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This paper proposes a novel on-chip learning method for hardware-implemented neural networks to achieve an adaptive wavelength division multiplexer (WDM) demultiplexer. The parameters of the neural network are perturbed by orthogonal bit sequences with small amplitude. The parameters are corrected based on the correlation detection result between the perturbed error signal and the corresponding perturbation signal. A learning experiment that transmits 200-Mb/s, four-channel WDM signals through a 40-km fiber and the tracking of the wavelength drift of the optical transmitter successfully demonstrate the proposed method.

We propose and demonstrate a programmable high-speed, frequency-swept laser for swept-source optical coherence tomography (SS-OCT). This new technique is based on Vernier effect of two pieces of Fabry-Perot electro-optic modulators. This technique offers a non-mechanical optical filter with high resolution and wide tuning range. By applying it to a Fourier domain mode-locked laser, such sweeps are generated. The Vernier effect filter can be modulated by arbitrary wave forms, thus this laser source can eliminate the rescaling process which is the main bottle-neck of the operation time in SS-OCT by applying frequency sweep to equidistant spacing in frequency. Effective repetition frequencies of 100kHz~1MHz are demonstrated with a tuning range of 17THz (140nm) at 1550nm center wavelength. OCT imaging of in vivo human sweat duct with A-line rate of 100kHz and 300kHz are also demonstrated. The resolution of 12μm~ is realized without rescaling process. We present an analysis which suggests design approaches for optimization performance.© (2008) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

A modified multifrequency oscillation learning method employing the phase multiplexing technique for the weight and threshold correction process is proposed. An exclusive-OR learning experiment based on the method is performed using learning hardware, and the results show good agreement with the simulation results.

A new channel selection sequence using a neural control WDM demultiplexer is proposed in packet-switched WDM network. This demultiplexer achieves demultiplexing through an electrically controlled neuro-circuit, thereby achieving fast tuning. In the tuning experiment for optical signals at three different wavelengths, tuning is completed in approximately 20 /spl mu/s. The channel switching function is also examined by experimentation.

Using a model which consist of an insulation cylinder, grounding electrode and HV electrode on the insulation cylinder surface, and the back electrode inside the insulation cylinder, the authors investigated the creepage discharge characteristic under lightning impulse voltage. They examined the surface flashover characteristic using several kinds of models whose distance between the back electrode and the insulation surface is constant vertically and whose back electrode configuration is a stair type. We also observed the streamer propagation length and examined estimation methods of flashover voltage (FOV) by combining the streamer propagation characteristic and FOV characteristic. They concluded that the flashover voltage is estimated well by the voltage addition method and for this estimation the streamer propagation characteristic is suitable up to the boundary where the distance between back electrode and insulation surface changes and the FOV characteristic or the streamer propagation characteristic is suitable in the area beyond the boundary.

The investigation of electrostatic charging tendency (ECT) of new oil has been studied since the 1970's, but that of aged oil has never been studied. We studied the following three factors on ECT and methods to prevent the increase of ECT; (1) Effect of the increasing of ECT of new oil by aging. (2) The influence on new oil mixed with oxidized oil or aged oil. (3) The influence on aged oil by exposure to air. It was found that the ECT of new oil increased in the case of containing small amounts of oxygen and that the ECT of new oil mixed with aged oil increased. The ECT of aged oil exposed to air changed variously depending on the condition of oil. It is confirmed that benzotriazole (BTA) is effective to prevent the increasing ECT of aged oil. Streaming electrification of the transformers in service can be diagnosed by four measurement indices; (1) ECT, (2) leakage current from transformer windings, (3) partial discharge, and (2) supporting properties relating to ECT such as dissolved copper in oil. ECT is the most practical diagnosis method amongst the above four methods.

Several methods for the measurement of electrostatic charging tendency (ECT) of transformer oils were developed in Japan after the streaming electrification phenomena was confirmed. The demand for standardization of the measurement has been raised because of the differences of the methods of measurement and evaluation of ECT. Also many types of measuring apparatus developed up to now have been evaluated for standardization of measuring methods at CIGRE. In the preliminary draft published recently it was concluded that the Mini-static Test is suitable for standardization with high reproducibility and repeatability. However, the ECT value obtained by a Mini-static Tester is often influenced by oil flow rate and varies largely even when using filters from the same lot. Recent investigation showed that the negative dependence of ECT on oil flow rate is caused by the property of the paper filter. The Mini-static Test was recommended as the standard method of ECT measurement although one needs to take a little care of the property of the paper filter in the report by Electric Technology Research Association (ETRA).

The electrostatic charging tendency (ECT) was measured for oils from 75 in-service power transformers (voltage classes, 275 kV and 500 kV) and the influences of number of operation years, operation conditions, addition of BTA (1,2,3-benzotriazol) and repair work history in the field were studied. It was found that the ECT increased with operation years. For BTA-added oils the ECT also showed an increasing tendency with operation years, except at the beginning of transformer operation for which ECT was low. The ECT change with operation year had no significant relationship with oil types, transformer types and operation conditions. It was also found that the ECT had good correlation with power factor and volume resistivity of oil, but Cu content in oil had no positive correlation. As a method for flow electrification diagnosis of transformers, estimation of the leakage current from transformer windings by using the ECT of oil was investigated. It was found that the correlation between the leakage current and the value of (ECT)/spl times/x(flow rate of the windings) was good. This method was judged to be useful as a reliable estimation method for the leakage current.

The voltage clamp phenomenon was investigated by measuring the dielectric characteristics of Ta/sub 2/O/sub 5//SrTiO/sub 3/ and SiO/sub 2//Ta/sub 2/O/sub 5/ multilayer films. These films consist of alternating high- and low-dielectric-constant layers. It was attempted to raise the between voltage of the multilayer films by lowering the resistivity of the insulating film with the low dielectric constant in a high electric field to a value near its breakdown strength. In this way, applied voltages higher than the breakdown field strength of the low-dielectric-constant film can be applied to the high-dielectric-constant insulating, and shared voltages of the former can be kept constant, as if in a voltage clamp, during any further applied voltage rise. The Ta/sub 2/O/sub 5//SrTiO/sub 3/ film was found to exhibit voltage clamp, resulting in higher breakdown strengths, but the SiO/sub 2//Ta/sub 2/O/sub 5/ film did not, and it was necessary to improve the deposition method used for the SiO/sub 2/ film. A self-healing breakdown characteristic was found to be necessary for the multilayer insulating film to attain higher breakdown strengths due to the voltage clamp phenomenon. >

This paper proposed a new method for the face extraction from a complex background. Based on the space gray level dependence (SGLD) matrices, the facial texture model composed by a set of inequalities was derived. Using this textural model, the authors designed a kind of scanning scheme for face detection in the complex backgrounds. An experiment using 60 images containing 150 faces gave the error rate 0% with the false alarm rate 5.4%.

The number of Internet users is now increasing rapidly because of the popularity of the WWW. Intra-nets and extra-nets have also become very popular as they enable efficient business processing. Accordingly, there is increasing demand for Internet/intra-net/extra-net services that offer higher speed, shorter delay, higher throughput, and stronger security at lower cost. To satisfy those demands, this paper proposes the network router/bridge concept that acts as a large router/bridge when constructing a nationwide computer network and a cut-through ATM-based forwarding engine (CAFE) that forwards IP packets/Ethernet frames with cell-by-cell processing in the network router/bridge. We also propose a hardware based fast search method to get the address entry table suitable for cell-by-cell processing, one of the key technologies of CAFE.

We extend the theory of finite topology that we constructed before to a fuzzy topological space by using fuzzy sets. Gray-scale images can be processed based on this fuzzy topology and color images can be processed by regarding the color image as multi-dimensional gray-scale images. We aim to construct a theory for systematic image processing by examining methods of image processing with fuzzy topology. We believe these theories will help organize and provide a theoretical foundation for image processing techniques.

Intranets have been receiving much more attention due to the success of the WWW. There is an increasing demand for intranets that offer higher speed, higher throughput, and stronger security at low cost. This paper points out the problems of constructing a nationwide computer network and proposes the cut-through ATM-based forwarding engine and a new network configuration concept that acts as a large router/bridge.

The demand for Internet services has exploded due to the emergence of the World Wide Web (WWW). Intranets have also been receiving much attention. There is increasing demand for Internet and intranet services that offer higher speed, higher throughput, and stronger security at low cost. This paper points out the problems of constructing a nationwide computer network and proposes the network router/bridge concept that acts as a large router/bridge. We also propose a cut-through ATM-based forwarding engine (CAFE) that handles IP packets/Ethernet frames, it has a forwarding function and high throughput. In conjunction with the existing ATM backbone network, it yields low communication cost.

This study sought to determine the predicted Cp50 of propofol required for laryngeal mask airway insertion (Cp50LMA) and to investigate whether nitrous oxide reduces these required concentrations. Using target-controlled infusion and incorporating the standard Diprifusor pharmacokinetic model, 46 unpremedicated patients were randomly assigned to one of two groups. The patients received either 40% oxygen in air (control group: n = 23), or 60% nitrous oxide in oxygen (nitrous oxide group: n = 23). The target concentration for each patient was determined using the up and down method. Following equilibration between the predetermined blood and effect site concentrations, had been established for10 min, laryngeal mask airway insertion was attempted without neuromuscular relaxants. The data were analysed using a probit analysis to obtain Cp50LMA levels. The values for Cp50LMA were 3.24 micro g.ml-1 in the control group and 1.93 microg.ml-1 in the nitrous oxide group.

The present study was undertaken to evaluate the utility of the serodiagnosis of pulmonary tuberculosis and nontuberculous pulmonary mycobacteriosis by ELISA using a Pathozyme-Myco kit (Myco kit) and a Pathozyme-TB complex kit (TB kit) (OMEGA Diagnostics Ltd.).The subjects comprised 256 healthy volunteers (HV, healthy hospital employees), 66 patients with sputum-positive active pulmonary tuberculosis (apTB), 14 patients with healed pulmonary tuberculosis (hpTB), 24 patients with nontuberculous pulmonary mycobacteriosis (NTM) and 32 patients with pulmonary diseases other than mycobacteriosis.1) The serum IgG antibody titers determined with the Myco kit were significantly higher in the apTB group (p0.01), the hpTB group (p0.01), and the NTM group (p0.01) than those in the HV and the other pulmonary disease group. At a cut-off value of the mean + 2SD of the values obtained in the HV, the positive rate was 47.0% in patients with apTB, 50.0% in those with NTM, 21.4% in those with hpTB, 3.1% in those with other pulmonary diseases, and 1.6% in the HV. Analysis of ROC curves showed that the HV and the pulmonary mycobacteriosis group (apTB and NTM) were best distinguished by a cut-off value of -0.280 OD (log), with the sensitivity and the specificity being 83.3% and 78.5%, respectively. It was impossible to distinguish apTB from NTM. 2) The serum IgG antibody titers determined with the TB kit were significantly higher in the apTB group than those in the HV (p0.01), the NTM group (p0.05) and the other pulmonary disease group (p0.01). No significant difference was observed between the HV and the patients with NTM or those with other pulmonary diseases. Although the positive rate of the test was low in the apTB group (42.4%), there was a significant difference between apTB and NTM (12.5%) (p0.05), suggesting that apTB could be distinguished from NTM. 3) Since the serum antibody titers determined by the Myco kit showed no significant difference between apTB and NTM, and there was also no difference in the positivity between the two diseases, we performed serologic examination using the Myco kit to detect both diseases as pulmonary mycobacteriosis. After diagnosing pulmonary mycobacteriosis by the Myco kit, we then used the TB kit to separate apTB from NTM. In this case, the sensitivity and specificity of the test were 55.6% and 85.7%, respectively. Better methods should be developed to distinguish apTB from nontuberculous mycobacteriosis.

We report a preeclamptic patient who revealed severe pulmonary edema. A 37-year-old woman, at 32-week gestation, underwent emergency cesarean section under general anesthesia. She had no particular past medical history. SpO2 was 84% (room air) on the arrival at the operating room, and a chest X-ray showed pulmonary edema. She was managed in the intensive care unit postoperatively, she received an intensive treatment (positive pressure ventilation, furosemide, and inotropic support), and was extubated successfully on the third postoperative day. From clinical course and echocardiographic findings, we consider that this pulmonary edema was caused by peripartum cardiomyopathy.

We report 3 patients in septic shock with panperitonitis. Endotoxin adsorption by polymixin B affinity column (PMX) and continuous hemodiafiltration (CHDF) were performed immediately after the surgery. Septic shock was not improved in patient 1 and 2 despite intensive care. Multimodal approach, including complete surgical repair, cardiovascular support and blood purification methods, is essential in treating septic patients.

Two extremely-low-birth-weight infants, weighing each 684 and 975 g at birth, underwent emergency surgery because of ileus. Our previous experience with an extremely low birth weight infant, whose hemodynamic control during the surgery had been difficult without administering extra preoperative fluid and transfusion, made us administer enough fluid and transfusion during operation although their urine output was more than 2 ml.kg-1.hr-1. We gave intravenous volume to the present 2 cases before the operations despite the level of preoperative urine output and made their hemodynamic situation more stable during surgeries. We conclude it is very important to administer some amounts of intravenous volume (approximately 8-12 ml.kg-1.hr-1) in extremely low birth weight infants for emergency surgery with ileus regardless of their preoperative urine output.

Transfusion of the irradiated blood has become popular in Japan to prevent the graft-versus-host disease. Case reports, however, of hyperkalemic death or lethal ECG change have been increasing since the irradiated blood was introduced nation-wide. The potassium concentration of the supernatant of irradiated blood becomes about 60 mEq.l-1 by the end of storage period. If the potassium concentration is 60 mEq.l-1, the estimated safe transfusion rate would be 6 ml.min-1 and this can not be agreed with by clinicians who transfuse daily in cases of massive bleeding. The calculated safe transfusion rate (10 mEq.hr-1 of potassium load) ranges from 6 to 72 ml.min-1 considering the storage period from the day of gathering and irradiation. This difference could affect the survival rate. On the other hand, only the difference of the potassium concentration in the supernatant between the irradiated blood and the non-irradiated blood could not explain the increasing number of hyperkalemic case report. The mechanical factors may be related to hemolysis that causes extreme hyperkalemia. Control studies of proper transfusion rate of irradiated blood should be performed to establish a safety guideline for rapid transfusion of irradiated blood.

The antimicrobial susceptibility test for Mycobacterium tuberculosis H37Rv and 43 clinical isolates was performed using a bioluminescence assay by measuring the content of adenosine triphosphate (ATP) derived from mycobacteria. The drugs tested were isoniazid (INH), rifampicin (RFP), ethambutol (EB), streptomycin (SM), and kanamycin (KM). The ATP contents of M. tuberculosis incubated in the Middle-brook 7H9 broth medium containing antituberculous agents were measured at days of 0, 1, 3, 5, 7 and 10. A reduction of ATP content, indicating growth inhibition, was observed in susceptible strains within 5 to 10 days of incubation. Optimal concentrations to distinguish between susceptible and resistant strains were determined as being INH 0.20, RFP 0.50, EB 5.0, SM 4.0, KM 6.0 g/ml. The agreements of ATP method (evaluated at 10 days) with Vite Spectrum and MIC determinations were 81.4% and 100%, respectively. Susceptibilities to most drugs, except for EB, could be determined within 7 days. This method is simple, rapid, nonradiometric, and can be used for drug susceptibility.

Elevated levels of serum surfactant protein-D (SP-D) have been previously reported in patients with idiopathic pulmonary fibrosis (IPF) and pulmonary alveolar proteinosis. To determine whether the same change is seen in other pulmonary diseases, especially pulmonary tuberculosis (TB), we measured the serum SP-D levels in active pulmonary TB (smear and/or culture: positive), acute interstitial pneumonia (AIP), IPF, acute exacerbation of IPF, hypersensitivity pneumonitis (HP), pneumoconiosis, bronchiectasis, and bacterial pneumonia by an enzyme-linked immunosorbent assay using monoclonal antibodies to human lung SP-D, and compared them with those of healthy elderly subjects over 50 years of age. The SP-D level in the healthy elderly subjects was 57.6 +/- 38.4 ng/ml (mean +/- SD, n = 287). The levels in patients with active pulmonary TB (140.6 +/- 18.2 ng/ml, n = 49), AIP (1,021 ng/ml, n = 1), IPF (307.0 +/- 180.7 ng/ml, n = 42), acute exacerbation of IPF (817.7 +/- 283.6 ng/ml, n = 3), and HP (716.6 +/- 548.8 ng/ml, n = 4) were significantly higher than those in the healthy elderly controls (p0.05), whereas those of pneumoconiosis, bronchiectasis, and bacterial pneumonia, 121.9 +/- 92.8 ng/ml (n = 8), 93.9 +/- 72.9 ng/ml (n = 11), and 72.7 +/- 3.4 ng/ml (n = 4), respectively, showed no significant difference with the controls. In active pulmonary TB, the percentage of patients whose serum SP-D levels were over 134.6 ng/ml (mean + 2SD of healthy elderly controls) was 34.7%, and therefore we considered the serum SP-D level was not useful for the diagnosis of pulmonary TB. However, it was significantly higher in the patients with cavity formation than in those without (p0.05), and there was a significant positive correlation between the serum SP-D level and the number of tubercle bacilli in the sputum (r = 0.416, p = 0.00165), erythrocyte sedimentation rate at 1 hr (r = 0.489, p0.01), and CRP level (r = 0.383, p = 0.003). These findings suggest that the serum SP-D level is a useful indicator of the disease activity in pulmonary TB.

The antihepatotoxic activities of soyasaponin I and kaikasaponin III, triterpenoidal saponins isolated from Abri Herba, the whole plant of Abrus cantoniensis, were studied on liver injury induced by CCl4 in primary cultured rat hepatocytes. The antihepatotoxic activities of these saponins and glycyrrhizin (positive control) were demonstrated by measuring the levels of glutamic pyruvic transaminase (GPT) and glutamic oxaloacetic transaminase (GOT). Soyasaponin I inhibited the elevation of GOT and GPT activities. The activities were comparable to those of glycyrrhizin. On the other hand, kaikasaponin III was more effective than soyasaponin I and glycyrrhizin. Kaikasaponin III showed the antihepatotoxic activity at less than 100 micrograms/ml. Furthermore, the highest activity was observed even in the lower doses (50, 100 micrograms/ml). However, soyasaponin I and kaikasaponin III showed some toxicity at the highest dose (500 micrograms/ml), though glycyrrhizin did not show toxicity at any dose.

We chose five sedatives for premedication and investigated the effect of these drugs on the induction doses of propofol. One hundred patients were allocated into one of five groups of 20. These groups consisted of control group (C) given only atropine 0.5 mg i.m.; CL group (plus clonidine 0.15 mg orally); H group (plus hydroxyzine 25 mg i.m.); M group (plus midazolam 3 mg i.m.) and D group (plus diazepam 10 mg orally). The induction dose was measured using loss of count technique. Arterial pressure and heart rate were measured, before and after propofol induction as well as after intubation. We also calculated rate pressure products (RPP) at each point. The induction doses were significantly lower in M-group than those in C-group. On the other hand, in hemodynamic responses, RPP was unchanged in any groups after propofol induction and after the intubation. Both propofol and midazolam have been known to have a depressive effect on the central nervous system via GABA-A receptor-mediated inhibition, although the exact receptor for propofol is unknown. We thought, therefore, that when the interaction occurred, both midazolam and propofol had the same effect on the GABA-A receptor and increased chloride ion flux through the channels. Hydroxyzine and clonidine, however, do not share a common receptor or exert effect on the GABA-A receptor. We consider that this was one of the reasons why induction doses of both H and CL group could not decrease significantly. We concluded that midazolam 3 mg decreased propofol induction dose significantly. Both midazolam 3 mg and clonidine 0.15 mg decreased RPP before induction and hemodynamic responses to induction and intubation were stable.

Thirty four patients undergoing transurethral resection of the prostate (TURP) under spinal anesthesia were assigned to a TUR syndrome (TURS) group (n = 7) or an asymptomatic (ASP) group (n = 27) depending on the clinical manifestations of the TUR syndrome. Blood loss and distribution of absorbed irrigating fluid (3% sorbitol-Uromatic S, 170 mOsm.kgH2O-1, Baxter) were computed together with serum osmolality, blood urea nitrogen and hematocrit. Postoperative serum sodium concentration and hematocrit were significantly lower in the TURS group than in the ASP group (124 +/- 8.7 vs. 133.9 +/- 5.9 mOsm.l-1 and 26. 8 +/- 4.2 vs. 35.0 +/- 4.6%, respectively). Postoperative serum osmotic pressure did not differ between the groups despite the difference in sodium concentration because 3% sorbitol could contribute to osmoles in the serum. The volume of irrigating fluid absorbed and its distribution into the intracellular space (delta ICF) did not differ between the groups. However, blood loss was significantly greater in the TURS group than in the ASP group (1457 +/- 434 ml vs. 173 +/- 450 ml, P0.01), and consequently extracellular fluid (ECF) volume was significantly reduced in the TURS group (-354 +/- 1201 ml vs. 802 +/- 1302 ml, P0.05). Thus, massive blood loss and reduced ECFs rather than dilutional hyponatremia, are thought to contribute to clinical manifestation of the TUR syndrome.

Twenty-three patients undergoing transurethral resection of the prostate (TURP) under spinal anesthesia were studied. The irrigating fluid widely used in Japan is a hypo-osmolar solution with 3% sorbitol (Uromatic S, 170 mOsm.kgH2O-1, Baxter). The blood loss and the distribution of the irrigating fluid absorbed were computed from serum osmolality, blood urea nitrogen, and hematocrit using the equation we had formulated. The blood loss, the total fluid absorbed (ABS), and the volumes distributed to intracellular space (delta ICF) and extracellular space (delta ECF) were 419 +/- 677 ml, 1,582 +/- 1,446 ml, 384 +/- 348 ml and 778 +/- 1,279 ml (mean+/-SD), respectively. The correlation coefficient of delta OSM (difference between pre- and post-surgical serum osmolality) vs ABS and that of delta OSM vs delta ICF were high (0.98, 0.98) but that of delta Na (difference between pre- and postsurgical serum sodium) vs ABS was low (0.56). The linear regression equations of ABS vs delta OSM and delta ICF vs delta OSM were ABS (L) = 0.362 x delta OSM and delta ICF (L) = 0.088 x delta OSM, respectively. These equations means that one mOsm.kgH2O-1 reduction of the serum osmolality is the result of 362 ml of irrigating fluid absorbed, 88 ml of which shifting into the intracellular space.

We investigated the amount of 7% sodium bicarbonate which could be added to local anesthetics (bupivacaine, mepivacaine and lidocaine) without any precipitation when temperature was altered (5 degrees C, 25 degrees C, 40 degrees C). Precipitations occurred at any temperatures and with any dose of bupivacaine. Interestingly, the higher the temperature, the more frequently precipitation with mepivacaine and lidocaine occurred. This was probably because the solubility of the precipitate produced by the interaction of the base of local anesthetics with bicarbonate was reduced when the temperature increased.

Summary form only given. In summary, we have proposed the high-speed tuning of a neural control WDM demultiplexer. The demultiplexer can retune to process a three wavelength optical signal in 200 /spl mu/s. Further speed up of the tuning can be made by increasing gain of the learning circuit.

Background The prognosis of gastric cancer with peritoneal metastasis is extremely poor. Neither systemic chemotherapy nor surgery alone prolongs survival of patients significantly. Methods Patients diagnosed with advanced gastric cancer underwent staging laparoscopy and received chemotherapy when peritoneal dissemination and/or cancer cells on peritoneal cytology were confirmed. The chemotherapy regimen consisted of S-1, weekly intravenous and intraperitoneal paclitaxel, which was verified in our phase II trial (Ann Oncol 2009). S-1 was administered at 80 mg/m2/day for 14 consecutive days, followed by 7 days rest. Paclitaxel was administered intravenously at 50 mg/m2 and intraperitoneally at 20 mg/m2 on days 1 and 8. Clinical response of chemotherapy was assessed by computed tomography, gastroendoscopy, peritoneal cytology and second-look laparoscopy. Radical gastrectomy was carried out when macroscopic curative resection was made achievable by chemotherapy. Chemotherapy was restarted after operation as soon as possible. Overall survival, relapse free survival, morbidity and mortality of gastrectomy were evaluated. Results Out of 100 patients with peritoneal metastasis who received chemotherapy, 60 patients underwent gastrectomy after response to chemotherapy, including 54 with macroscopic metastasis and 6 with positive peritoneal cytology only. A median of three courses were administered preoperatively (range 1–16). Total or distal gastrectomy with lymphnode dissection was carried out in 54 or 6 patients, respectively. The median survival time was 34.5 months. The median relapse-free survival was 16.7 months. The first site of relapse was the peritoneum in 24 patients and the other organ site in 17 patients. Postoperative complications included anastomotic leakage and pancreatic fistula in two patients each, which were healed conservatively. There were no treatment-related deaths. Conclusions Gastrectomy combined with S-1, intravenous and intraperitoneal paclitaxel is safe and active for gastric cancer patients with peritoneal metastasis.

Sodium bicarbonate has been added to various local anesthetics for shortening the onset time. We often noticed the precipitate in the pH-adjusted local anesthetics several minutes after adding the bicarbonate. We confirmed that this drug interaction was caused by large changes in pH. We have analyzed the precipitates by mass spectrometry and infrared absorption spectrum and have revealed it as unionized base forms of local anesthetics. Since these forms tend to be insoluble, we must limit the amount of 7% sodium bicarbonate. This study proposes a guideline for adding 7% sodium bicarbonate to the various local anesthetics. The amount of 7% sodium bicarbonate which can be added to bupivacaine without precipitation is below 0.02 ml. In cases of mepivacaine and lidocaine, allowable amount of 7% sodium bicarbonate is 0.5 ml. It is not known whether this lower dose of 7% sodium bicarbonate compared with the recent reports is effective or not. Further clinical investigation may be necessary.

A patient with mild hypothyroidism underwent a repair of abdominal aortic aneurysm. Although the serum TSH level of this patient was very high and T4, free T4 levels were low, T3 level remained within normal ranges. Inhalation anesthesia with continuous epidural block was selected and there was no complication such as hypotension or hypothermia during perioperative period. Recently, several reports demonstrate that the preoperative supplemental therapy of the thyroid hormone should not be necessary in the case of mild hypothyroidism. Moreover, the biological potency of T3 is higher than that of T4. Thus, in patients whose T3 level is kept within normal ranges even if serum T4 level is low and serum TSH level is high, we may say that they are in euthyroid state. We think these patients can be anesthetized safely.

To evaluate the effects of fresh gas flow rate on the work of breathing during semi-closed circuit anesthesia, we measured respiratory frequency, tidal volume, inspiratory work of breathing, peak inspiratory and expiratory flow rate and fluctuations in airway pressure during breathing with fresh gas flow of 6 l.min-1, 3 l.min-1 and 1.5 l.min-1. There was no significant difference among three flow rates in terms of tidal volume, respiratory frequency, inspiratory work of breathing, peak inspiratory flow rate and fluctuation in airway pressure at inspiration. On the other hand, in the expiratory phase, peak expiratory flow rate was lower and fluctuation in airway pressure at expiration was higher at 6 l.min-1 than those at 3 l.min-1 and 1.5 l.min-1, which may be indicative of increased expiratory work of breathing. The present study shows that low fresh gas flow rate does not increase the inspiratory work of breathing and high fresh gas flow rate may increase the expiratory work of breathing, implying that lowering the fresh gas flow is profitable for the work of breathing during semi-closed circuit anesthesia.

During the 9 years between 1983 and 1992, 36 patients with renal pelvic and ureteral tumors were treated in our hospital. There were 24 males and 12 females. The most common chief complaint was macrohematuria. Intravenous pyelography (IVP) revealed the finding of non-visualized kidney, filling defects and hydronephrosis in 99%. Histologically, 26 were found to have transitional cell carcinoma, one squamous cell carcinoma and one adenocarcinoma. The 5-year survival rate of this study was 54.5% according to the Kaplan-Meier's method. In our study the most important prognostic factor was histopathological grading.

Interaction of midazolam and thiopental in amnestic effect was studied in 30 adult patients who underwent elective surgery of lower extremities under epidural or spinal anesthesia in combination with oxygen, nitrous oxide and low concentration of sevoflurane. Combination of midazolam 2.0-3.0 mg (0.041 +/- 0.006 mg.kg-1) and thiopental 3-5 mg.kg-1 produced amnestic effect in 87% of patients. No side effects, such as decrease in O2 saturation, upper airway obstruction, cardiovascular depression and delayed emergence were observed with this small dose of midazolam. Administration of midazolam 2.0-3.0 mg before epidural, or spinal anesthesia in the operating room under observation of anesthesiologists, followed by thiopental 3-5 mg.kg-1, was safe and comfortable to the patients.

The circulatory responses to tracheal intubation using timing principle were investigated in 40 adult patients who underwent elective surgery. They were randomly assigned to one of two groups; 1) timing principle group, and 2) SCC group. In timing principle group, vecuronium 0.15 mg.kg-1 was administered. At the onset of clinical muscle weakness, thiopental 5 mg.kg-1 was given promptly. Sixty seconds after thiopental, patients were intubated. In SCC group, thiopental 5 mg.kg-1 was administered, and when patients lost consciousness, SCC 1 mg.kg-1 was given. After fasciculation, patients were intubated. The increases in systemic blood pressure, heart rate and rate pressure product were significantly lower in patients in timing principle group than in those in SCC group. Intubating conditions were almost excellent in both groups, and there were no complications in this study. In timing principle group, intubation was done 60 seconds after thiopental administration, and its timing coincided with the peak cerebral concentration of thiopental. We considered this coincidence was one of the reasons of fewer responses in patients in timing group than in those in SCC group.

The intubating conditions using the timing principle combined with small priming doses of vecuronium were evaluated in forty patients who underwent elective surgery. They were randomly assigned to one of two groups: 1) timing, 2) timing with priming. In timing group, vecuronium 0.15 mg.kg-1 was administered, and at the onset of clinical muscle weakness, thiopental 4-5 mg.kg-1 was given promptly. Sixty seconds after thiopental, patients were intubated. In the timing with priming group, vecuronium 0.005 mg.kg-1 was administered as priming doses. Four minutes later vecuronium 0.15 mg.kg-1 was given. The administration of thiopental and the intubation were done in the same way as in timing group. The time to onset of clinical weakness after the administration of vecuronium 0.15 mg.kg-1 was significantly shorter in the timing with priming group than that in the timing group (46.1 +/- 4.8 vs. 57.6 +/- 7.8, P0.01). There were no significant differences in intubating score, T1, TR, onset time, and duration between the two groups. We conclude that the timing principle combined with small priming doses of vecuronium might be safe and useful for rapid tracheal intubation.

We evaluated the usefulness of the timing principle with vecuronium in 60 patients who underwent elective surgery, and divided into two groups according to the dose of vecuronium (0.15 and 0.2 mg.kg-1). First, we studied the interval between vecuronium and thiopental administration in 40 patients. The time after vecuronium administration to onset of clinical muscle weakness was 57.6 +/- 7.8 sec in 0.15 mg.kg-1, and 42.2 +/- 2.2 sec in 0.2 mg.kg-1 group. Then, we made and examined the protocol of the timing principle for the rapid tracheal intubation. Induction of anesthesia with 4-5 mg.kg-1 thiopental was done 40 sec after 0.15 mg.kg-1 in 10 patients, and 30 sec after 0.2 mg.kg-1 vecuronium administration in 10 patients. Intubating conditions were almost excellent 70 sec after thiopental administration. In our study, there were no patients who experienced discomfort during induction. We conclude that the timing principle with vecuronium is useful for rapid-sequence tracheal intubation.

The movement of the cephalic margin of the zone of apposition (ZOA) of the diaphragm associated with ventilatory movement was measured using ultrasonography in 24 healthy subjects and 45 patients with various pulmonary diseases. A transducer was placed on the lower chest wall, and movement of the cephalic margin of ZOA was measured during maximal inspiratory maneuver and expiratory maneuver from end expiratory position in supine and sitting positions in healthy subjects, and in the supine position in patients. In healthy subjects, there was a linear relationship between inspiratory or expiratory volumes and movement of the cephalic margin of ZOA. Movement in the supine position during vital capacity maneuver was 103.0 +/- 15.6 (mean +/- SD), 106.6 +/- 17.2, 108.5 +/- 18.2, and 114.8 +/- 16.3 mm on the left anterior, right anterior, left posterior, and right posterior axillary lines, respectively. In the supine position, movement on the right posterior axillary line was significantly larger than that measured on other axillary lines (p less than 0.05). Movement during maximal inspiratory maneuver in the supine position was significantly larger than that in the sitting position (p less than 0.01). Movement during maximal expiratory maneuver in the supine position was significantly smaller than that in the sitting position (p less than 0.01). Patients showed decreased movement and great differences in movement between the left and right anterior axillary lines. Seven patients out of 28 with normal spirograms showed decreased movement on either or both sides. These data suggest that: 1) the movement of the cephalic margin of ZOA reflects diaphragm displacement; and 2) difference in ventilatory function of right and left hemithorax can be detected by movement of the cephalic margin of ZOA.

A 63-yr-old man weighing 56kg was scheduled for pharyngoplasty under general anesthesia. The patient had no history of ischemic heart disease. Preoperative ECG showed incomplete right branch block. We administered thiopental and succinylcholine for intubation. Anesthesia was maintained with enflurane, nitrous oxide, oxygen and pancuronium bromide. Thirty minutes after the start of incision, the patient developed a severe hypotension and ECG revealed ST elevation and complete AV block. We administered ephedrine hydrochloride, phenylephrine hydrochloride and atropine sulfate. The ECG returned to sinus rhythm but ST segment was depressed this time. We considered it due to coronary spasm, so we started continuous intravenous administration of nitroglycerin (0.5 microgram. kg-1. min-1). One hour later, ST segment returned to normal. ECG showed no remarkable changes and no symptoms were seen after the operation. We found it important to suspect coronary spasm when ECG showed PVC-like abnormal waves with ST elevation. We consider that continuous administration of nitroglycerin at a rate of 0.5 microgram. kg-1. min-1 was effective for the treatment of coronary spasm in this case.

A high-speed analogue neural-network LSI is developed using super selfaligned Si bipolar process technology. The LSI contains four neurons and 16 electrically-modifiable synaptic weights. Neural processing is demonstrated with ‘exclusive OR’ logic at a speed of 150 megapatterns per second.

Experiments by a method which uses a strain meter have shown that inter-fiber contacts and entanglements have a considerable bearing on drawing fibers from variously oriented fiber assembly.Force for drawing fiber from a parallel sliver shows only resistance force proportional to the fiber length. Force for drawing fiber from a fiber assembly is the sum of force proportional to the fiber length and force proportional to less than the cube of the fiber length.Force for fiber-drawing from a lap in the carding process is produced by interfiber contacts and entanglements of drawn fibers.