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Objectives The aim of this AFIRE (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease) trial subgroup analysis was to examine rivaroxaban monotherapy benefits and their relation to the time between stenting and enrollment among patients after coronary stenting. Background Of 2,215 patients with atrial fibrillation and stable coronary artery disease in the AFIRE trial, rivaroxaban monotherapy was noninferior to rivaroxaban plus antiplatelet therapy (combination therapy) in terms of efficacy and superior for safety endpoints. However, thrombotic risk after antiplatelet therapy cessation remained a concern among 1,444 patients who had undergone coronary stenting >1 year before enrollment. Methods The benefits of rivaroxaban monotherapy in coronary stenting subgroups were assessed for efficacy (a composite of stroke, systemic embolism, myocardial infarction, unstable angina requiring revascularization, or death of any cause), safety (major bleeding defined according to International Society on Thrombosis and Haemostasis criteria), ischemic endpoints, net adverse clinical event, and time between stenting and enrollment. Results Efficacy and safety endpoints for monotherapy were superior to combination therapy, with HRs of 0.70 for efficacy (95% CI: 0.50-0.98; P = 0.036) and 0.55 for safety (95% CI: 0.33-0.92; P = 0.019). For ischemic endpoints, the HR was 0.82 (95% CI: 0.58-1.15; P = 0.240). The HR became smaller with longer time between stenting and enrollment (efficacy, P for interaction = 0.158; safety, P = 0.097). Conclusions In patients with atrial fibrillation after coronary stenting, the benefits of rivaroxaban monotherapy for efficacy and safety endpoints were consistent with those in the whole AFIRE trial population. The benefits became apparent with longer time between stenting and enrollment. (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease Study [AFIRE]; UMIN000016612 , NCT02642419 )

Background The current system of HeartFlow fractional flow reserve derived from computed tomography (FFRCT) is not available for stented coronary arteries. However, the latest version of HeartFlow FFRCT has the potential of rendering an accurate assessment for stented coronary arteries. Objectives To evaluate the feasibility of FFRCT for the stented coronary arteries. Methods We retrospectively enrolled patients with a history of coronary stent implantation who underwent invasive fractional flow reserve (FFR) for the stented coronary arteries within 3 months after coronary computed tomographic angiography (cCTA). As a subgroup analysis, we analyzed optical coherence tomography (OCT) images in patients who underwent OCT for stented vessels. OCT was performed as a part of the Kobe University Hospital OCT registry, which is a single-centre registry of consecutive patients who underwent OCT for the coronary arteries. The diagnostic performance of HeartFlow FFRCT for stented vessels was evaluated by comparing with that of cCTA alone. Minimum lumen area (MLA) within stent segments derived from cCTA was also compared with MLA derived from optical coherence tomography (OCT). Results A total of 30 vessels in 23 patients were studied. The diagnostic accuracy, sensitivity, specificity, positive and negative predictive value of FFRCT for myocardial ischemia using invasive FFR as a reference standard was 73.3%, 88.9%, 67.7%, 53.3% and 93.3%, respectively. FFRCT provided superior diagnostic performance than cCTA alone (p=0.016). FFRCT was significantly correlated with the invasive FFR (r=0.620, p Conclusions The latest version of the HeartFlow FFRCT has the potential to be available for stented coronary arteries. Further investigation is required to elaborate our results. Funding Acknowledgement Type of funding sources: None. Figure 1Figure 2

Oxysterols are cholesterol oxygenated derivatives which possess several biological actions. Among oxysterols, 7-ketocholesterol (7KC) is known to induce cell death. Here, we hypothesized that 7KC cytotoxicity could be applied in cancer therapeutics. 7KC was incorporated into a lipid core nanoemulsion. As a cellular model the murine melanoma cell line B16F10 was used. The nanoparticle (7KCLDE) uptake into tumor cells was displaced by increasing amounts of low-density-lipoproteins (LDL) suggesting a LDL-receptor-mediated cell internalization. 7KCLDE was mainly cytostatic, which led to an accumulation of polyploid cells. Nevertheless, a single dose of 7KCLDE killed roughly 10% of melanoma cells. In addition, it was observed dissipation of the transmembrane potential, evidenced with flow cytometry; presence of autophagic vacuoles, visualized and quantified with flow cytometry and acridine orange; and presence of myelin figures, observed with ultrastructural microscopy. 7KCLDE impaired cytokenesis was accompanied by changes in cellular morphology into a fibroblastoid shape which is supported by cytoskeletal rearrangements, as shown by the increased actin polymerization. 7KCLDE was injected into B16 melanoma tumor-bearing mice. 7KCLDE accumulated in the liver and tumor. In melanoma tumor 7KCLDE promoted a >50% size reduction, enlarged the necrotic area, and reduced intratumoral vasculature. 7KCLDE increased the survival rates of animals, without hematologic or liver toxicity. Although more pre-clinical studies should be performed, our preliminary results suggested that 7KCLDE is a promising novel preparation for cancer chemotherapy.

A single 3.3-V only, 8-Gb NAND flash memory with the smallest chip to date, 98.8 mm2, has been successfully developed. This is the world's first integrated semiconductor chip fabricated with 56-nm CMOS technologies. The effective cell size including the select transistors is 0.0075 mum2 per bit, which is the smallest ever reported. To decrease the chip size, a very efficient floor plan with one-sided row decoder, one-sided page buffer, and one-sided pad is introduced. As a result, an excellent 70% cell area efficiency is realized. The program throughput is drastically improved to twice as large as previously reported and comparable to binary memories. The best ever 10-MB/s programming is realized by increasing the page size from 4kB to 8kB. In addition, noise cancellation circuits and the dual VDD-line scheme realize both a small die size and a fast programming. An external page copy achieves a fast 93-ms block copy, efficiently using a 1-MB block size

Objective: The urinary ratio of 6β-hydroxycortisol to cortisol is known as a possible marker of CYP3A4 activity. We investigated the correlation between this ratio and the disposition of alprazolam, which is a substrate of CYP3A4. Methods: Twelve healthy volunteers took a single dose (0.8 mg) of alprazolam at 0800 hours. Blood samplings were conducted up to 48 h after the dosing. Urine was collected during the 24 h prior to dosing. Quantification of alprazolam in plasma and that of cortisol and 6β-hydroxycortisol in urine was performed using high-performance liquid chromatography. Results: Mean (±SD) values of peak plasma concentration (Cmax), time to Cmax (tmax), area under the plasma concentration–time curve [AUC(0–48)] and elimination half-life (t1/2) of alprazolam were 12.0±3.0 ng/ml, 1.5±0.9 h, 200±41 ng/ml h and 16.0±4.3 h, respectively. Mean (±SD) urinary ratio of 6β-hydroxycortisol to cortisol was 3.28±0.67. No significant correlations were found between urinary ratio of 6β-hydroxycortisol to cortisol and any pharmacokinetic parameters of alprazolam (Cmax: rs=–0.06; tmax: rs=0.34; AUC(0–48): rs=0.08; t1/2: rs=–0.36). Conclusion: This study suggests that the urinary ratio of 6β-hydroxycortisol to cortisol is unlikely to predict pharmacokinetics of alprazolam.

To gain insight into the space-time kinetics of coupled core systems, a series of simple one-dimensional model solutions were investigated. The spatial and temporal decay of a plane pulse was calculated in one- and three-region systems with one- and two-group diffusion theory. The solution technique consisted of a temporal Laplace transform, analytical solution for the space dependence and finally a numerical inverse Laplace transform back to time domain. The space-time behaviour of the pulse relaxation in many-region systems has been used to support the development and verification of lumped (many-point) coupled core models.

Accepted: 2014-02-24, 資料番号: SA1140021000

We propose a novel integration of image compression and sensing in order to enhance the performance of an image sensor. By integrating a compression function onto the sensor focal plane, the image signal to be read out from the sensor is significantly reduced and the pixel rate of the sensor ran consequently be increased. The potential applications of the proposed sensor are in high pixel-rate imaging, such as high frame-rate image sensing and high-resolution image sensing. The compression scheme we employ is a conditional replenishment, which detects and encodes moving areas. In this paper, we introduce two architectures for on-sensor compression; one is the pixel parallel approach and the other is the column parallel approach. We prototyped a VLSI chip of the proposed sensor based on the pixel parallel architecture. We show the design and describe the results of the experiments obtained by the prototype chip.

The increasing demand for Renewable Energy Sources like solar and wind power opens up adoption of Web services communications for wide-area and real-time smart grid applications. Since the behavior of web services with TCP/IP is stochastic, detailed characteristics of data transmission delay should be investigated for time-constraint smart grid communications. In this paper, we have chosen a new Web services standard IEEE1888 as the protocol for soft-real-time applications such as Automated Demand Response (ADR) aggregation. The statistical distribution of data transmission delay was measured using our emulator experiments and NS2 network simulations. We found that the variation of delay sometimes reaches more than ten times of the average in the cases of heavy packet loss rate. Although the IEEE1888 is better than conventional protocols, attentions on time-out occurrence should be paid for the smart grid web services communications.

To investigate the pharyngeal morphologic features and its pathogenic role on obstructive sleep apnoea syndrome in the elderly population.Prospective controlled, comparative cohort study.Territory referral centre.We enroled 320 consecutive patients with complaints of snoring who visited Nagoya University Hospital from January 2004 to December 2007. We also collected 26 control subjects aged over 60 years from community-dwelling people.We underwent a morphological evaluation, measurement of nasal resistance, assessment of daytime sleepiness and nocturnal polysomnography.Two hundred and ninety-two patients were analysed. The constitution ratio of men, the body mass index and Epworth sleepiness scale were decreased with ageing. Tonsil size was reduced progressively with ageing. Retroglossal space was wider, and soft palate was lower in ≥ 60 year group than in40 year group. Retroglossal space was wide in elderly patients with sleep apnoea compared with control subjects. Tonsil size was not correlated to apnoea/hypopnoea index in ≥ 60 year group unlike the other generations. Modified Mallampati Score and tongue size were significantly but mildly correlated only in ≥ 60 year group. Width of fauces was correlated in all the groups. Multiple regression analysis showed that body mass index, age, gender, tonsil size and width of fauces were independent factors for apnoea/hypopnoea index.Morphologically, the tonsil could play a minor role but the width of fauces could play relatively a major role. Additionally, wide retroglossal space, low positional soft palate and large tongue size may be characteristics for elderly patients of obstructive sleep apnoea syndrome.

Sudden sensorineural hearing loss (SSNHL) and Ménière's disease are the most common inner ear diseases in which the causes are unknown. As recent magnetic resonance imaging has demonstrated disruption of the blood-labyrinth barrier in these inner ear diseases, inflammatory reaction associated with increased permeability of the blood vessels may be involved. The genotypes of interleukin 1A (IL1A) (-889C/T; rs1800587) and interleukin 1B (IL1B) (-511C/T; rs16944) were determined using an allele-specific primer-polymerase chain reaction method in 72 patients with SSNHL, 68 patients with Ménière's disease, and 2202 control subjects living almost in the same area as the patients. A significantly higher prevalence of the IL1A-889T allele was observed in SSNHL and Ménière's disease compared with controls, although no significant difference in distribution of IL1B-511C/T genotypes was observed between the patients and controls. Adjusted odd ratios for SSNHL and Ménière's disease risks in the -889TT genotypes were 25.89 (95% confidence interval (CI) 12.19-54.98) and 18.20 (95% CI 7.80-42.46), respectively, after age and gender were taken as moderator variables. Our results suggested that IL1A is closely associated with susceptibility of SSNHL and Ménière's disease.

With nanometer processes, at-speed testing is required to filter out failing chips with delay defects to ensure high product quality. Locating delay defects is important not only for improving yield but also providing important information to enhance at-speed test methods to meet quality goals. In this paper, a method that leverages successful static defect diagnosis method to diagnose delay defects is presented. To avoid missing any defect suspects, transition fault model is used with special considerations of self masking, glitch detection and passing bit mismatch. The effectiveness of this approach is demonstrated with simulation experiments as well as two case studies on failing chips from Renesas Technology's 130nm process.

NAND flash memory use in digital still cameras and cellular phones is driving demand for larger-capacity storage. Moreover, NAND flash has the potential to replace HDDs. To achieve larger capacity while maintaining low cost per bit, technical improvements in feature size and area reduction are essential. To meet the stringent requirements, we develop a 16 Gb 4-level NAND flash memory in 43 nm CMOS technology. In 43 nm generation, gate-induced drain leakage (GIDL) influences the electrical field on both sides of NAND strings. GIDL causes severe program disturb problems to NAND flash memories. To avoid GIDL, two dummy wordlines (WL) on both sides of NAND strings are added. This is effective because the dummy gate voltages, are selected independent of the program inhibit voltage.

Fabricated in 56nm CMOS technology, an 8Gb multi-level NAND Flash memory occupies 98.8mm2, with a memory cell size of 0.0075mum/b. The 10MB/s programming and 93ms block copy are also realized by introducing 8kB page, noise-cancellation circuits, external page copy and the dual VDD scheme enabling efficient use of 1MB blocks

The growth of mobile equipment market is spurring demand for low-power SRAM macros. For mobile applications, in particular, there is a need to reduce standby current leakage while keeping memory cell data. For this purpose, several techniques have been reported. They introduce reduction of cell bias voltage in standby state, but the cell bias level is determined by Vth and supply voltage as described later. In 90nm technology and beyond, fluctuation of Vth is increasing and leakage reduction efficiency of these techniques is greatly affected. Therefore, a cell leakage reduction technique immune to process and/or environment fluctuations is required. In addition, leakage reduction in row decoder circuit is also desirable, because standby current leakage in peripheral circuits is dominated by row decoders. In order to meet these requirements, a novel cell bias control technique and a novel row decoder circuit are proposed. We fabricated a 90nm 512Kb low leakage SRAM macro.

Neutropenic enteritis is a septic or inflammatory disease of the colon. It is usually encountered in patients with hematological malignancy who have undergone chemotherapy, and it presents as fever, diarrhea, and abdominal pain, although the symptoms are not always specific. The diagnostic features of neutropenic enteritis revealed by barium enema, CT and ultrasonography have been reported previously. Here we report 4 cases of neutropenic enteritis in which ultrasound was used for diagnosis, and also for monitoring the clinical course of the disease. Because neutropenic enteritis is rapidly progressive, early diagnosis and therapeutic intervention are required. We believe that ultrasonography is a useful method for examining patients with neutropenic enteritis, being noninvasive, mobile, and providing rapid results in real time, thus aiding early diagnosis and clinical follow-up.

Cardiac sarcoidosis, the main cause of death among patients with sarcoidosis, frequently becomes clinically apparent when the disease is far advanced. To evaluate the usefulness of the 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in detecting cardiac sarcoidosis, 18F-FDG PET was performed in 16 patients with sarcoidosis (13 female, 63 +/- 12 yrs), compared with scintigraphic findings of 99mTc-MIBI and 67Ga. Ten of 16 patients were considered to have cardiac complications on clinical grounds with tissue confirmation such as positive endomyocardial biopsy, severe ventricular arrhythmia, more than second degree atrioventricular block, and echocardiographically proven ventricular dysfunction. Among these patients with cardiac complications, abnormal myocardial uptake of FDG were observed in all (100%), which confirms significantly higher frequency compared to 67Ga scintigraphy (50%) (abnormality of 99mTc-MIBI SPECT were observed in 80%). Although abnormal FDG accumulations were observed in region with decreased uptake of 99mTc-MIBI in many cases, localization of regional abnormality of each tracer was frequently independent. This discrepancy may reflect inflammatory and degenerative process of myocardium in cardiac sarcoidosis. 18F-FDG PET is thought to be a useful noninvasive method in detecting cardiac involvement of sarcoidosis and may provide a useful information on the activity of the disease.

This study was performed to compare imaging ability between pentavalent 99mTc-DMSA and 201TlCl in primary and metastatic brain tumors and to evaluate the relationship between retention and histologic malignancy.Patients with a brain tumor were selected by MRI and/or CT. Dynamic, early and delayed static SPECT images of the brain were obtained immediately, 30 min and 3 hr after intravenous administration of approximately 555 MBq 99mTc(V)-DMSA and 111 MBq 201Tl-Cl, respectively. Both studies were performed on separate days within a week. Uptake ratios, retention ratio and retention index were calculated and compared with tumor histology and malignancy grade.One-hundred six studies were performed on 100 patients and 118 lesions were demonstrated: 16 glioblastomas, 13 anaplastic astrocytomas (Grade III), 19 astrocytomas (Grade II), 29 meningiomas, 11 schwannomas and 14 metastases. Approximately 93% and 88%, respectively, of primary and metastatic brain tumors were demonstrated by 99mTc(V)-DMSA and 201TlCl. The early uptake ratios were closely related to the tumor vascularity, but had no statistically significant difference in the tumor histology or histologic malignancy on either radiopharmaceuticals. The delayed uptake ratio, retention ratio and retention index were higher in malignant tumors than benign ones on 99mTc(V)-DMSA, however, there was no statistically significant difference between benign and malignant tumors on 201TlCl.Technetium-99m(V)-DMSA washout from the tumor was highly dependent upon its histology and histologic malignancy. The delayed uptake ratio, retention ratio and retention index significantly reflected tumor histology and clearly distinguished between benign and malignant tumors with a statistically significant difference. There was no statistically significant difference in 201TlCl uptake or washout among the brain tumors. Technetium-99m-DMSA is superior to 201TlCl in imaging quality, sensitivity to brain tumors and specificity for differentiating benign tumors from malignant ones. These results could suggest the clinical utility of 99mTc(V)-DMSA in imaging primary and metastatic brain tumors and differentiating their histological malignancy grade noninvasively.

This study assessed pentavalent 99mTc-DMSA uptake in primary brain tumors and evaluated the relationship between retention and histologic malignancy.SPECT images of the brain were obtained at 30 min and 3 hr after intravenous administration of approximately 555 MBq 99mTc(V)-DMSA in patients with brain tumors. Sixty studies were performed in 57 patients and 63 lesions were demonstrated: 11 glioblastomas, 13 anaplastic astrocytomas (Grade 3), 11 astrocytomas (Grade 2), 18 meningiomas and 10 schwannomas. Uptake ratios, retention ratio and retention index were calculated and compared with tumor histology and malignancy grade.Approximately 95% of both benign and malignant primary brain tumors were demonstrated by 99mTc(V)-DMSA SPECT images. False negative was noted in three cases. The early uptake ratios were closely related to the tumor vascularity but had no statistically significant difference in the tumor histology or histologic malignancy. The delayed uptake ratio, retention ratio and retention index were higher in the malignant tumors than the benign tumors.Technetium-99m(V)-DMSA washout from the tumor was highly dependent upon its histology and histologic malignancy. The delayed uptake ratio considerably reflected tumor histology and differentiated benign tumors from malignant tumors. The retention ratio and retention index significantly reflected tumor histology and histologic grade of primary brain tumors and clearly distinguished between benign and malignant tumors with statistically significant difference (p0.05). These results could suggest the clinical utility of 99mTc(V)-DMSA in imaging primary brain tumors and differentiating their histological malignancy grade noninvasively.

Simultaneous transmission emission protocol (STEP), developed for the non-uniform attenuation correction of single photon emission computed tomography (SPECT) was evaluated using the cardiac phantom prepared with and without a myocardial wall defect. Emission computed tomography (ECT) of the cardiac phantom using 201Tl was acquired. Transmission data (TCT) were taken using a line source of 99mTc. Myocardial images with STEP method were superior in the homogeneity of intramyocardial radioactivity and spatial resolution to the conventional SPECT images. This is an excellent method because of the accurate matching position between TCT and ECT images and shortening the examination time by simultaneous data acquisition. It would be clinically useful for diagnosing various myocardial diseases.

A primary carcinoid tumor of the thymus showing ectopic ACTH syndrome was evaluated scintigraphically with four radiopharmaceuticals and a fluorescence method. Iodine-123-MIBG and 201Tl-Cl scintigraphy clearly demonstrated the tumor. Gallium-67-citrate and 99mTc(V)-DMSA showed no tumor uptake. The fluorescence method confirmed numerous storage granules of norepinephrine. Iodine-123-MIBG scintigraphy could be useful in the presurgical diagnosis of carcinoid tumors of the thymus.

To assess the clinical role of 99mTc(V)-DMSA in primary lung cancers, SPECT imaging was performed on 31 patients with suspected lung cancer.Planar and SPECT images were obtained at 3 to 4 hr after intravenous injection of approximately 555 MBq 99mTc(V)-DMSA. Two uptake ratios (the maximum counts/pixel in the lesion to the average counts in normal tissue) were calculated.Various types of primary lung cancers (adenocarcinoma, squamous-cell carcinoma, small-cell carcinoma, large-cell carcinoma and bronchial carcinoid tumor) were imaged by 99mTc(V)-DMSA SPECT. Approximately 90% of the lung carcinomas showed increased uptake and were clearly demonstrated by SPECT images. Four cases incidentally revealed osseous metastatic lesion. Three benign lesions did not show increased uptake. Three cases were false-negative and there were no false-positive cases for the primary lesions.Technetium-99m(V)-DMSA SPECT images demonstrated approximately 90% of the primary lung cancers. Uptake ratios were higher in squamous-cell carcinomas than adenocarcinomas. Evaluation of mediastinal tumor extension and nodal metastatic lesion was very difficult by high blood-pool activity in the major cardiovascular structures due to slow blood-pool clearance. However, 99mTc(V)-DMSA SPECT imaging was very useful for detecting primary lung cancers and metastatic lesions to the osseous structures.

"SD-8729" is a one-step IRMA kit employing OC125 antibody as 125I-labeled tracer and M-11 antibody as an immunoadsorbent. Higher bound-radioactivity to beads was observed with shorter incubation time than that of a currently used CA125 IRMA kit which employed OC125 antibody both as 125I-labeled ligand and immunoadsorbent attached to beads. Almost identical CA125 values were obtained by using two kits. The antigenic nature recognized by the M-11 antibody seems substantially different from those of 130-22 or 145-9 antibodies recognizing CA130 antigen.

We performed basic and clinical studies of IRMA "BL-CA195" kit in which monoclonal antibody CC3C195 was used as 125I-labeled tracer and solid phase antibody. The reproducibility of the assay results and dilution curves were satisfactory. There was a close correlation between serum CA195 and CA19-9 values, and many patients with pancreatic and colorectal cancer had elevated serum CA195 concentrations. Unlabeled CC3C195 antibody dose-dependently and completely inhibited the binding of 125I-labeled anti-CA19-9 antibody to its corresponding antigen. These findings suggest that CA195 and CA19-9 share common antigenic determinants.

We report successful descending thoracic aorto-circumflex coronary artery bypass grafting using a saphenous vein graft through left thoracotomy in a 44-year-old female. The patient developed severe angina attack after aortic and mitral valve replacement. Coronary angiography showed 99% stenosis of the circumflex coronary artery. Under general anesthesia, left femoral vein to arterial partial cardiopulmonary bypass was performed via left 4 th intercostal space. Body temperature was lowered to 22 degrees centigrade, and spontaneous cardiac fibrillation occurred. After minimal exposure by pericardial dissection of the circumflex coronary artery, distal anastomosis and then proximal anastomosis at the descending thoracic aorta was carried out under cardiac fibrillation. This surgery was done with minimal intra-and postoperative bleeding. Postoperative course was very smooth, and the patient was discharged and leading a normal life for 6 months after surgery.

A successful surgical treatment of right ventricular myxoma of twenty-year-old male was presented, who healed already previous resection of left atrial myxoma two year and eight months prior to this operation. He has been followed up closely after the first resection of left atrial myxoma for the recurrence in the left atrium. Follow-up echocardiography demonstrated the development of myxoma in the free wall in the right ventricle. The resection for this myxoma was found to be relatively easy at the second operation. The tumor was removed with the stark, without any postoperative problem. According to the literature, this case seems to be the second Japanese case of surgical treatment of right ventricular myxoma following the removal of left atrial myxoma.

This is the first Japanese case of the successful emergency coronary artery bypass grafting (CABG) surgery for failed percutaneous transluminal coronary angioplasty (PTCA) using percutaneous cardiopulmonary support (PCPS). A 81-year-old woman with old myocardial infarction and angina pectoris is presented. Her coronary angiogram showed the 90% and 50% stenosis of the right coronary artery (RCA) and the total occlusion of the left anterior descending artery (LAD). PTCA for the 90% stenosis of RCA was performed. But, during the balloon dilation, her heart rate and blood pressure decreased. PTCA was stopped. As her chest pain was worse, re-PTCA was tried, using PCPS. Under PCPS (3 l/min), the balloon dilation was performed safely and smoothly. But, the unexpected dissection of RCA occurred, and became larger rapidly. After 85 minutes, the emergency CABG was performed. By using PCPS, the stable hemodynamics was given till the operation. CABG to RCA and LAD was performed safely. After the surgery, the patient progressed well. PCPS was a very useful cardiopulmonary assist device.

A successful emergency replacement of the ruptured ascending thoracic aorta by means of ringed Dacron tube graft for 69-year-old male was presented, who had been admitted to our hospital with deep cyanosis and shock. He had experienced severe chest pain one hour prior to admission followed by mental confusion and was brought by ambulant service. Emergency chest enhanced computed tomography showed a clear ruptured dissecting aneurysm (DeBakey Type I) with complicated with pericardial tamponade. Soon after this admission he developed bradycardia with hypotension and quickly went into shock. After induction of anesthesia, cardiac arrest developed. External cardiac massage was started at the same time. Partial cardiopulmonary bypass using femoral vein to artery bypass with the membrane oxygenator was instituted and the body was cooled until moderate hypothermia (25 degrees C). The pericardium was opened and blood clot was removed. The ascending aorta ruptured which was replaced with ringed Dacron tube graft (24 mm in diameter). Patient tolerated procedure well and made good postoperative recovery with temporally mild mental confusion. He discharged 2 months after the surgery without any neurological or mental complication. He has been followed up for six months in excellent condition.

This paper was presented to demonstrate the efficacy of postoperative PTCA for varying degree of stenosis aortocoronary bypass with saphenous vein grafts. The following conclusions were drown. 1. The success rate of postoperative PTCA for 15 grafts showed 88.8%. 2. The rate of success for PTCA was much more effective in patients within one year after bypass operations. The authors concluded that postoperative PTCA can be done with excellent rate of success. Therefore, postoperative cine-coronary angiography should be done to evaluate the state of the graft and to decide to perform possible postoperative PTCA in order to keep long time patency rate of saphenous vein grafts.

A 20-month-old child was admitted to our hospital due to obstructive renal failure caused by cystine calculi. After recovering from the renal failure by bilateral percutaneous nephrostomy, pelvic irrigation with N-acetylcysteine was performed using a 12Fr. flexible double lumen catheter. In 2 weeks the calculus was reduced by 39% in size, then residual calculi were successfully removed by percutaneous nephrolithotripsy using 11.5Fr. rigid ureteroscope and postoperative irrigation with N-acetylcysteine.

We performed division of accessory pathways in five asthma patients associated with Wolff-Parkinson-White (WPW) syndrome, for whom the administration of a beta-blocker for the tachycardia is contraindicated, and the administration of bronchodilators for the asthma attack may cause premature ventricular contractions. As a result, the tachycardic attacks disappeared postoperatively, both at rest and following administration of bronchodilators. Radical treatment of WPW syndrome by division the accessory pathway is considered to be necessary for the safe treatment of asthma.

Magnetic properties were investigated for an amorphous Fe80.5Si6.5B12C1 alloy prepared in ribbon form with various thickness between 13 and 104 μm. The coercivity is proportional to the inverse of the ribbon thickness. The result can be explained by the wall pinning model proposed by Georgy. On the other hand, the intrinsic magnetic properties such as saturation magnetization, Curie temperature, magnetostriction and magnetic anisotropy constant are independent of the thickness. The thinner ribbons exhibit a broader distribution in disaccomodation versus driving magnetic field curve than those of thicker ribbons. The dependance of disaccomodation on temperature depends on the ribbon thickness.