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Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a systemic autoimmune disease characterized by necrotizing inflammation of the small blood vessels. ANCA-associated vasculitis is subclassified into three variants: granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, and microscopic polyangiitis (MPA). Myeloperoxidase (MPO) ANCA is a marker antibody for MPA. Interstitial pneumonia (IP) is occasionally complicated with MPA. However, only a few cases of idiopathic IP develop MPO-ANCA-positive conversion and MPA. Therefore, we present a case of a 70-year-old Japanese man with idiopathic IP who developed MPO-ANCA-positive conversion and MPA. We performed renal biopsy, which revealed pauci-immune crescentic glomerulonephritis. The patient was treated with intravenous methylprednisolone pulse therapy and oral prednisone, and the patient's laboratory data gradually improved with steroid therapy. The association between the production of MPO-ANCA and IP remains unclear, and the present case suggests that IP plays a role in inducing MPO-ANCA production. Patients with idiopathic IP should be followed-up carefully for an examination of increased MPO-ANCA levels and MPA development. In addition, early gastric cancer was detected during upper gastrointestinal endoscopy in our case, and it could also be important not to miss malignancy in patients with ANCA-associated vasculitis.

Although Takayasu arteritis (TAK) is a form of large vessel vasculitis, complications of glomerulonephritis have occasionally been observed, with mesangial proliferative glomerulonephritis as the most common. The aim of this work was to present a case-based review regarding the association of glomerulonephritis and IgA nephropathy (IgAN) with TAK. A literature search was carried out using the PubMed and Scopus databases for articles published in English, and the Ichu-shi Web for Japanese. A 34-year-old Japanese man was evaluated for proteinuria, and IgAN was diagnosed by renal biopsy. Simultaneously, aortic wall thickening and right renal artery stenosis confirmed a coexisting TAK. Prednisolone and methotrexate improved both diseases, and percutaneous transluminal renal angioplasty resulted in right renal artery reopening. Our case and literature review revealed that membranous proliferative glomerulonephritis and IgAN are common in eastern Asia, while focal segmental glomerulosclerosis and mesangial proliferative glomerulonephritis are common in other regions. The incidence of IgAN is higher in TAK cases and is mostly reported in Asia. Abdominal aortic involvement and renal artery stenosis are common in cases with preceding TAK. IgAN could be related to the cytokine network involving interleukin-6, suggesting the usefulness of tocilizumab in patients with TAK accompanied by IgAN. The type of glomerulonephritis complicated with TAK differs among regions, and patients with TAK are more likely to experience IgAN than the healthy population.

Nephrolithiasis is a common renal disease with no effective medication. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, an anti-diabetic agent, have diuretic and anti-inflammatory properties and could prevent nephrolithiasis. Here, we investigated the potential of SGLT2 inhibition against nephrolithiasis using large-scale epidemiological data, animal models, and cell culture experiments.This study included the data of diabetic patients (n = 1,538,198) available in the Japanese administrative database and divided them according to SGLT2 inhibitor prescription status. For animal experiments, renal calcium oxalate stones were induced by ethylene glycol in Sprague-Dawley rats, and phlorizin, an SGLT1/2 inhibitor, was used for the treatment. The effects of SGLT2-specific inhibition for renal stone formation were assessed in SGLT2-deficient mice and a human proximal tubular cell line, HK-2.Nephrolithiasis prevalence in diabetic men was significantly lower in the SGLT2 inhibitor prescription group than in the non-SGLT2 inhibitor prescription group. Phlorizin attenuated renal stone formation and downregulated the kidney injury molecule 1 (Kim1) and osteopontin (Opn) expression in rats, with unchanged water intake and urine volume. It suppressed inflammation and macrophage marker expression, suggesting the role of the SGLT2 inhibitor in reducing inflammation. SGLT2-deficient mice were resistant to glyoxylic acid-induced calcium oxalate stone formation with reduced Opn expression and renal damages. High glucose-induced upregulation of OPN and CD44 and cell surface adhesion of calcium oxalate reduced upon SGLT2-silencing in HK-2 cells.Overall, our findings identified that SGLT2 inhibition prevents renal stone formation and may be a promising therapeutic approach against nephrolithiasis.

The number of patients aged ≥ 75 years and who need renal replacement therapy is steadily increasing. The study aimed to determine the safety of open surgery for peritoneal dialysis (PD) catheter placement in such patients.This prospective cohort study included patients who underwent PD catheter placement by open surgery under dexmedetomidine (DEX) and local anesthesia at our institution from January 2015 to February 2021. Patients were divided into the following two groups according to age at the time of surgery: ≥ 75 years (group A) and 75 years (group B). We compared the perioperative and postoperative complications (i.e., time to the first PD-related peritonitis and catheter obstruction requiring surgical intervention within 1 year) between the groups.A total of 118 patients were categorized into groups A (n = 65) and B (n = 53). No significant intergroup differences were observed in the postoperative fever, total duration of surgery, perioperative hemoglobin decrease, changes in the white blood cell count and C-reactive protein, postoperative catheter leakage, postoperative hospital stay, time to the first PD-related peritonitis, and catheter obstruction requiring surgical intervention within 1 year.The surgery for PD catheter placement by open surgery under DEX and local anesthesia in elderly patients is safe and effective.

Purpose To develop and validate a new clinical prediction model that accurately predicts the failure of shockwave lithotripsy (SWL) using information obtained from non-contrast-enhanced computed tomography (NCCT). Methods This multicentre retrospective cohort study consecutively enrolled patients diagnosed with upper urinary tract calculi by NCCT at five hospitals in Japan from January 1, 2006 to December 31, 2016. Among the candidate predictors, we selected the six most significant predictors a priori. The main outcome was SWL failure after three sessions. Model calibration was evaluated by the calibration slope and the Hosmer–Lemeshow test. Discrimination was evaluated by the receiver-operating characteristic curves and the area under the curve (AUC). A multivariable logistic regression analysis was performed; based on the estimated β coefficients, predictive scores were generated. Results Of 2695 patients, 2271 were included. Patients were divided into the development cohort (1666 patients) and validation cohort (605 patients) according to geographical factors. We developed a clinical prediction model with scores ranging from 0 to 49 points. We named the prediction model the S3HoCKwave score based on the initials of the predictors (sex, skin-to-stone distance, size, Hounsfield units, colic, and kidney or ureter). As a result of internal validation, the optimism-corrected AUC was 0.72. In the validation cohort, the Hosmer–Lemeshow test did not show statistical significance (P = 0.33), and the AUC was 0.71 (95% confidence interval 0.65–0.76). Conclusions The S3HoCKwave score is easy to understand, has a relatively high predictive value, and allows clinicians to make appropriate treatment selections. Electronic supplementary material The online version of this article (10.1007/s00345-020-03125-y) contains supplementary material, which is available to authorized users.

Germanium (Ge) has been considered a promising material candidate for Optoelectronic Integrated Circuit (OEIC) on silicon (Si) substrates [1, 2, 3]. Although Ge is an indirect-band-gap semiconductor, the energy difference between its direct and indirect band gaps is rather small. Tensile strain and heavy n-type doping have been proposed and demonstrated to be able to compensate for this difference and significantly enhance the direct-gap light emission [4]. To fabricate device structures for optical resonators, lithography and dry etching are desirable. However, defects on the sidewall induced by dry etching would have deleterious effects on the devices performance. In this study, we fabricate circular mesa structures (microdisks) from Ge grown on Si substrate and observe enhanced light emission from device by surface passivation via thermal oxidation. A 740-nm-thick Ge film with a tensile strain of about 0.22% was grown on a p-type Si(100) substrate by solid source molecular beam epitaxy (SSMBE) using two-step growth method [5]. The samples were heavily n-type doped to a concentration up to about 4×1019 cm-3 by phosphorus diffusion from a spin-on-dopant (SOD) source [6]. Electron-beam lithography was used to define circular patterns with different radii on resist. The patterns were then transferred to the Ge by inductively coupled plasma reaction ion etching. After resist removal and cleaning, the samples were oxidized at atmospheric pressure in a furnace. The light emission was then measured by micro-photoluminescence (PL) under a normal-incidence backscattering configuration, immediately after oxidation, to avoid degradation of oxide film in atmosphere. The PL spectra of a blank Ge film and microdisks with radii of 0.8 µm, before and after thermal oxidation at 550 °C for 1 hour, are shown in figure 1(a) and (b). The pump laser power was fixed at 5 mW in all cases. For blank Ge film, the light emission intensity is enhanced by a factor of 1.31 (with respect to the integrated PL intensity) after oxidation. And the emission peak is slightly blue-shifted, which might be attributed to the reduced doping concentration due to out diffusion of phosphorus during oxidation under such a high temperature. The PL intensity of the microdisks with radii of 0.8 µm after thermal oxidation is significantly enhanced compared with that without thermal oxidation. The enhancement factor is about 3.42. We thus attribute this to reduced surface recombination or defects induced by dry etching. Compared with blank Ge film, the enhancement factor for microdisk is much larger. This indicates that the effect of surface passivation of the etched sidewall is dominant over the top surface. We also investigated the light emission properties of microdisks with different radii, as shown in figure 1(c) and 1(d). The enhancement factors are 1.42 and 1.27 for disk with radii of 1.8 and 3.0 µm, respectively, e.g, enhancement factor decreases with increasing disk size. During PL measurement, the pump laser spot was fixed at the same size (a diameter of about 2 µm) and at the same position (the center of the microdisks). For lager microdisks, the sidewall is further from the pumped area where carriers are generated. The contribution of nonradiative recombination induced by sidewall is less dominant for lager microdisks. Therefore, under the same surface passivation condition, the enhancement of the light emission intensity is more pronounced for smaller microdisks. In summary, the effect of thermal oxidation on the light emission properties of dry-etched n-type doped Ge-on-Si microdisks was investigated. The direct-gap light emission was significantly enhanced owing to surface passivation, up to 3.42 times for microdisks with radii of 0.8 µm. The enhancement factor increased as the disk size decreased, indicating that a sidewall-related nonradiative recombination process was an important limiting factor achieving a high injected carrier density and it could be mitigated by thermal oxidation. With this simple method, it is thus highly promising to realize low-threshold Ge lasers monolithically integrated on Si substrates by a mature and low-cost complementary metal-oxide-semiconductor-compatible process. [1] J. Liu et al, Semicond. Sci. Technol. 27. 094006 (2012) [2] P. Boucaud et al, Photo. Res. 1, 102 (2013) [3] J. Liu et al, Opt. Express. 15. 11272 (2007) [4] X. Sun et al, Appl. Phys. Lett. 95. 011911 (2009) [5] K. Nishida et al, Thin Solid Films 557, 66 (2014) [6] X. Xu et al, Appl. Phys. Express 8, 092101 (2015) Figure 1

As a measure to perform a burnishing process easily on an NC lathe, the authors propose a new method using a flank face positioned in a few millimeters lower part of the nose cutting edge of a tool. In the experiment, giving a fixed depth of burnishing (t=1, 2 and 4μm/pass), the carbon steel workpiece (S45C) of φ30mm which had been turned at V=200m/min and f=0.15mm/rev was burnished by predefined number of times. As a result, the surface roughness improved in nearly proportion to the total depth of burnishing and the roughness value of Rz≈10μm measured after turning could be improved to Rz≈2.5μm. Utilizing the feed control with an accuracy level of micron meters of the NC lathe, an attempt to control the dimensional accuracy of the workpiece diameter in the order of micron meters was also made. As a result, the workpiece radius came down constantly by 0.6~0.8 times in proportion to the tool depth of burnishing (t=1μm/pass), which reveals that the dimensional accuracy of the workpiece diameter could be controlled by the proposed burnishing process utilizing a fixed depth of burnishing system. Using the same burnishing process, circularity of the workpiece Δr could be improved to Δr≈2μm from Δr≈4μm measured after turning.

For the purpose of improving the electric discharge machinability of PCD, the authors have proposed a method using an electrode made of a specific transition metal which is easy to react with diamond. As a result, Ti, Nb, Ta, Mo, and W among various reactive metals brought very high efficiency, higher than 3 times of existing electrode materials (Cu, CuW) in the EDM of PCD. It was thought that the higher removal efficiency was due to the material properties such as mixing enthalpy between transition metal atom and carbon atom and a crystal structure of body centered cubic (bcc) lattice.

Recent years, use of the strong alkali ion water produced by electrolyzing high purity water (RO water) with addition of a small amount of electrolyte (potassium carbonate) is becoming widely used as a substitutable cleaning liquid in place of organic solvent which is said to exert a bad influence on the environment. The authors have been conducting a research to apply this strong alkali ion water (pH12 or so) to a working fluid for material removal processing. This is to cope with various problems relating to the existing water-soluble working fluid such as coolant putridity and the associated deterioration of factory environments and increased disposal costs of working fluids as well as to improve machining efficiency and tool life. In this study, the authors would like to describe how the working fluid consisting of water-soluble lubricant diluted with the strong alkali ion water contributes to an improvement of the factory environment and verify experimentally that the said fluid could improve the tool life by 1.2 to several times. In addition, a factor contributing to the improvement of material removal characteristics has been found to be the fact that the friction resistance of the said fluid containing the strong alkali ion water is as low as 2/3~1/2 of that of the fluid diluted with the city water.

Resonant light emission with high Q-factor and fringe contrast, corresponding to Fabry-Perot modes, have been observed over 250 nm wavelength range from highly n-doped Ge-on-Insulator microdisks by combining with highly reflective circular Bragg grating.

Purpose: To introduce a simple technique to create a posterior vitreous detachment (PVD) through the posterior precortical vitreous pocket (PPVP) during microincision vitreous surgery using a wide-angle viewing system (WAVS). Methods: This study included 20 eyes of 20 consecutive patients (mean age, 65.6 years; range, 56-76) with a stage 2 or 3 idiopathic macular hole who underwent 25-gauge microincision vitreous surgery using a WAVS and phacoemulsification surgery. A triamcinolone suspension was injected into the vitreous cavity. The triamcinolone facilitated visualization of the posterior wall of the PPVP. Using a vitreous cutter, we suctioned the outer margin of the PPVP. After a resultant small break of the posterior hyaloid membrane developed and enlarged rapidly, a PVD easily expanded at the periphery. Results: Using this technique, we induced a PVD without close proximity to the optic disk and macula. Conclusion: This technique is an easy and safe method for creating a PVD during microincision vitreous surgery using a WAVS.

Micro-disk resonators with high Q-factor have been experimentally demonstrated on germanium-on-insulator (GOI). GOI substrates fabricated by direct wafer bonding show better crystal quality that germanium films directly grown on Si. Sharp resonant peaks with Q-factor around 1000–4000 have been observed from micro-disks fabricated on GOI substrate by low-temperature photoluminescence measurements. The light emission properties against pump laser power and device temperature are also investigated. Our results indicating that GOI micro-disks are promising resonators for low threshold, ultra-compact Ge lasers on Si.

We report on the use of sensing devices that have a metal-insulator-gap-insulator-semiconductor structure. We have used capacitance-voltage measurements from a metal-insulator-gap-insulator-semiconductor sensing device to characterize different pH solutions and deoxyribonucleic acid (DNA) solutions. Hysteresis in the capacitance-voltage curves results from mobile ionic charges in the solutions and the influence of changes on the sensing surface condition. As the pH decreases in the pH range of 2.7 to 7.0, the flatband voltage shift toward the negative voltage increases. The differences in the flatband voltage shift in capacitance-voltage curves are related to the mobile ionic charge density in solutions with different pH values or DNA molecules.

A metal-insulator-gap-insulator-semiconductor sensing device has been characterized in different pH solutions and with different single strand DNA solutions by capacitance-voltage measurements. The capacitance-voltage curves show the difference from pH and the difference from DNA base by hysteresis and flat band voltage shift due to mobile ionic charge in the solution. As the pH decreases, the flat band voltage shift increases in the pH range of 2.7 to 7.0. The hysteresis in the capacitance-voltage curves shows the influence of ionic charge in the solutions and the change of the sensing surface condition. The difference of the flat band voltage shift in the capacitance-voltage curves is related to the mobile ionic charge in the solutions due to pH or DNA molecules.

The photodetective characteristics of aluminum grid gate–ultrathin silicon dioxide–silicon structures have been studied. The on–off ratio calculated from the photo and dark current densities rapidly changes at the threshold optical-power density. The threshold optical-power density is controlled by the silicon dioxide film thickness and increases with decreasing silicon dioxide film thickness. The difference between the surface potential with and without light irradiation rapidly changes at the same optical-power density. Holes do not significantly accumulate under optical-power densities lower than the threshold.

Background/Aims: The Japanese version of the Clinician’s Interview-Based Impression of Change plus Caregiver Input (CIBIC-plus J) consists of 3 subscales: Disability Assessment of Dementia Scale (DAD), Behavioral Pathology in Alzheimer’s Disease Rating Scale (Behave-AD), and Mental Function Impairment Scale (MENFIS), as well as the Clinician’s Global Impression of Change (CGIC). While the interrater reliability of CGIC has already been reported, that of the 3 subscales has not. The aim of the present report was to examine the reliabilities of the subscale items and investigate their relationships with CGIC. Methods: Eleven raters who were clinical physicians watched videotapes of 20 patients with Alzheimer’s disease, completed the CIBIC-plus J assessment form, and assigned a CGIC score to the patients. Reliability was assessed using the kappa coefficient. Results: The kappa coefficient of the subscale items was in most instances higher than that of CGIC (0.453) and substantial reliability was observed. The Spearman rank correlation that was calculated between CGIC and the total score change of items was very high for MENFIS (0.990) and DAD (0.910), and moderate for Behave-AD items (0.576). The incidence of comments by the raters was highest for MENFIS (89%), followed by DAD (70%). The incidence was low for Behave-AD items (48%). Conclusion:Based on the results, it is concluded that DAD, Behave-AD, and MENFIS are necessary constituents of CIBIC-plus J, and indispensable for the reliability of CGIC.

Electrical properties of metal/SiC/p-Si(100) structures have been examined under conditions with and without light exposure. SiC films are formed by thermal chemical vapor deposition using a monomethylsilane gas, and are amorphous. The dark current density of the metal/SiC/p-Si structure at positive voltages is lower than that at negative voltages. The difference between the photo and dark current of metal/SiC/p-Si structures is relatively large at positive voltages. A SnO2/SiC/p-Si structure has high sensitivity compared with an Al/SiC/p-Si structure. Metal/SiC/p-Si structures can be used as photodetectors at positive voltages.

In this paper, we propose a parametric model checking algorithm for a subclass of Timed Automata called Parametric Time-Interval Automata (PTIA). In a PTIA, we can specify upper- and lower-bounds of the execution time (time-interval) of each transition using parameter variables. The proposed algorithm takes two inputs, a model described in a PTIA and a property described in a PTIA accepting all invalid infinite/finite runs (called a never claim), or valid finite runs of the model. In the proposed algorithm, firstly we determinize and complement the given property PTIA if it accepts valid finite runs. Secondly, we accelerate the given model, that is, we regard all the actions that are not appeared in the given property PTIA as invisible actions and eliminate them from the model while preserving the set of visible traces and their timings. Thirdly, we construct a parallel composition of the model and the property PTIAs which is accepting all invalid runs that are accepted by the model. Finally, we perform the extension of Double Depth First Search (DDFS), which is used in the automata-theoretic approach to Linear-time Temporal Logic (LTL) model checking, to derive the weakest parameter condition in order that the given model never executes the invalid runs specified by the given property.

We have developed an advanced infrastructure and technologies for collaborative remote operations, enabling multiple operators with large physical separation to control multiple slave robots in a common environment over the network. Human operators’ delayed visual perception arising from communication time delays seriously affects the performance of collaborative multi-site operations and accordingly requires supplementary information locally available to operators irrespective of time delays. Few facilities exist to investigate remote multi-site operations, thus we have built an experimental test bed connecting Tsukuba and Kawasaki in Japan via an integrated services digital network. In particular, an on-line predictive graphics simulator is incorporated to cope with image feedback delays from the remote site. Specifically, exploiting audio-visual features of the simulator, operators can detect a priori the possibility of collision between robots and guide them towards task goal through time delays. To verify the validity of the simulator assisted approach, we have performed a demonstration of prototype plant maintenance in April 2000 between Tsukuba and Kawasaki.

Fe-bearing prehnite, Ca2Al2-pFepSi3O10(OH)2 (Z=2), from Kouragahana, Shimane Peninsula, Japan, was investigated using 57Fe Mossbauer spectroscopy and X-ray Rietveld method. Iron and aluminum contents of the prehnite are variable, with p ranging from 0.003 to 0.425 (n=97). Fe-poor and Al-rich prehnites generally grow over clusters of Fe-rich prehnite crystals. Intergrowth texture of Fe-poor and Fe-rich crystals is also common in spherical aggregates. The 57Fe Mossbauer spectrum consists of one doublet with isomer shift = 0.360 mm/s, quadrupole splitting = 0.276 mm/s and peak width = 0.310 mm/s. The doublet is assigned to Fe3+ in the octahedral site. X-ray Rietveld refinement was carried out using two structural models of space groups Pmna and Pma2, Results of the refinement are characterized by R-weighted pattern (Rwp) = 9.30 %, ‘Goodness-of-fit’ indicator (S) = 1.276 and Durbin-Watson statistic d (D-W d) of 1.485 for the refinement in space group Pmna, and by Rwp = 10.00 %, S = 1.367 and D-W d of 1.383 in space group Pma2, indicating that the fit of the former refinement is better than the latter. The refined Fe occupancies at the octahedral site in space groups Pmna and Pma2 are 0.16 ± 0.01 and 0.20 ± 0.01, respectively. In the Pmna-structure, the T2 site is occupied by Si0.5Al0.5 with disordering scheme, and average T2-O distance is 1.668 A. In contrast, in the Pma2-structure, Al and Si are distributed in an ordered state in the T2 site, and average AlT2-O and SiT2-O distances are 1.72 and 1.61 A, respectively. Absence of Fe3+ from the tetrahedral site may be attributed to the small size for the cation and inflexible character of the T2 site. A very small quadrupole splitting of the Mossbauer doublet by Fe3+ in the octahedral site suggests the octahedral site has a highly symmetrical site-geometry. This is consistent with a more symmetrical environment in the centrosymmetric space group Pmna.

We describe a new approach to minimize the power used by servers and computer room air conditioners (CRACs) in data centers by controlling them in an integrated way. This approach consists of air conditioning control using a new thermal model to keep inlet temperatures of servers under certain limits and allocation control of virtual machines (VMs) for servers with placement constraints to minimize server and CRAC power consumption. We formulated the resulting optimization problem as a mixed integer quadratic programming problem. We also developed an energy-aware resource management system which is coordinated with a VM management system. We conducted an experiment in our server room and found that our approach resulted in up to 30% less power consumption of CRACs compared to the case with the most inefficient allocation of VMs.

Purpose To observe the progression of affected lesions using ultra-wide-field fundus autofluorescence (FAF) in multiple evanescent white dot syndrome. Design Retrospective, observational case series. Methods setting : Institutional. patient population : 14 eyes of 13 patients (mean age, 35.8 years) with acute disease unilaterally. observation procedures : Patients underwent ultra-wide-field FAF, spectral-domain optical coherence tomography (SD OCT), multifocal electroretinography (mfERG), and Goldmann or automated perimetry; the best-corrected visual acuity (BCVA) and refractive error were measured. main outcome measure : Ability of ultra-wide-field FAF to detect lesions with greater sensitivity compared with color fundus photography. Results Ultra-wide-field FAF imaging enabled improved visualization of the affected lesions and showed that the core lesion was in the posterior fundus involving the peripapillary retina and posterior pole and surrounded by hyper-autofluorescent spots outside the vascular arcade. The posterior lesions expanded rapidly and peripheral spots spread farther peripherally and reached a maximal extent during the acute stage. During follow-up, the peripheral hyper-autofluorescent spots resolved and then hyper-autofluorescence of the posterior fundus gradually faded. SD OCT showed diffuse disruption of the photoreceptor inner segment/outer segment junction (IS/OS) in the posterior fundus during the acute stage. The correlation between the IS/OS abnormality and hyper-autofluorescent areas was unclear. The disrupted IS/OS was restored with normalization of the FAF. Conclusions Ultra-wide-field FAF showed that the lesions arise from the peripapillary retina and the posterior pole and spread peripherally in a centrifugal manner during the acute stage. The hyper-autofluorescent spots faded from the periphery in a centripetal manner.

(2001). Proposal of a new medical manipulator for laparoscopic surgery. Advanced Robotics: Vol. 15, No. 3, pp. 379-382.

A novel hybrid quantum mechanical (QM)/molecular mechanical (MM) approach that employs the real-space grids for the QM subsystem is proposed for investigating chemical reactions in an aqueous condensed phase. All of the Hamiltonian matrix elements including electric fields formed by the point charges on MM waters is represented in the real space. Details of the practical implementations are presented. The solute polarization, solvation structure, and the solvation energy of a water are computed, and the results are compared with those obtained by experiments and other QM/MM approaches that used the LCAO basis. It is shown that the real-space grid QM/MM method is adequate and superior for the description of the polarization of QM water in a water solution as well as in the gas phase. Solvation structures of classical water solvents are also properly reproduced by this method. Further, parallelization of the code is implemented on a distributed memory architecture, and it is demonstrated that the real-space grid approach is suitable for the high-performance parallel computing due to the localization of Hamiltonian operations in the real space. © 2001 John Wiley & Sons, Inc. J Comput Chem 22: 1252–1261, 2001

The anti-biofilm effect of a newly developed antibacterial coating, a mixture of a silver citrate, soybean lecithin and liquid silicon at the ratio of 2:2:8, for silicon catheters was investigated in an in vitro experimental system using a modified Robbins device. The inhibitory effect against bacterial adherence, killing effect against adhered bacteria and durability of these anti-biofilm effects were examined using two strains of Pseudomonas aeruginosa and one of Escherichia coli. Almost complete inhibition of bacterial adherence was demonstrated in the case of one of two strains of P. aeruginosa and E. coli. The more resistant strain of P. aeruginosa OP 14-210 adhered at scattered sites of the silicon with antibacterial coating, while mature biofilm developed on the surface of the silicon without coating. Using already adhered P. aeruginosa OP 14-210, we confirmed the killing effect of silver ion released by this new coating. These anti-biofilm effects did not change after treatment with artificial urine for at least 48 hours.

Helical computed tomography (CT) was used to demonstrate the distribution of crossing vessels in patients with ureteropelvic junction (UPJ) obstruction for planning surgical management. Twenty patients with symptomatic UPJ obstruction were evaluated with dual-phase contrast material-enhanced helical CT. In addition to axial images, coronal, sagittal, and curved paracoronal images along the crossing vessels or the UPJ were obtained by means of multiplanar reconstruction. Crossing vessels were evaluated according to type, position, and association with UPJ obstruction. Fifteen vessels in 12 of the 20 patients were found to cross the UPJ at helical CT. Nine vessels were arteries and six were veins; seven vessels crossed anteriorly and eight crossed posteriorly. In 11 patients, crossing vessels were thought to be associated with UPJ obstruction at helical CT; retroperitoneoscopic repair was performed, and the diagnosis was found to have been accurate in all except one. In the eight patients in whom no significant vessels were seen and the one patient in whom the crossing vessel was not associated with UPJ obstruction at helical CT, endopyelotomy was performed and UPJ obstruction was relieved, with no complications. Helical CT is useful for evaluation of vessels crossing the UPJ and for planning surgical management.

The potency and effectiveness of an anti-bacterial catheter coated with a mixture of silver citrate, soybean lecithin and liquid silicon at the ratio of 2:2:8 were compared with those of commercially available anti-bacterial and conventional urethral catheters. This new anti-bacterial catheter showed a strong activity and excellent durability in ordinary in vitro experimental studies. In the present series we have developed new in vitro experimental models for the evaluation of anti-bacterial catheters in inhibiting bacterial ascent via intraluminal or extraluminal route. The characteristic features of the silver citrate/lecithin catheter, namely strong activity and excellent durability, were confirmed using these new models that mimic urinary catheter-associated clinical infections.

Dear Editor, Oguchi disease, characterized by stationary night blindness, is an inherited and non-progressive retinal disorder that affects the rods and causes impaired night vision [1]. Histologic findings have not been reported. We observed microstructural change of the retina in Oguchi disease using spectral domain optical coherence tomography (SD-OCT). A 31-year-old man had night blindness since childhood. His best-corrected visual acuity was 1.2 bilaterally. On ophthalmoscopic examination (Fig. 1), his fundus had a golden sheen reflex, except for the macular and perimacular areas. The macula had a normal red reflex, but the perimacular area was grayish bilaterally. A full-field ERG showed normal cone and flicker responses; the rod response was non-recordable. Multifocal ERG showed a normal response. The visual field was within normal limits on Goldmann perimetry. He was diagnosed with Oguchi disease. Oguchi disease has five subtypes depending on the location of the golden sheen reflex, i.e., the entire fundus, macula sparing, posterior fundus sparing, peripheral sparing, and far periphery sparing. The current case corresponds to the posterior fundus-sparing type. In a horizontal 6-mm scan across the fovea, the junction between photoreceptor inner and outer segment (IS/OS ) appeared normal in the macula within a 3-mm diameter; however, the distance between the IS/OS and retinal pigment epithelium (RPE) suddenly decreased, and the IS/ OS line was not identifiable in a 3-mm-wide perimacular ring, where the retina was attenuated because of decreased thickness of the outer nuclear layer (ONL). The IS/OS line emerged outside of the perimacular ring in the midperiphery, but the distance between the IS/OS and RPE was short, such that the two reflective lines fused into one broad reflective band in some areas. The midperipheral retinal thickness was normal. SD-OCT (Fig. 2) showed that the distance between the IS/OS line and RPE was short in the midperipheral fundus, which had a golden sheen. However, the IS/OS line appeared normal in the macula, where the fundus color was normal. The IS/OS line was not identifiable in the perimacular area, where the fundus was grayish, resembling an early change in retinitis pigmentosa. Since the IS/OS line indicates high reflectivity at the proximal portion of the photoreceptor outer segment, the decreased distance between the IS/OS and the RPE suggests shortening of the outer segment. OCT suggested that the lesion responsible for the golden sheen reflex appeared to be shortening of the rod outer segment. Full-field ERG showed a normal cone response and a non-recordable rod response. Since the cones were intact, the IS/OS appeared normal in the macula where the cones aggregate, and the fundus reflex was normal. It was noteworthy that the fundus reflex was grayish in the perimacular area where the IS/OS was not identifiable with attenuation of the ONL. The loss of the Graefes Arch Clin Exp Ophthalmol (2009) 247:1561–1563 DOI 10.1007/s00417-009-1114-6

We have proposed a metal-gap-semiconductor (MGS) sensing device. Different concentrations of λDNA solutions have been characterized by capacitance–voltage measurements of the sensing device. Hysteresis due to electron traps and flatband voltage shift due to negative charge are observed in capacitance–voltage curves. As the λDNA concentration increases, the flatband voltage shift toward the positive voltage increases in the concentration between 0.01 and 0.3 µg/µl. It is suggested that the hysteresis in capacitance–voltage curves arises from the capture and emission of electrons through the states of the λDNA solution, and the flatband voltage shift is attributed to the charge of the λDNA solution. Copyright © 2008 John Wiley & Sons, Ltd.

Objective A prospective trial was performed to propose a suitable antimicrobial prophylaxis in patients undergoing transurethral resection of the prostate (TUR-P). Subjects and methods Patients who underwent TUR-P due to symptomatic prostatic hyperplasia between April 1995 and February 1996 were included. Based on the results of urinalysis obtained within preoperative 3 days, the patients were classified into Group I (less than 5 WBC/hpf and bacterial count of less than 10(4) CFU/ml in urine specimen), and Group II (5 or more WBC/hpf or bacterial count of 10(4) or more CFU/ml in urine specimen). Furthermore, each group was randomly subdivided into Group A and Group B according to the period of antimicrobial administration. As prophylactic antimicrobials, cefazolin (CEZ) was used in Group I and CEZ or cefotiam (CTM) in Group II. The antimicrobial was administered only on the day of operation in Group IA (n = 92), for 3 days in Group IB (n = 96), 2 days in Group IIA (n = 37), and 4 days in Group IIB (n = 30). On the day of operation, the antimicrobial was infused immediately before the operation. The presence or absence of pyuria, bacteriuria and febrile infection, and the period required for normalization of the urinalysis were the major points evaluated here. Results No significant differences were observed in any parameters with respect to the period of administration of antimicrobial between the groups, but in both Group I and Group II, the incidence of febrile infection was higher in the groups with shorter antimicrobial administration periods. The mean period for normalization of the urinalysis required 68.4, 68.6, 65.2 and 58.2 days in Group IA, Group IB, Group IIA and Group IIB, respectively. Conclusion It is concluded that 3 or 4-day administration of first or second generation parenteral cephems is generally acceptable regimen for antimicrobial prophylaxis in patients undergoing TUR-P.