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Finite element method based numerical simulation (CAE) came to be utilized in the strength design by the development of the design technology. In particular, it is very important to use CAE when evaluating the safety of products subjected to impact loads. This is because the Product testing with impact load is difficult and expensive to perform. However, there are two major problems with this CAE. The first problem is the high cost of installing and maintaining CAE software. The second problem is that only some of the materials implemented with CAE have material properties that take into account the strain rate dependence needed to assess material fracture. Ductile fracture prediction formulas for evaluating material failure are implemented in many CAE software. However, in order to use the ductile fracture prediction formula, material properties that take strain rate dependence into consideration are required. In this study, we examined a design method based on an energy of fracture of materials and input energy of impact phenomenon by using experiments and numerical simulations without using material properties considering strain rate dependence. In this research, static three-point bending test, Charpy impact test and elasto-plastic analysis were performed to confirm the validity of the proposed design method. Firstly, In the three-point bending test, the amount of energy input to the test pieces was examined. Secondly, in the Charpy impact test, the same energy as the static three-point bending test was input to the test pieces. Thirdly, the elasto-plastic analysis used material properties that did not take into account the strain rate dependence obtained from static tensile tests. Finally, these results were compared. As results of comparison, it is clear to the efficacy of the proposed impact strength design method.

Introduction Donor shortages occasionally necessitate the use of hepatic allografts from hepatitis B core antibody–positive (HBcAb+) donors, with an attendant risk of post-transplantation hepatitis B virus (HBV) infection. The aim of the present study was to develop and evaluate a protocol of active immunization for prevention of post-transplantation de novo HBV infection in patients receiving liver grafts from HBcAb+ donors. Patients and Methods Ten patients who had received HBcAb+ liver grafts at Shinshu University Hospital between October 1996 and December 2012 were enrolled. All the recipients were negative for HBV serological tests, and HBV-DNA. Hepatitis B immunoglobulin (HBIG) was given routinely in the peritransplantation and post-transplantation periods, without antiviral drugs. Subcutaneous vaccination with recombinant HBV was given at a dosage of 20 μg in adults and 5 μg in children concomitant with HBIG until acquisition of active immunization. The timing to start HBV vaccination was dependent on the condition of the patient. Results The median follow-up period after liver transplantation was 140 months, and the median period after transplantation until the start of vaccination was 7.0 months. Nine patients (90%) acquired active immunity after a median number of 4 (range, 2–13) vaccinations (hepatitis B surface antibody >300 mIU/mL for 1 year, or >100 mIU/mL thereafter), and did not require HBIG administration thereafter. None had any side effects of HBV vaccination or developed hepatitis B infection during the study period. Four fast responders who achieved antibody high titers by active immunization within 9 months received pretransplantation vaccinations, whereas 5 slow responders did not. Conclusions Our vaccination protocol provides a new effective strategy for prevention of de novo hepatitis B infection after liver transplantation in recipients with HBcAb+ liver grafts. Pretransplantation HBV vaccination was helpful for the post-transplantation vaccine response.

The growth of Zn1-xMgx Sey Te1-y layers was performed on (100) ZnTe substrate by metalorganic vapour phase epitaxy using dimethylzinc, bis-methylcyclopentadienyl-magnesium, diethyltelluride and diethylselenide. The effects of substrate temperature upon the compositions of Mg and Se have been investigated. The Mg composition in Zn1-xMgx Sey Te1-y layer is significantly enhanced at low substrate temperature. Although the Se composition decreases with decreasing the substrate temperature, Zn1-xMgx Sey Te1-y layer with a relatively high Se composition of 0.3 is obtainable at a low substrate temperature as low as 380 oC. For all the layers, a two-mode behaviour with ZnTe- and MgTe-like longitudinal optical phonon modes is confirmed by Raman scattering. (© 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)

We report the first two cases of adult-onset type II citrullinemia (CTLN2) successfully treated by liver transplantation from deceased donors in Japan. One patient was a 34-year-old female, who had suffered from depression since the age of 28 years and developed consciousness disturbance at 34 years old. The other patient was a 41-year-old man who began to experience consciousness disturbance with abnormal behavior at 37 years old. Both patients were first treated with non-surgical therapies, including low-carbohydrate diet, arginine granules and sodium pyruvate. However, their therapeutic efficacy was limited and attacks of encephalopathy occurred frequently with elevation of plasma ammonia despite treatment. While both patients and their families desired liver transplantation, no candidate donors for live-donor liver transplantation were available. Fortunately, within a relatively short period after enrollment for liver transplant from deceased donors in Japan (13 and 43 days, respectively), they underwent cadaveric liver transplantation. The clinical courses after the operation were uneventful in both cases and no attacks of hepatic encephalopathy have occurred. Although there have been no reports of good therapies for CTLN2 patients with resistance to non-surgical therapies and no live-donor candidates, our observations indicate that cadaveric liver transplantation can be a promising therapeutic option for CTLN2 patients.

Donor shortage is a major issue in liver transplantation. We have successfully performed temporary auxiliary partial orthotopic liver transplantation (APOLT) using a small volume graft procured from a living donor for recipients with familial amyloid polyneuropathy (FAP). The aim of this study was to evaluate this procedure by comparing it with standard living donor liver transplantation (LDLT). We compared 13 recipients undergoing this procedure with 23 recipients undergoing a standard LDLT for the treatment of FAP. The estimated donor graft volume and the graft volume/recipient's standard liver volume ratio were significantly smaller in the temporary APOLT group than in the standard LDLT group. Postoperative complications were comparable, although the hospital stay was longer in the temporary APOLT group. All the patients safely underwent a remnant native liver resection about 2 months after their first operation in the temporary APOLT group. No symptoms related to FAP developed before the remnant liver resection, and no significant differences in graft and patient survival were observed between the two groups. We successfully performed temporary APOLT using a small volume liver graft without postoperative liver failure for FAP. Temporary APOLT for FAP might be a useful alternative procedure for expanding the donor pool for LDLT.

To introduce duct-to-duct biliary anastomosis to conventional temporary auxiliary partial orthotopic liver transplantation (APOLT) using living donor graft for patients with familial amyloid polyneuropathy, we modified the conventional APOLT procedure in a manner characterized by the use of the recipient's common hepatic duct for biliary reconstruction and the preservation of the right posterior section alone for the certain placement of a tube into the corresponding biliary tree for external biliary drainage (modified APOLT). This procedure was performed in 3 patients without biliary complications. No complications associated with the external drainage tube occurred. Here we report the techniques and results for this new procedure.

Summary Aims Recurrent hepatitis is a significant complication after liver transplantation for hepatitis C virus (HCV) disease. To evaluate responsiveness to treatment of HCV disease after liver transplantation, in situ hybridisation (ISH) was employed. Methods Sense and anti-sense probes for HCV were synthesised, and ISH studies were performed on 19 liver biopsy specimens from 19 recipients who had undergone living donor liver transplantation for HCV disease. ISH positive cells and total hepatocytes were counted, and the percentage of positive cells was calculated. Other clinical findings were compared retrospectively with the ISH results. Results The subjects were divided into three groups: recurrent HCV hepatitis (RHC, n = 11), acute cellular rejection (ACR, n = 5), and recurrent HCV hepatitis with ACR (MIX, n = 3). The percentage of ISH positive cells was almost the same degree (10-20%) in the three groups. The RHC group was subdivided into two sets of patients in whom serum HCV titres decreased (group D, n = 7) or did not decrease (group ND, n = 3) after 1 month of IFN therapy. The percentage of ISH positive cells in group D was significantly lower than that in group ND ( p 0.05) Conclusions ISH for the recipients with HCV may be useful for predicting the response to interferon therapy.

Introduction. Once-daily extended-release tacrolimus (Tac-OD) is expected to reduce non-adherence in recipients after liver transplantation (LT). The aim of this study was to determine the optimal initial dose of orally administered Tac-OD after intravenous tacrolimus (Tac-IV) therapy after LT. Patients and Methods. This prospective study included 10 adult recipients who had undergone LT at our institute. The recipients were prescribed tacrolimus by continuous intravenous administration with a steroid as initial immunosuppression therapy. Tacrolimus was converted from intravenous administration to once-daily oral intake when gastrointestinal function returned. We evaluated tacrolimus concentrations in blood 9 times a day and area under the blood concentration time curve (AUC) during conversion. The optimal initial dose of Tac-OD was determined based on simple regression analysis between the oral dose of Tac-OD and the total dose of Tac-IV during a 24-hour period. Results. The AUC before and after conversion showed no differences. We found that the optimal initial dose of Tac-OD was 8 times the dose of Tac-IV. There was a relationship between the AUC and the trough level. No recipients experienced acute rejection or adverse effects such as renal failure, neurotoxicity, or cardiac failure during conversion. Conclusions. We successfully converted continuous Tac-IV to oral intake of Tac-OD by adjusting the dose using trough levels without acute rejection or adverse effects. The AUC of Tac-OD correlated with the trough level. The optimal initial dose ratio of Tac-OD after Tac-IV was 8:1., Article, TRANSPLANTATION PROCEEDINGS. 46(3):794-796 (2014)

Beginning in 2004, dalteparin doses based on activated clotting time (ACT) were administered for hepatic vessel thrombosis prophylaxis in living donor liver transplantation (LDLT). We verified the feasibility of this new therapy by comparing it with the previous one. From 1993 through 2008, 42 metabolic liver patients who underwent LDLT were divided into two groups. Group A (1993-2003, n = 32) was administered a fixed dalteparin dose and a large amount of fresh frozen plasma (FFP); Group B (2004-2008, n = 10) was administered an appropriate dosage of dalteparin to maintain the ACT levels from 140 to 150 seconds and a small amount of FFP. Group B was administered a lesser amount of FFP and more dalteparin. This resulted in longer activated partial thromboplastin time, lower fibrinogen degradation products D-dimer, and lower aspartate aminotransferase levels compared to group A; all differences were significant. Group B showed neither thrombotic nor hemorrhagic complications. Anticoagulation therapy comprising adjustment of the dalteparin dose based on ACT reduces thrombotic complications without increasing hemorrhagic complications. ACT measurement is a simple, reliable method for bedside monitoring of dalteparin anticoagulant effects for LDLT.

We have previously reported that a graft volume (GV) > 30% of the recipient's standard liver volume (SLV) can meet the recipient's metabolic demands. Here we report our experience with adult-to-adult living donor liver transplantation using left side grafts or = 35% of their SLV. Patient characteristics, postoperative liver function, duration of hospital stay, and recipient survival rates were compared between the 2 groups. There were no significant differences between groups in recipient or donor background characteristics. The mean GV/SLV ratio of group S was 31.8%, whereas that of group L was 42.5%. There were no significant differences in the postoperative serum total bilirubin levels, prothrombin time international normalized ratio, daily ascites volume, or duration of postoperative hospital stay between the groups. The 1- and 5-year survival rates in group S were 80.7% and 64.2%, respectively, whereas those of group L were 90.8% and 84.9%, respectively, with no significant difference between groups. In conclusion, graft size was not considered to be the only cause of so-called small-for-size graft syndrome, and left side grafting appears to be the procedure of choice for adult-to-adult living donor liver transplantation because of the lower risk to donors in comparison with right lobe grafting.

A manufacturing study has been conducted to examine the welding and machining capabilities for strengthened austenitic stainless steels with a high nitrogen content, JJ1 and ST-SS316LN, to be employed for ITER Toroidal Field (TF) coil structural components. It was found that the applicable EB welding condition for JJ1 was limited to up to 40 mm thick plates. A wider range of welding conditions was found in the vertical upward direction. Based on those results, a verification test up to 900 mm in length was successfully conducted. With respect to TIG welding, an average deposition rate of 26 g/min (i.e. the filler wire supplying speed of 3000 mm/min) was achieved. In addition to the welding tests, a series of machining tests has been conducted to examine the machinability of JJ1 and ST-SS316LN. Various types of machining tools were examined. In practical application, the cutting speed should be low to extend the tool life. At a cutting speed of 40 m/min, a tool life of more than 2 h (at a traveling distance of up to 9 m) was attained. The degree of cutter wear after 30 min of operation, at a cutting speed of 40 m/min, was found to be around 0.1 mm, which is within an acceptable range.

Demonstration tests for manufacturing and assembly of the International Thermonuclear Experimental Reactor (ITER) vacuum vessel have been conducted to confirm manufacturing and assembly process of the vacuum vessel (VV). The full-scale partial mock-up fabrication was planned and is in progress. The results will be available in the near future. Field-joint assembly procedure has been demonstrated using a test stand. Due to limited accessibility to the outer shell at the field joint, some operations, including alignment of the splice plates, field-joint welding, and examination, were found to be very difficult. In addition, a demonstration test on the selected back-seal structures was performed. It was found that the tested structures have insufficient sealing capabilities and need further improvement. The applicability of ultrasonic testing methods has been investigated. Although side drilled holes of 2.4 mm in diameter were detected, detection of the slit-type defects and defect characterization were found to be difficult. Feasibility test of liquid penetrant testing has revealed that the selected liquid penetrant testing (LPT) solutions have sufficient low outgas rates and are applicable to the VV.

The JFT-2M tokamak has been modified three times during the Advanced Material Tokamak Experiment (AMTEX) program to investigate the compatibility of the low-activation ferritic steel F82H with tokamak plasmas as structural material for future reactors. The ferritic steel plates/wall were installed inside and/or outside of the vacuum vessel to reduce the ripple of the toroidal magnetic field step by step through three modifications. This paper focuses on engineering aspects of these modifications: electromagnetic analysis to find a suitable way to attach these plates, installation procedure to keep small tolerances, and a three-dimensional magnetic field measurement device used to obtain information of the actual shape of the vacuum vessel used as a standard installation surface. To maintain good surface conditions of the ferritic steel plates/wall that rust easily, careful treatment was executed before the installation. To reduce oxygen impurities further, a boronization system with trimethyl boron, which is safe and easy to operate, was developed.

In JFT-2M, the toroidal magnetic field (TF) ripple was reduced by ferritic insert. Two kinds of ripple reduction were carried out. In the first case, ferritic steel was installed between the TF coil (TFC) and the vacuum vessel, just under the TFCs outside the vacuum vessel. In the second one, ferritic steel was installed inside the vacuum vessel covering almost the whole inside wall. The ripple was successfully reduced in both cases. The temperature increment on the first wall, which indicates the ripple-induced loss of fast ions, was measured by infrared television and was also reduced. The effect of the localized larger ripple was also investigated by attaching additional ferritic steel. A new version of the orbit-following Monte Carlo (OFMC) code was developed including the three-dimensional complex structure of the TF ripple and the nonaxisymmetric first-wall geometry. The experimental results and the new OFMC calculation were consistent.

We have developed a model to predict the process-window length in SiOCH etching using fluorocarbon plasmas (C4F8∕Ar∕O2 and C4F8∕Ar∕N2). The amount of incident reactive particles such as CF2, O, and N radicals were estimated by calculating the partial pressure and dissociation degree of each parent molecule. We have evaluated the relationship between the incident flux and film properties and found that regardless of the film composition and density, the optimum etching condition (Pc) was determined based on the balance between the total C flux and the C removal ability by O and N. Lower concentration of O in SiOCH resulted in a narrow process window because a thick polymer layer formed on the etched surface even under lower CFx flux conditions. In the etching of porous SiOCH film, lower film density increased the etch rate. Because of the narrow process window in the SiOCH etching, the slight change in the incident flux (caused by the aspect ratio or nonuniformity and/or instability of the plasma reactor) ...

Plasma control on high-βN steady-state operation for JT-60 superconducting modification is discussed. Accessibility to high-βN exceeding the free-boundary limit is investigated with the stabilising wall of reduced-activated ferritic steel and the active feedback control of the in-vessel non-axisymmetric field coils. Taking the merit of superconducting magnet, advanced plasma control for steady-state high performance operation could be expected.

Recent energetic particle physics research in JT-60U and JFT-2M is reported. Alfven eigenmodes (AEs) are investigated in reversed-shear (RS) plasmas in JT-60U where frequency sweeping (FS) modes are observed to follow the q-profile evolution. The RS-induced AE model can explain the FS of the modes within the context of an evolving q-profile. Enhanced energetic ion transport is also investigated with the appearance of modes in the toroidicity-induced AE range of frequency in JT-60U using a multi-channel neutron profile monitor and in JFT-2M using a lost ion probe. Additionally, the ripple loss in the complex toroidal field ripple due to ferritic steel inserts in JFT-2M is shown and compared with model analysis. The simulation code developed to predict ripple loss in JFT-2M will be of use in estimating the heat flux in the complex ripple field of a future device such as ITER.

Recent progress in the physics and engineering design study for the modification programme of JT-60 is presented. In order to achieve a steady state high-β plasma operation, which is the dominant issue of this programme, physics design for the MHD control and the stability analysis is investigated. Engineering design and the R & D for the superconducting coils, irradiation shield are performed well towards the mission of programme.

Modification of JT-60 as a full superconducting tokamak (JT-60SC) is planned. The objectives of the JT-60SC programme are to establish scientific and technological bases for steady-state operation of high performance plasmas and utilization of reduced-activation materials in an economically and environmentally attractive DEMO reactor. Advanced fusion technologies relevant to the DEMO reactor have been developed for the superconducting magnet technology and plasma facing components of the JT-60SC design. To achieve a high current density in a superconducting strand, Nb3Al strands with a high copper ratio of 4 have been newly developed for the toroidal field coils (TFCs) of JT-60SC. The R&D to demonstrate the applicability of the Nb3Al conductor to TFCs by a react-and-wind technique has been carried out using a full-size Nb3Al conductor. A full-size NbTi conductor with low ac loss using Ni-coated strands has been successfully developed. A forced cooling divertor component with high heat transfer using screw tubes has been developed for the first time. The heat removal performance of the carbon fibre composite target was successfully demonstrated on an electron beam irradiation stand.

Defective plasma activity of Von Willebrand factor (VWF)-cleaving protease (CP) and/or the inhibitors against this protease has been shown to have a pathological role in several forms of thrombotic microangiopathy (TMA). This report describes a patient for whom a diagnosis of TMA was made immediately after living donor liver transplantation. In this patient, activity of VWF-CP and its inhibitor were analyzed serially. At the onset of the disease, VWF-CP activity was quantified as 17%. Inhibitor against this protease was positive, with a titer of 0.6 Bethesda U/mL, and its inhibitory activity was quantified as 3.8 Bethesda U/mg immunoglobulin G.. Laboratory parameters and clinical features were significantly improved after induction of plasma exchange (PE) with fresh frozen plasma and concurrent cessation of tacrolimus therapy. The inhibitors disappeared after one session of PE. However, VWF-CP activity after a transient increase and again decreased to subnormal levels after completion of PE. Nevertheless, this did not result in disease recurrence. In view of sustained VWF-CP activity at disease onset and the absence of definite correlations between levels of this protease and clinical features, abnormality of this enzyme system had no essential role in the pathogenesis of TMA in this case. Clinical findings suggest that TMA was tacrolimus-induced.

A modification of the JT-60 is planned to be a superconducting tokamak (JT-60SC) in order to establish steady-state operation of high beta plasma for 100 s, and to ensure the applicability of ferri...

The analyses of the plasma position and shape control in the superconducting tokamak JT-60SC in JAERI are presented. The vacuum vessel and stabilizing plates located closely to the plasma are modeled in 3 dimension, and we can take into account the large ports in the vacuum vessel. The linear numerical model used in the design for the plasma feedback control system is based on Grad–Shafranov equation, which allows the plasma surface deformation. For a slower control of the plasma shape, the superconducting equilibrium field (EF) coils outside toroidal field coils are used, while for a fast control of the plasma position, in-vessel normal conducting coils (IV coil) are used. It is shown that the available loop voltages of the EF and IV coils are very limited, but there are sufficient accuracy and acceptable response time of plasma position and shape control.

In JFT-2M, ferritic steel plates (FPs) were installed on almost the whole inner surface of the vacuum vessel. This arrangement is called the ferritic inside wall (FIW), and is the third step of the advanced material tokamak experiment programme. The toroidal field (TF) ripple was reduced by optimizing the thickness of FPs but the total ripple structure has become more complex, with a non-periodic feature in the toroidal direction, because of the existence of ports and other components that limit the periodic installation of FPs. We investigated the effect of this complex ripple on the heat flux onto the first wall due to fast ion loss. The ripple trapped loss was reduced as a result of the reduced magnetic ripple of the FIW. Additional FPs were also installed outside the vacuum vessel to produce a localized larger ripple. A small ripple trapped loss was observed when the shallow ripple well exists in the poloidal cross section, and a large ripple trapped loss was observed when the ripple well extends deep into the plasma region. Experimental results were almost consistent with computation with a newly developed fully three-dimensional magnetic field orbit-following Monte-Carlo code including the three-dimensional complex structure of the TF ripple and the non-axisymmetric first wall geometry.

Background A major prerequisite for living donor liver transplantation (LDLT) as an acceptable treatment modality is thoughtful consideration of the donor. However, there has been no comprehensive audit of living liver donation focusing on issues such as donor selection, anatomic surveys, and long-term outcome. Methods Between June 1990 and January 2002 at our institution, 160 LDLTs were performed and 177 patients were referred for LDLT. For these patients, a total of 203 potential donors were screened. The process of donor selection, safety of donor hepatectomy, and postoperative morbidity were investigated. Additionally, an anonymous questionnaire was administered to 100 donors who had undergone LDLT more than 3 years previously. Results Thirty-eight (19%) of the 203 donor candidates were excluded. Precise estimation of the hepatic anatomy was indispensable for donor safety. None of the donors showed prolonged postoperative liver dysfunction nor developed complications requiring reoperation or readmission. There was no donor mortality. The responses to the questionnaire indicated that 95% of the living donors had not felt coerced to donate and that 5% were neutral about coercion pressure. There were no severe postoperative aftereffects, but minor problems were reported by 51% of the respondents. Conclusions Our appraisal of the perioperative and long-term postoperative course of LDLT donors revealed that although most donors are satisfied after undergoing LDLT, there is a need for strict attention to the process of donor selection and long-term postoperative follow-up. The outcome of the present series seems to confirm the safety of donor hepatectomy.

Living donor liver transplantation (LDLT)has been performed in more than 2000 cases around the world. This procedure is considered to have certain advantages over cadaveric liver transplantation, because detailed preoperative evaluation of the donor liver is possible and superior graft quality is available. The indication has recently been widened to include adult patients. The results of LDLT have been reported to be very good. In this article,several considerations on LDLT,including living donor selection and application to adult patients, are discussed. Between June 1990 and March 2001, 143 patients underwent LDLT at Shinshu University Hospital. During this period, 160 patients were determined to be candidates for liver transplantation in our institution, and 185 candidates were evaluated as potential donors for these patients. Thirty-eight of 185 donor candidates were excluded for reasons including liver dysfunction and withdrawal of consent. The recipients included 60 adults, 50 (83%) of whom are currently alive. Taking into account the worldwide shortage of cadaveric organ donation,the importance of LDLT will probably never diminish. This procedure should be established on the basis of profound consideration of donor safety as well as accumulated expertise of hepatobiliary surgery.

We report the case of a 58-year-old man referred to our hospital for liver tumor treatment. The patient had a history of neurosurgery for a meningeal hemangiopericytoma 16 years previously. Pre-operative imaging revealed a hypervascular tumor extending from Couinaud segment 4 to segment 8 of the liver, measuring 95 mm in diameter, indicating an atypical hepatocellular carcinoma. Because right trisectionectomy of the liver was considered to be high risk, living-donor liver transplantation (LDLT) was indicated. After transcatheter arterial embolization, LDLT was performed with the use of a left-lobe liver graft from the patient's son. Post-operative histological findings of the liver tumor were identical to those for meningeal hemangiopericytoma, therefore the patient was diagnosed with meningeal hemangiopericytoma that had metastasized to the liver. After LDLT, the patient had a healthy, active life for 2 years; then, a subcutaneous relapse was discovered in the left chest. The patient did not undergo any systemic chemotherapy in response to the relapse. After thoracic and orthopedic surgeries and radiotherapy for multiple metastases, the patient died 5 years and 5 months after LDLT. LDLT could be an effective treatment for localized metastatic hemangiopericytoma in the liver, but it should be indicated only for carefully selected patients.

A 20-year-old woman was admitted to an emergency hospital after ingesting 66 g of acetylsalicylic acid in a suicide attempt. Although she was treated with gastric lavage, oral activated charcoal, and intravenous hydration with sodium bicarbonate, her hepatic and renal function gradually deteriorated and serum amylase levels increased. Steroid pulse therapy, plasma exchange, and continuous hemodiafiltration did not yield any improvement in her hepatic or renal function, and she was transferred to our hospital for living donor liver transplantation. Nine days after drug ingestion, she developed hepatic encephalopathy: thus, we diagnosed the patient with acute liver failure with hepatic coma accompanied by acute pancreatitis due to the overdose of acetylsalicylic acid. Living donor liver transplantation was immediately performed using a left lobe graft from the patient’s mother. Following transplantation, the patient’s renal and hepatic function and consciousness improved, and she was discharged. In this report, we describe a rare case of acetylsalicylic acid-induced acute liver failure with acute hepatic coma and concomitant acute pancreatitis and acute renal failure, which were treated successfully with emergency living donor liver transplantation.

Covering the inside wall of the vacuum vessel with the ferritic boards (FBs) is planned in the third stage of the Advanced Material Tokamak Experiment (AMTEX) on JFT-2M. The total magnetic forces induced on FBs were calculated by the three-dimensional dynamic electromagnetic field analysis code, EMSolution, with solid magnetic elements to consider the coupled effects of eddy current and magnetization, and the skin effect of eddy current. The structural integrity was evaluated on the bolts fixing the FBs to the vacuum vessel.

The geochemical cycle of CO2 and the hydrological cycle in the Taroko Gorge karst area, Taiwan, are discussed using chemical composition data of the natural water, together with stable isotope ratios of carbon and oxygen of the water and soil CO2. The soil CO2 concentration at a depth of 1 m showed seasonal variations with a maximum of 5.2% (v/v) and the minimum of 0.6% (v/v) at three different altitudes ranging from 50 to 2000 m asl. The soil temperature is the most important factor controlling the soil CO2 concentration in this area. The solubility of carbonates in groundwater can be explained by evolution under closed system conditions depending on the soil CO2 concentration measured. Unexpectedly, high δ13C values of HCO3− in groundwater were observed at some springs. There was also an equivalent relationship between the sum of the concentration of Mg2+ and Ca2+ ions and that of HCO3− and SO42− ions in their waters. These two facts suggest that some deep source CO2 and sulfuric acid derived from weathering of pyrite may take part in the chemical weathering of carbonate rocks (mainly calcareous schist) as well as the soil CO2. After the correction for the contribution of sulfuric acid, the δ13C values of HCO3− of groundwater issuing from some springs were still high, suggesting the presence of a deep source CO2 flux. Altitude isotope effects were observed for surface water and rainwater in this area and could be expressed as δ18O (‰)=−0.0024h−3.67 (h: altitude, m asl). The estimated altitudes of catchment basins of springs using this equation were over 1000–2000 m higher than those of springs. The rain falling high in the mountains is supplied with soil CO2, dissolves carbonate rocks under closed system conditions, penetrates deep underground, and comes out again from springs together with the deep source CO2 along fault crushing belts.

Background Difficulties of cadaveric donation and serious donor shortage have led to the development and popularization of living-related donor liver graft transplantation (LRLT). Because the history of this procedure is rather short, important aspects specific to this procedure have not been sufficiently documented. The objective of this study was to analyze a single center's 10-year experience with 110 LRLT in pediatric and adult patients with end-stage liver diseases. Methods The medical records of 110 consecutive patients who underwent LRLT were reviewed. The recipients were comprised of 72 children and 38 adults. The graft volume corresponded to 26-192% of the recipient's standard liver volume. The relationship between pretransplant covariates and patient and graft survival was analyzed. Actuarial patient/graft survival rates were determined at 1, 3, and 5 years. The type and incidence of posttransplant complications were analyzed, as was long-term graft function. Results The 1-, 3-, and 5-year actuarial patient and graft survival rates were 88%, 85%, and 85%, respectively. Log-rank test demonstrated that ABO-compatibility predicted patient survival rate, whereas patient age, underlying disease, patient's clinical status, donor-recipient relation, donor age, and graft volume/standard liver volume ratio did not. Long-term liver function remains excellent. All the donors have returned to normal daily lives with an uneventful course. Conclusions LRLT is an efficacious procedure that provides excellent short-term and long-term survival. The indication criteria for both recipient and donor were legitimate in this series, except for transplant across ABO-incompatibility. Cautious expansion of this procedure may be justified under the situation of serious shortage of cadaveric donor.

A design and related studies of equilibrium field control coil system of TPE-RX reversed field pinch (RFP) machine are described. Here the equilibrium field control coil system stands for the coils to produce poloidal magnetic field necessary for the plasma equilibrium condition. The configuration and the number of turns of the equilibrium field control coil system were designed so as to minimize the field error for reducing the plasma–wall interaction, especially at the shell gap of the thick metal shell. The design method of the equilibrium field control coil system taking account of an iron core with two yokes and the thick metal shell with the poloidal shell gap is described. As a result of the design of the equilibrium field control coil system, field error at the plasma surface is less than 1.0%. The field error can be canceled for wide range of the plasma equilibrium condition by adding the compensatory vertical field. Construction of TPE-RX was successfully completed at the end of 1997 and the coil system showed the expected performances.

Key design points of the front-end system of TPE-RX reversed-field pinch (RFP) machine are described. Here the front-end system is the components of the machine between the thick shell and the plasma surface and it consists of the vacuum vessel, shell system and pulsed vertical field coil (PVC). The effect of the multi-layered shell system is examined in terms of the relative radial magnetic perturbation. A summary of the port error field and the magnetic field produced by the PVC are also shown. The actual construction procedure is also described. Construction of the TPE-RX was completed at the end of December 1997 and it is now routinely in operation with RFP configuration.

Background Hepatic arterial reconstruction is one of the critical issues in living donor liver transplantation (LDLT). Herein we have reported an LDLT case whose celiac arterial trunk tributaries were insufficient as host arteries because of extensive subintimal dissection proceeding to all tributaries of the celiac arterial trunk. Patients and Methods A 45-year-old woman with fulminant hepatic failure underwent LDLT. After reperfusion of the hepatic and portal veins, subintimal dissection of the recipient right and left hepatic arteries was found to extend to all tributaries of the celiac arterial trunk, preventing an anastomosis using the more proximal part of these arteries. Therefore, a jejunal arterial arcade of Roux-en-Y limb mobilized for biliary reconstruction was anastomosed to the donor left hepatic artery in end-to-end fashion. Results Arterial blood flow to the grafted liver was established successfully, and the patient's postoperative recovery was excellent. Postoperative computed tomography demonstrated sufficient hepatic arterial blood flow. The patient is doing well 4 years after transplantation. Conclusion The method of hepatic graft arterialization described herein is an important option for LDLT recipients when tributaries of the celiac arterial trunk are insufficient as host arteries.

In the International Thermonuclear Experimental Reactor (ITER), the divertor high heat-flux components are subjected not to only severe heat and particle loads, but also to large electromagnetic loads during reactor operation. A great deal of R&D has been carried out throughout the world with regard to the design of robust high heat-flux components. Based on R&D results, small and intermediate size mock-ups constructed from various armor tile materials have been successfully developed with respect to a thermomechanical point of view. However, little analysis has been carried out with regard to the elastic stresses induced with in the high heat-flux components via the electromagnetic loads during a plasma disruption. Furthermore, past research has only considered thermomechanical and electromagnetic loadings separately and uncoupled. Therefore, a systematic analysis of the combined effects of thermomechanical and electromagnetic loadings has been performed, with the analytical results assessed by ASME section 3 evaluation code.

Chaotic features in the arrival times of cosmic-ray air showers are detected. The observed chaotic series of air showers measured in distant sites for the same time period cannot be explained by the hypothesis of a stochastic noise mixture as proposed by the Torino group.

BACKGROUND Nisoldipine, a calcium antagonist, has been reported to improve the quality of grafted rat livers. We thus assessed the protective effect of two calcium antagonists, nisoldipine and nickel, during extended cold ischemia-reperfusion. METHODS Rat livers were isolated and perfused before or after 24 hr of cold ischemia in University of Wisconsin solution (4 degrees C) with or without nisoldipine or nickel. Sinusoidal endothelial cell and hepatocyte functions were measured by hyaluronic acid and taurocholate elimination, respectively. RESULTS Similar alterations in hepatocyte and sinusoidal cell functions were found in all groups after cold ischemia with or without calcium antagonists. In a second set of experiments, liver transplantation was performed in two groups of rats with livers stored under identical conditions with or without nisoldipine. Seven of 12 animals (62.5%) in both groups survived for over 10 days after 24-hr preservation in University of Wisconsin solution. Survival rates were similar in both groups. CONCLUSIONS Calcium antagonists do not appear to have a direct protective effect on sinusoidal endothelial cell and hepatocyte functions, nor on the overall liver preservation after extended cold preservation-reperfusion.

Unexpected chaotic features are found in time series of arrival time intervals of successive air showers with (E > 3 × 1014 eV). Over 99 % of air shower arrival time intervals obey the Poisson distribution law representing stochastic behaviors, but occasionally there are air showers showing real chaotic behaviors as distinguished from both random and colored noises. With two systems of the Kinki university installations, we found 13 cases showing chaotic time series in 3.36 yr with the system-1 and the 1.37 yr with the system-2. Five out of 10 chaotic air showers of the Kinki installation are detected during the same time zone also by the Osaka City university installation which is at 115 km distance from the Kinki one. In a remarkable example of September 19, 1991, the correlation dimension was observed to have dropped from about 4 to the minimum of 1.3 and recovered smoothly in about 38 h. The chaos structure in this case is detected in nearly the same time zone at the Ohya station of the Institute for Cosmic Ray Research, University of Tokyo, which is separated from the Kinki one by 460 km. Formation of chaos structure due to energetic cosmic ray dust particles is suggested. Progress of cosmic ray physics may be expected with the study of air showers marked with chaos.

A newly developed integral method for the static magnetic field analyses in shell structures is presented. The system matrix in weak form is symmetric and the magnetization is represented by triangular vector finite elements preserving continuity of the normal components across element boundaries. The validity of this method is confirmed by calculating test shielding problems. The results by this method agree with the results by the finite element method and the analytical solution. >

It is confirmed experimentally and theoretically that the strong Fresnel diffraction disturbing electron microscope images of crystal surfaces in the profile-imaging mode is greatly reduced by means of observing the phase distribution of electron waves. High-resolution electron holography affords this clear observation of the surface, and it is shown how each electron potential of Mg and O atoms on a MgO (001) surface extends into a vacuum.

Noncompliance with immunosuppressant therapy is a serious problem that leads to the possibility of graft rejection, even in the long term after liver transplantation. The objectives of the present study were to review and describe features of patient noncompliance after living-donor liver transplantation (LDLT).Among pediatric patients (age18 years) surviving more than 5 years after LDLT, noncompliant patients were identified, and their clinicopathologic characteristics were studied retrospectively.Of 108 pediatric recipients who survived more than 5 years after LDLT, 6 female patients (5.6%) were noncompliant. Median (range) age at transplantation was 5 (2-15) years, and at noncompliance was 18 (9-21) years. Median time to noncompliance after transplantation was 8 (5-16) years. The 6 noncompliant patients received increased immunosuppression therapy, and liver function test results improved. Noncompliance was improved via intervention with medication, but recurred in 2 patients (33%). Noncompliance did not result in graft or patient loss.The prevalence of noncompliance was not so high in LDLT recipients. Liver dysfunction secondary to noncompliance improved with increased immunosuppression therapy.

Fabrication of 90-element CdTe-array radiation detectors, their radiation detecting characteristics and reliability tests have been studied. To obtain detectors with uniform characteristics, the use of large-grain crystals having homogeneous defect distribution and a controlled fabrication process, such as surface preparation, contact formation and proper assembly technique, are required. An average energy resolution of 5.1 keV for 60 keV γ-rays and a count rate variation for each detector of less than 11% have been achieved. Furthermore, the detector exhibits stable operation with a count rate drift of less than 1% within one week after bias application. Environmental tests, including a temperature-cycle test and a mechanical shock test, are systematically carried out and no severe problems are found with the detector under a normal environment. A high-temperature operating test has also been performed and the mean time to failure (MTTF) is estimated to be more than 1 × 106 h at room temperature.

Summary Biliary complications remain a significant cause of morbidity following living donor liver transplantation. The purpose of this retrospective study was to assess the outcome of nonsurgical management for hepatojejunostomy stricture in our institution. We reviewed 22 patients with hepatojejunostomy stricture among the 231 patients who underwent living donor liver transplantation between June 1990 and December 2005. Hepatojejunostomy stricture was confirmed by percutaneous transhepatic or endoscopic retrograde cholangiography. Anastomotic strictures were treated by balloon dilatation. Percutaneous transhepatic cholangiography was performed on 15 of the 22 patients. Two of 15 patients, with complete obstruction of the anastomosis, were treated successfully by Yamanouchi magnet compression anastomosis. Although another two patients died of infectious disease that was unlikely to have been related to biliary complications, anastomotic patency was maintained in the other 13 patients. Endoscopic retrograde cholangiography was performed on seven of the 22 patients. None of the 22 patients required re-operation or died of biliary complications. The 5-year graft survival rate of 85.6% in the 22 patients with stricture was equivalent to that of the patients without stricture (82.9%, P = 0.98). Advances in intervention techniques have enabled wider application of nonsurgical approaches for this complication, and fair results have been obtained.

In the JFT-2M tokamak, a low activation ferritic steel, which is a candidate material for a blanket of demo-reactor, has been introduced step by step to investigate the compatibility with plasma. The ferritic plates was installed to cover almost whole inside wall of the vacuum vessel (VV) as a simulate of the blanket wall (ferritic inside wall; FIW). The toroidal field ripple was decreased by adjusting the plate thickness distribution. Prior to the installation, electromagnetic force was calculated. Static force related to ferromagnetism was in the order of 1000 N for each segment (32 pieces in toroidal direction and 7 pieces in poloidal direction). The electromagnetic force is comparable to the static force. The support structure was decided based on this calculation. The most dangerous stress on the support was bending stress. Its maximum value was 170 MPa, which is 2/3 as large as allowable value of M12 bolt. The FIW was installed with a tolerance of a few mm. Tokamak discharges were obtained after the installation and no deteriorative effects have been observed up to now.

Background/Purpose This study was carried out to investigate the risk factors contributing to hepatic artery thrombosis in living-donor liver transplantation. Methods Two hundred and twenty-two recipients (113 adults and 109 children) of living-donor liver transplantation were the subjects of this study. The diagnosis of hepatic artery thrombosis was made by color-Doppler ultrasonography and/or hepatic angiography. Parameters for this study were: (1) donor sex, age, and body weight; (2) recipient sex, age, body weight, liver disease, preoperative prothrombin time, and type of arterial reconstruction; and (3) previous liver transplantation. Results Hepatic artery thrombosis occurred in 12 patients (5.4%) at 3 to 15 days posttransplant. Recipient female sex and metabolic disorder as the original disease were found to be significantly associated with hepatic artery thrombosis. The 5-year patient survival rate in recipients with hepatic artery thrombosis (58.3%) was significantly lower than that in recipients without this complication (84.4%). Conclusions Female sex and metabolic disease may be factors contributing to hepatic artery thrombosis after living-donor liver transplantation. More intensive anticoagulation therapy for this patient population might decrease the incidence of hepatic artery thrombosis and, thus, posttransplant recipient mortality.

Domino liver transplantation (DLT) has been developed as a method to expand the donor pool. In living donors DLT, the prime concern is to avoid any disadvantage to the donor and the first recipient. Seven DLTs were performed among 211 patients who underwent living donor liver transplantation. The domino recipients included six with hepatocellular carcinoma and one with citrullinemia. The domino grafts were obtained from patients with familial amyloid polyneuropathy (FAP) including the left liver in three cases and the right liver in four. Among the seven domino recipients, a 64-year-old woman with advanced hepatocellular carcinoma died of lung metastasis. The other six domino recipients are alive without FAP symptoms. In living donor liver transplantation, because the vessels of the graft from the first donor are not long enough for anastomosis, the hepatic vessels must be left as long as possible when removing the liver from the FAP patients in order to ensure sufficient safety for vascular reconstruction. With careful decision making during the procedure, such as where to divide the vessels in the FAP patients, DLT may help address the shortage of liver grafts.

The calcineurin inhibitors cyclosporine and tacrolimus have distinct advantages and drawbacks. Therefore it is important to tailor their use to the patient's tolerance. In some patients, the need to ameliorate the adverse effects of tacrolimus may necessitate a switch to cyclosporine-based therapy. Rescue therapy with a cyclosporine microemulsion (Neoral)-based regimen for transplant patients intolerant of tacrolimus has been evaluated to assess the best method of switching and determine the initial and maintenance doses of Neoral in children and adults. Our aims were to evaluate not only these facets, but also the pharmacokinetics of Neoral in stable patients, including target 2-hour postdose blood concentrations (C2) of cyclosporine in liver transplant recipients. Eighteen liver transplant patients switched from tacrolimus to Neoral underwent a program of cyclosporine blood level monitoring. The conversions were conducted safely; the incidence of acute rejection episodes was low (11.1%). Statistical analysis showed that the C2 correlated with the area under the time-blood concentration curve of cyclosporine for 0 to 4 hours after dosing (R=0.970). We determined the maintenance doses of Neoral for pediatric and adult patients as well as the feasibility of C2 quantitated monitoring in liver transplantation.