a function of immunoreactivity and avidity for GD3. R24 variants with 40-fold lower avidity for GD3 demonstrated a similar decrease in homophilic binding. Inasmuch as R24 bound to R24 F(ab')2 fragments and specifically to anti-GD3 mAb, it appeared that the target for homophilic binding was an epitope within the V region of anti-GD3 mAb. It is likely that homophilic interactions result in increased affinity of R24 for GD3 through increased effective valency of antibody-Ag complexes.

This paper considers a synthesis approach to a decentralized autonomous system in which the functional order of the entire system is generated by cooperative interaction among its subsystems, each of which has the autonomy to control a part of the state of the system, and its application to pattern generators of animal locomotion. First, biological locomotory rhythms and their generators, swimming patterns of aquatic animals and gait patterns of quadrupeds, are reviewed briefly. Then, a design principle for autonomous coordination of many oscillators is proposed. Using these results, we synthesize a swimming pattern generator and a gait pattern generator. Finally, it is shown using computer simulations that the proposed systems generate desirable patterns.

We have integrated a high speed and high density 6T-SRAM cell (0.998 /spl mu/m/sup 2/) for system-on-a-chip (SOC) using enhanced 100 nm CMOS logic technology. This is achieved by a systematic integration methodology, which includes high-NA ArF lithography, optimized optical proximity correction (OPC) CAD, narrow well isolation, poly-buffered shallow trench isolation (STI), offset spacer transistor, and 9-level Cu interconnect and low-k dielectric technologies with the lithographically scalable SRAM cell design.

Some kinds of spatiotemporal pattern generator systems are expressed by evolution equations. Such evolution equations are composed of many dynamic units which behave from only its local information. This is a typical structure of self-organizing system, which have many desirable properties for large scale systems, such as flexibility, adaptability, fault tolerability, and so on. We showed that such a system can be modeled by a reaction diffusion equation on a graph in the previous work. The result was that a reaction diffusion equation on a graph decreases the value of a potential functional monotonously. This means that a network of dynamic units which observe only their connecting units' states can generate a global order in the same way of continuous media. This theory can treat some internal dynamic network system which should coordinate without some kinds of central controllers. Generally, the pattern which is generated by a self-organizing system is suitable for its environment. This means that such pattern is very affected by its environment. Therefore, the theory which treats such a system must be able to formulate the environment. One of the most suitable theory to treat it is evolution equation on a graph with boundary. In this paper, we derive the Stokes' formula on a graph with boundary. Using this formula, the reaction diffusion equation on a graph with boundary is derived by constructing a gradient system in function space on the graph.

Distributed system is usually constructed from many homogeneous subsystems with their local couplings, and does not have a control center. From the structural similarity to biological systems, the distributed system is expected to possess the flexibility or adaptability. To construct a distributed system, two problems arise: One is how to control the whole system by only using local interactions based on local couplings, and another is how to design the adaptation mechanisms. To the former problem, a method based on the gradient system has been discussed in our previous paper. In this paper, we develop this method further and propose an new adaptation rule executable in the subsystems with local couplings. The essence of the adaptation is to adjust the desired system states so that interactions among subsystems are made small. We show a simulation result of a coupled oscillator system where the oscillation pattern changes adaptively with environmental conditions.

The authors consider a synthesis approach to autonomous decentralized systems in which the functional order of the entire system is generated by cooperative interaction among its subsystems, each of which has the autonomy to control a part of the state of the system, and its application to pattern generators of animal locomotion. Biological locomotive rhythms, their generators, and gait patterns of quadrupeds are reviewed briefly. A design principle for autonomous coordination of many oscillators is proposed. Using these results, a gait pattern generator that suitably changes gait patterns for its moving speed is synthesized. It is shown, using computer simulations, that the system generates and changes patterns suitable for its moving speed, i.e., walk, trot, and gallop. >

This paper shows a system composed of multiple robots which cooperate with each other through local communications, in order to search the goal of a given maze. The diameter of each robot is only 40 mm and it equips with a very simple algorithm; each robot plays a part to find the goal of an unknown maze as a whole system. In this study, a computer simulator has also been developed in order to examine the validity of the designed algorithms.

Some kinds of spatiotemporal pattern generator systems are expressed by evolution equations. Such evolution equations are composed of many dynamic units which behave from only its local information. This is one example to coordinate many subsystems which observe the system from inside and to generate a global order. This paper shows how to treat these evolution equations and how to apply it to network systems. First, a continuous media system which is expressed by a gradient system in function space is considered. One of the simplest potential functionals derives a reaction diffusion equation which decreases the value of potential functional monotonously. The similar result is found in graph space. That is, a reaction diffusion equation on a graph decreases the value of a potential functional monotonously. This means that a network of dynamic units which observe only their connecting units' states can generate a global order in the same way of continuous media. This theory can treat some internal dynamic network system which should coordinate without some kinds of central controllers.

We have newly developed a single crystal silicon micromachined pulsed infrared light source, with a microbridge. The chip size is 2/spl times/1/spl times/0.35 mm/sup 3/. The microbridge size is 365/spl times/85/spl times/1.5 /spl mu/m/sup 3/. We can easily control the temperature of silicon microbridge by pulsed electric signal up to the frequency range of 2 kHz. The modulated temperature is more than 700/spl deg/C at 100 Hz and 100/spl deg/C at 2 kHz. The thermal time constant is 0.4 msec. We measured transient temperature distribution of microbridge. We estimate performance of infrared light source from these results.

This paper studies the adaptability of animals' rhythmic movements to the changes in their environments. Rhythmic movements are usually modeled by a central pattern generator (CPG) using coupled oscillators. In our research, by analyzing the perturbed locomotion of a decerebrate cat, we propose a mathematical model for an adaptation mechanism. In this model, we take into account the environmental changes and give the adaptation rules so as to minimize the interaction between each oscillators. We also propose a general framework describing adaptive behaviors in rhythmic motion.

Learning approach is effective to design a agent that takes action autonomously. We propose to adopt teaching approach to design autonomous agents for RoboCup soccer tasks. Our teaching system consists of the ceiling CCD camera, SONY legged robots, and a PC for the teaching terminal. As a first step of the teaching process, we realized the self-localization of the robot using BP algorithm of feed forward neural networks.

The case of a 48-year-old man with an aneurysm of the inferior mesenteric artery is described. This aneurysm was associated with extensive vascular disease characterized by multiple sites of stenosis and occlusion in addition to an upper abdominal aortic aneurysm. Repair of both aneurysms and reconstruction of the left renal artery and inferior mesenteric artery, which supplied all splanchnic circulation, were performed. The aetiology of the disease was thought to involve Takayasu's arteritis.

5a-Carba-alpha-L-fucopyranose and -alpha-DL-fucopyranosylamine were synthesized in conventional manner starting from 2,3,4-tri-O-acetyl-6-bromo-6-deoxy-5a-carba-beta-D- and -DL-glucopyranosyl bromides, respectively, and assayed for inhibitory activity against alpha-fucosidase (bovine kidney). Although the former proved to be only a moderate inhibitor (Ki = 4.3 x 10(-5) M), the latter could be shown to possess strong inhibitory potential (Ki = 2.3 x 10(-7) M). Diastereoisomeric imino-linked 5a'-carbadisaccharides were synthesized by coupling of the racemic 5a-carba-alpha-fucopyranosylamine and 1,6:3,4-dianhydro-2-azido-2-deoxy-beta-D-galactopyranose, in order to estimate approximately the inhibitory activity of individual optical antipodes of 5a-carba-alpha-fucopyranosylamine.

ABC (angry backfiring C-nociceptor) syndrome-like pain disorder categorized in sympathetic independent pain appeared after amputation during spinal anesthesia. A 69-year-old female who had undergone amputation of the right leg below knee 5 months before, received amputation of the left leg below knee this time because of diabetic neuropathy and gangrene of her both legs. There were no complications in her right leg after the former amputation. Spinal anesthesia was maintained in the left one-side by hyperbaric local anesthetic. After changing the body position from left lateral to supine, the left leg was completely anesthetized and the right leg was incompletely anesthetized with only loss of cold sensation. In this state, she had pain in her right leg, and this pain was relieved by intravenous lidocaine administration. It was indicated that this type of pain was caused by the presence of ABC syndrome probably after right leg amputation.

A rare case of sarcoid meningoencephalitis with no systemic lesion is reported here. A 58-year old man was admitted experiencing dull headache and speech disturbance. He had never received a diagnosis of systemic sarcoidosis. On admission, neurological examination revealed dysarthria, a defect of the right-side visual field and accelerated right Achilles tendon reflex. A T2-weighted MRI showed a high-intensity signal in the white matter of the left parieto-occipital lobe surrounded by severe brain edema with a mass effect. The meninges around the lesion were enhanced by gadolinium, but no enhancement was observed in the basal portion. Angiotensin-converting enzyme (ACE) activities of cerebrospinal fluid (CSF) and serum were within normal range. The level of interleukin-6 in the CSF was slightly elevated. Chest X ray films and chest CT revealed no abnormal lesions. Whole body gallium scanning showed a hot region only in the intracranial lesion. A brain biopsy was performed. Histological examination revealed typical granuloma of sarcoidosis accompanied by microvasculitis and epithelioid cell granuloma without caseous necrosis. Oral administration of prednisolone improved all symptoms and MRI findings. These observations suggest that release of cytokines from macrophages and epithelioid cells, as well as disruption of the blood-brain barrier due to microvasculitis, are involved in the mechanism responsible for producing lesions of sarcoid meningoencephalitis.

Acid-treated yeast cell wall (AYC) was newly prepared by acidifying the cell wall of brewer's yeast and the potential to use AYC as a novel coating material was studied. AYC had an oval shape with the diameter of several microm. The rheogram of AYC aqueous dispersion showed the plastic fluid property that is generally observed in the suspension. Core tablets containing 3% of acetaminophen (AAP) were coated with the AYC aqueous dispersion containing 5% (w/v) of AYC and 0.35% (w/v) of glycerol at various coating percents. The AAP release profile from the AYC-coated tablets was studied by the JP13 paddle method using solutions at various pH. Tensile strength and permeability of oxygen and water vapor of AYC cast film were measured. The AAP release from the AYC-coated tablets showed sigmoidal release profile with an initial lag time and the duration of the lag time depended on the coating percent of AYC. The pH of the dissolution fluid or the storage at room temperature for 120 days had little affect on AAP release from the AYC-coated tablets. These results suggest that it is possible to control the start time of medicine release independent of the pH by coating of AYC, that is the time-controlled release. The AYC cast film showed a large tensile strength and an extremely small oxygen permeability coefficient and a sufficient level of water permeability coefficient in order to protect from moisture. These results present that AYC has the high utility as a novel aqueous coating material for DDS preparations.

We describe an autopsy case of parkinsonism with bradykinesia, muscle rigidity, and dementia as major symptoms. The patient had developed bradykinesia at the age of 62, and then muscle rigidity, a parkinsonian posture, bradylalia, and dementia gradually appeared. Neurological examination revealed rigidity in the neck and limbs, with motion and speech being generally slow. He lacked involuntary movements including alien hand, tremor, chorea, and dystonia. Vertical gaze palsy, both upward and downward was noted, but other cranial nerves were intact. He was diagnosed as suffering from PSP clinically based on vertical gaze palsy, bradykinesia, instability on standing and gait, and dementia. Levodopa was only transiently effective. Within three years he became bed-ridden and in a state of akinetic mutism. At age 65 he died from pneumonia. Neuropathology revealed severe neuronal degeneration and gliosis in the substantia nigra. Because atrophy of the tegmentum of brainstem, dentate nuclei, inferior olivary nuclei was very mild and Alzheimer neurofibrillary tangles in the brainstem were relatively few, PSP was ruled out. Cortical neuronal degeneration was not apparent, but in the deep layer of cingulate gyrus, frontal lobe, and insula, there were several ballooned neurons. Gallyas-Braak silver staining showed no tuft-shaped astrocytes, specific for PSP, but it disclosed astrocytic plaques in the basal ganglia and the cerebral cortex. At present, astrocytic plaques are recognized as a hallmark of corticobasal degeneration (CBD), along with ballooned neurons in the cerebral cortex. The present case thus illustrates that CBD has a wide spectrum and may include cases in which degeneration of cerebral cortex is very mild.

A case of malignant fibrous histiocytoma of the chest wall. A 56-year old man was admitted to the hospital with a complaint of showing abnormal shadow on chest X-ray. Chest X-ray and chest CT scan showed a calcified tumor of the chest wall. Histological diagnosis could not be made prior to the operation. Wide resection of the right chest wall containing the tumor and partial resection of the right lung were done. Malignant fibrous histiocytoma (MFH) showing a striform-pleomorfic pattern was recognized histologically with resected specimen. MFH commonly arises in the soft tissues of the extremities, but rarely in those of the chest. This paper also presents a review of 38 reported cases of MFH originated from the chest wall.

Fourteen kinds of salts consisting of various cations and anions in the Hofmeister series were used as additives for suppression of particle agglomeration in the fluidized bed coating. We attempted to clarify the relationship between the suppression effect of the salts and the Hofmeister series of their consistent ions.Fluidized bed coating was carried out with hydroxypropylmethyl cellulose (HPMC) aqueous coating solution containing the salts and Celphere as core particles. To elucidate the salting-out power of the salts for HPMC, the transmittance of the coating solutions at 600 nm was measured at various temperatures and the phase separation temperature (T(PS)) was determined from the values at 50% transmittance.A high suppression effect was observed when the salts including high order ions in the Hofmeister series were added to the coating solution. T(PS) decreased in the presence of the salts except for sodium iodide and sodium thiocyanate and lowered with the higher order ion in the Hofmeister series. The particle agglomeration was suppressed with decrease in T(PS) of the HPMC aqueous coating solution.It has been suggested that the suppression effect of a salt on the particle agglomeration depended on the salting-out power of the salt. We regard sodium citrate and potassium citrate as very useful pharmaceutical additives for the suppression of particle agglomeration in actual pharmaceutical coating.

Multi-facility joint randomized clinical trials for cancer treatment are the most common method of current clinical study. However, the difference in the rate of participation in multi-facility randomized clinical trials may damage the resulting general validity. Therefore, we studied whether the rate of participation in randomized clinical trials is different between university hospitals and other general hospitals using a questionnaire (with anonymity preserved). There were 744 subjects from university hospitals and 339 from general hospitals participating in the study. The results showed that 10.9 percent of those from university hospitals were willing to participate, against 28.1 percent who were not. Of those from general hospitals (public hospitals in this study) 10.6 percent answered that they would participate and 27.4 percent that they would not. Little difference was found in the rate of participation in randomized clinical trials between university hospitals and other general hospitals. The focus is thus on doctors to solve the possible differences between the facilities in further multi-facility joint studies.