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Isomura E.T., Matsukawa M., Yokota Y., et al. Clinical application of endoscopic soft palate augmentation in the treatment of velopharyngeal insufficiency. International Journal of Oral and Maxillofacial Surgery, (2023); https://doi.org/10.1016/j.ijom.2023.01.003., Velopharyngeal structure augmentation with the injection of autologous fat tissue into the nasal mucosa of the soft palate has been reported previously. However, as the injection points in the velopharyngeal space cannot be observed directly, these injections may be difficult to perform accurately. This report describes a new endoscope-assisted approach in which the materials for velopharyngeal structure augmentation are administered while observing the injection points directly, also enabling adjustment of the amount of material injected. A case series of five patients aged 8–16 years who underwent endoscopic soft palate augmentation under general anaesthesia is reported. Autologous fat tissue was injected into the nasal mucosa of the soft palate using a needle-type device of an endoscope, and the effects of the treatment were evaluated. The injections were performed successfully, and the velopharyngeal function was improved. This new technique of endoscopy-assisted augmentation was useful for the treatment of velopharyngeal insufficiency.

To characterise the dissemination patterns of uropathogenicEscherichia coli(UPEC) in a community, we conducted a study utilising molecular and fundamental descriptive epidemiology. The subjects, consisted of women having community-acquired acute urinary tract infection (UTI), were enrolled in the study from 2011 to 2012. UPEC isolates were subjected to antibacterial-susceptibility testing, O serogrouping, phylotyping, multilocus-sequence typing with phylogenetic-tree analysis and pulsed-field-gel electrophoresis (PFGE). From the 209 unique positive urinary samples 166 UPEC were isolated, of which 129 were fully susceptible to the tested antibiotics. Of the 53 sequence types (STs), the four most prevalent STs (ST95, ST131, ST73 and ST357) accounted for 60% of all UPEC strains. Antimicrobial resistance was less frequently observed for ST95 and ST73 than for the others. A majority of rare STs and a few common STs constituted the diversity pattern within the population structure, which was composed of the two phylogenetically distinct clades. Eleven genetically closely related groups were determined by PFGE, which accounted for 42 of the 166 UPEC isolates, without overt geo-temporal clustering. Our results indicate that a few major lineages of UPEC, selected by unidentified factors, are disseminated in this community and contribute to a large fraction of acute UTIs.

Three options of fusion DEMO plant are proposed characterized by functions of the center solenoid (CS). The prime option uses a downsized CS, which does not provide sufficient V-s for plasma current ramp-up but supplies enough coil current for plasma shaping. This option produces a fusion output of 3 GW with a major radius of 5.5 m, aspect ratio of 2.6, normalized beta of 4.3 and maximum field of 16.4 T. The estimated reactor weight is lighter than that of other conventional tokamak reactors, suggesting an economic advantage. The plant uses rather conservative technologies such as Nb3Al superconductor, water-cooled solid breeder blanket, low activation ferritic steel as the structural material and tungsten monoblock divertor plate. The design philosophy and key issues related to the constituent technologies of the plant are described in the present paper.

The effect of depression and anxiety upon neuropsychological test scores of candidates for coronary artery bypass graft (CABG) surgery was examined. Sixty patients were administered the Beck Depression Inventory II and the State-Trait Anxiety Inventory, along with a battery of neuropsychological tests. Regression analyses were conducted in which the neuropsychological test scores were predicted using age, education, depression, anxiety, and combined depression-anxiety scores. While age and education were significant predictors of several neuropsychological test measures, no significant regression analysis results were obtained for the depression, anxiety and combined depression-anxiety scores. Similarities and discrepancies between this research and previous studies are discussed. It appears that low levels of preoperative depression and anxiety states do not affect neuropsychological functioning among CABG candidates.

The Paleolithic-Threat hypothesis reviewed here posits that habitual efferent fainting can be traced back to fear-induced allelic polymorphisms that were selected into some genomes of anatomically, mitochondrially, and neurally modern humans (Homo sapiens sapiens) in the Mid-Paleolithic because of the survival advantage they conferred during periods of inescapable threat. We posit that during Mid-Paleolithic warfare an encounter with "a stranger holding a sharp object" was consistently associated with threat to life. A heritable hardwired or firm-wired (prepotentiated) predisposition to abruptly increase vagal tone and collapse flaccidly rather than freeze or attempt to flee or fight in response to an approaching sharp object, a minor injury, or the sight of blood, may have evolved as an alternative stress-induced fear-circuitry response. Such a stable (balanced) polymorphism for the hemodynamically "paradoxical" flaccid-immobility in response to these stimuli may have increased some non-combatants' chances of survival. This is consistent with the unusual age and sex pattern of fear-induced fainting. The Paleolithic-Threat hypothesis also predicts a link to various hypo-androgenic states (e. g. low dehydroxy-epiandrosterone-sulfate. We offer five predictions testable via epidemiological, clinical, and ethological/ primatological methods. The Paleolithic-Threat hypothesis has implications for research in the aftermath of man-made disasters, such as terrorism against civilians, a traumatic event in which this hypothesis predicts epidemics of fear-induced fainting.

We have previously demonstrated that reactive oxygen species (ROS) are involved in cartilage degradation. A decrease in the size of hyaluronan (HA), which is the major macromolecule in synovial fluid and is responsible for imparting viscosity to it, is reported in arthritis patients. The purpose of this study is to determine the ROS that depolymerize HA. The luminol derivative, L-012, was used to determine the generation of ROS. To generate hydroxyl radicals, a mixture of hydrogen peroxide (H 2 O 2 ) and ferrous ions (Fe 2+ ) was added to HA. The antioxidants and the depolymerization of HA were studied in this system. The hydroxyl radical is one of the ROS, causing the depolymerization of HA, which reacts with L-01. These data suggest that hydroxyl radicals play an important role at the site of inflammation.

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 largest pulsed superconducting coils ever built, the Central Solenoid (CS) Model Coil and Central Solenoid Insert Coil were successfully developed and tested by international collaboration under the R&D activity of the International Thermonuclear Experimental Reactor (ITER), demonstrating and validating the engineering design criteria of the ITER Central Solenoid coil. The typical achievement is to charge the coil up to the operation current of 46 kA, and the maximum magnetic field to 13 T with a swift rump rate of 0.6 T/s without quench. The typical stored energy of the coil reached during the tests was 640 MJ that is 21 times larger than any other superconducting pulsed coils ever built. The test have shown that the high current cable in conduit conductor technology is indeed applicable to the ITER coils and could accomplish all the requirements of current sharing temperature, AC losses, ramp rate limitation, quench behavior and 10 000-cycle operation.

Teachers' personality assessments of over 2000 children were obtained by John M. Digman between 1959 and 1967 in elementary schools on two Hawaiian islands. In July 1998, we began tracing these former students, who were now adults in the 40- to 50-year-old age range. Over a 2-year period, roughly 75% of the original sample has been located, and over 60% of those located have completed a survey of their personality attributes, health status and history, and health-related habits and practices. The most successful methods for tracing these individuals included public records, personal contacts, and an Internet-based people-finder. Comparisons of the located and recruited samples with the original samples on gender and the Big Five personality dimensions indicated virtually no selection biases. The lessons learned for locating such individuals are discussed.

Objective: Recent observations demonstrated that reactive oxygen species facilitate cartilage degradation. We demonstrated that hydrogen peroxide (H2O2) caused inhibition of proteoglycan synthesis, induction of apoptosis and stimulation of extracellular signal-regulated protein kinase (ERK) of the chondrocytes (Inflamm Res 48: 399-403, 1999). To determine whether activation of ERK is involved in the induction of chondrocyte apoptosis, we examined the signal transduction pathways in this hydrogen peroxide induced apoptosis.¶Design: Bovine articular chondrocytes were cultured. To determine the induction of apoptosis, Annexin V staining and terminal deoxynucleotidyl transferase were used. The activity of caspase-3 was measured using an apopain assay kit. Intracellular Ca2+ imaging was observed after fura2-AM loading.¶Results: Hydrogen peroxide enhanced annexin V positive apoptotic cells and caspase-3 activity, which is an executor of apoptosis. Hydrogen peroxide also enhanced intracellular Ca2+ and preincubation with the intracellular Ca2+ chelator protected chondrocytes against hydrogen peroxide-induced cell apoptosis, indicating that an increase in the cytosolic Ca2+ plays a decisive role in this action. When ERK activity was blocked with geldanamycin and PD098059, increased apoptosis was evident.¶Conclusion: Hydrogen peroxide induces chondrocyte apoptosis via Ca2+ signaling, and ERK is involved in these signal transduction pathways.¶

This paper presents the experimental qualification of the Hybrid Circuit Breaker developed for the full scale prototypes of the Quench Protection Circuit (QPC) used for Poloidal Field Coils (PFC) and Toroidal Field Coils (TFC) of JT-60SA within a contract placed to Ansaldo Sistemi Industriali S.p.A.. JT-60SA will be built in Naka, Japan, as a satellite tokamak of ITER in the framework of the Broader Approach Agreement; it is a complementary facility which accelerates the development of magnetic confinement fusion reactors. It is designed to perform long lasting plasma pulses up to 5.5 MA, with a flat-top duration of 100 seconds thanks to additional heating systems. In order to limit the power dissipation it will be equipped with both toroidal and poloidal magnets manufactured with low temperature superconductors and protected against quench by means of QPCs, which are capable of interrupting and diverting the current into a dump resistor avoiding major damages to the coils. The heart of the QPC is the Hybrid mechanical-static Circuit Breaker (HCB) an innovative concept which has no similar applications either industrialor laboratory at such power values. HCB is a device which combines a mechanical bypass switch (BPS) and a static circuit breaker (SCB): It takes advantage of the low power losses during normal operation while the BPS is closed, and the fast, reliable, arch-less current interruption of the SCB when it is operated. The SCB does not need a counterpulse network to turn-OFF the SCBthanks to the selection of static devices (IGCTs) which can be controlled both at turn-ON andturn-OFF. The HCB has been developed by Consorzio RFX team since 2007, starting from the conceptual design and the feasibility studies [1] which allowed to explore and solve open issues such as the reliable turn-ON of single and paralleled static switches with a very low voltage. The 10 kA unidirectional HCB prototype [2] has been a major step through the adoption of this solution for QPC, because it highlighted the suitability and reliability of the arc voltage to divert the current into the static devices in few ms. The final step has been the development and construction of the full scale prototypes for toroidal and poloidal HCBs which match JT-60SA requirements in terms of current polarity, current value, reapplied voltage and intervention time. In particular HCB for PFC is rated for a bidirectional current up to 21 kA and a maximum voltage of 5 kV, while the HCB for TFC is rated for a unidirectional current up to 25.7 kA and a maximum voltage of 2.8 kV; the operational time for both HCBs is 350 ms. Since the QPC is a safety component a full qualification process, based on a complete set of tests, has been designed and performed during 2012. It allowed to highlight the commutation between BPS and SCB which is one key aspect of the HCB and also the robustness of solutions and technologies employed for the HCB prototypes. The performances of the prototypes during the tests proved the compliance with the requirements and verified also the goodness of the electrical and thermal models developed during the design phase. [1] Novello et al. "Feasibility Study of a Hybrid Mechanical-Static DC Circuit Breaker for Superconducting Magnet Protection" IEEE Transactions on applied superconductivity, vol. 19, no. 2, April 2009, pages 76-83 [2] Novello et al. "Development and Testing of a 10-kA Hybrid Mechanical-Static DC Circuit Breaker" IEEE Transactions on applied superconductivity, vol. 21, no. 6, December 2011, pages 3621-3627

Three major groups of endogenous digitalis-like substances (EDLS) have been identified in the plasma of the toad, Bufo marinus. One group of compounds, present in fresh plasma, is composed of chromatographically homogeneous polar conjugates, principally bufadienolide 3-sulfates, which exhibit relatively weak Na(+)-K(+)-adenosinetriphosphatase (ATPase) inhibitory activity. A second and larger group of compounds, also found in fresh plasma, includes chromatographically heterogeneous conjugates, which are effective inhibitors of Na(+)-K(+)-ATPase; these compounds possess properties similar to those of bufotoxins. The third group of EDLS consists of free unconjugated bufadienolides, which are also effective Na(+)-K(+)-ATPase inhibitors. These unconjugated bufadienolides are present in relatively low concentrations in fresh toad plasma, but appreciable quantities are enzymatically generated from conjugates (believed to consist principally of bufotoxins) during the in vitro incubation of plasma. We suggest that the extent to which circulating polar EDLS are enzymatically deconjugated in vivo may be important in the regulation of the digitalis-sensitive Na(+)-K(+)-ATPase of toad brain, the only known digitalis-sensitive Na(+)-K(+)-ATPase in the toad.

The ITER poloidal field (PF) coil system consists of a central solenoid coil and seven ring coils. The PF coils must provide the magnetic fields to confine the plasma and control its position during the various phase of operation including plasma initiation, ramp-up, burn and shut-down. They contribute the magnetic flux change to ramp up the plasma current and a part of the flux change to maintain it. This paper describes the requirements and the conceptual design for the seven outer PF coils.

We report a harmonically mode-locked fiber laser employing a 151-cm-long bismuth-oxide-based erbium-doped fiber. Near-transform-limited short pulses at 10 GHz are obtained with an ultra-broadband wavelength tuning range of 83 nm covering both the C-band and the L-band.

In the framework of the ITER Broader Approach, CEA is carrying out the procurement of the Cryogenic System to the JA-EU Satellite Tokamak JT-60SA, which should be operated in Japan at JAEA, Naka in 2014. According to the Conceptual Design Report, JT-60SA is to operate for periods of at least 6 months per year, with major shutdown periods in between for maintenance and further installation upgrades. For this operation scenario, the cryoplant and the cryodistribution have to cope with different heat loads which depend on the different JT-60SA operating states. The cryoplant consists of one 4.5 K refrigerator and one 80 K helium loop, each pre-cooled by LN2. These cryogenic subsystems have to operate simultaneously in order to remove the heat loads from the superconducting magnets, 80 K shields and the divertor cryopumps.The first part of this study is based on the Process Flow Diagram (PFD) and presents the current design status of the JT-60SA cryogenic system. The second part is dedicated to the analysis of the cryoplant normal operation modes including the regeneration mode of the divertor cryopumps.Thanks to this analysis, the architecture of the present PFD is proposed in order to match the technical specifications of the cryoplant with the JT-60SA operation requirements.

Recent lower hybrid current drive (LHCD), and heating (LHH) experiments on JT-60 are reported. The current drive product of neRpIRF approximately 12.5*1019 m-2 MA was achieved at the LH power of approximately 4.5 MW, and the CD efficiency, the energy confinement, the global power balance and the heat load on divertor plates were investigated in high power LHCD plasmas. Nearly steady state H-mode discharges were found during LHCD with two different frequency injections. Sawtooth suppression in NB heated plasmas by LHCD have shown an improvement in confinement near the plasma center. Parametric instabilities in LH heating experiments were significantly reduced by increasing the plasma current, and the stored energy increased linearly with heating power of up to approximately 9 MW at ne approximately 7*1019 m-3 and Ip=2.75 MA. Parametric instabilities near the plasma edge in the ion heating regime were also reduced in peaked density plasmas produced by pellet injection and LH waves increased the central plasma pressure at ne(0) > 1.4*1020 m-3.

We report a steplike lattice transformation of single crystalline (La0.4Pr0.6)1.2Sr1.8Mn2O7 bilayered manganite accompanied by both magnetization and magnetoresistive jumps, and examine the ultrasharp nature of the field-induced first-order transition from a paramagnetic insulator to a ferromagnetic metal phase accompanied by a huge decrease in resistance. Our findings support that the abrupt magnetostriction is closely related to an orbital frustration existing in the inhomogeneous paramagnetic insulating phase rather than a martensitic scenario between competing two phases.

A 19-year-old man was punched on the back, and anterior chest pain appeared about 3 hours after injury. The patient was consulted a physician complaining of anterior chest pain. On chest X-ray, mediastinal emphysema was suspected, and transferred to our hospital. Chest computed tomography (CT) revealed mediastinal emphysema. On esophageal radiography and bronchofiberscopy, no abnormal findings were detected. Conservative therapy was conducted, and symptoms had gradually improved. On the 8th hospital day, mediastinal emphysema was improved on chest CT. The patient was discharged on the 10th hospital day. The most frequent cause of mediastinal emphysema after trauma is traffic or downfall accident, and no report on this condition after the punch on the back was found.

We have investigated the in-plane thermal conductivity $\kappa_{ab}(T,H)$ of large single crystals of optimally oxygen-doped (Y$_{1-x}$,Sm$_{x}$)Ba$_{2}$Cu$_{3}$O$_{7-\delta}$ ($x$=0, 0.1, 0.2 and 1.0) and YBa$_{2}$(Cu$_{1-y}$Zn$_{y}$)$_{3}$O$_{7-\delta}$($y$=0.0071) as functions of temperature and magnetic field (along the c axis). For comparison, the temperature dependence of $\kappa_{ab}$ for as-grown crystals with the corresponding compositions are presented. The nonlinear field dependence of $\kappa_{ab}$ for all crystals was observed at relatively low fields near a half of $T_{c}$. We make fits of the $\kappa(H)$ data to an electron contribution model, providing both the mean free path of quasiparticles $\ell_{0}$ and the electronic thermal conductivity $\kappa_{e}$, in the absence of field. The local lattice distortion due to the Sm substitution for Y suppresses both the phonon and electron contributions. On the other hand, the light Zn doping into the CuO $_{2}$ planes affects solely the electron component below $T_{c}$, resulting in a substantial decrease in $\ell_{0}$ ., Comment: 7 pages,4 figures,1 table

Papillary muscle rupture is a rare but severe complication of acute myocardial infarction. Two cases successfully underwent mitral valve replacement and concomitant coronary artery bypass grafting (CABG) for acute myocardial infarction with the anterior papillary muscle rupture in cardiogenic shock. Each of them needed preoperative massive inotropic infusion, respiratory support and intraaortic balloon pumping assist. The first case was a 76-year-old female. Double vessel disease (seg 7 : 90%, seg 11 : 100%) was revealed by coronary angiography and rupture of the papillary muscle was confirmed by transesophageal echocardiography. The second case was a 69-year-old female. Double vessel disease (seg 2 : 90%, seg 11 : 100%) was revealed and severe mitral regurgitation due to prolapse of the anterior leaflet was confirmed by transthoracic echocardiography. To assess the diagnosis of postinfarction papillary muscle rupture, transthoracic and/or transesophageal echocardiography is mandatory. Coronary angiography is also desirable because concomitant myocardial revascularization may improve the prognosis.

The origin of a long common channel in pancreaticobiliary maljunction was suggested to be the ventral pancreatic duct. Pathogenesis of long common channels was investigated by anatomically analysing the arrangement of pancreatic ducts in pancreaticobiliary maljunction.Cholangiopancreatography was performed for 66 cases of pancreaticobiliary maljunction and 200 controls. The accessory pancreatic duct was classified according to course and shape. In cases with long- or short-type accessory pancreatic duct, lengths of the main pancreatic duct from orifice to first inferior branch and junction with the accessory pancreatic duct, and the common channel were measured.Lengths of the main pancreatic duct from orifice to first inferior branch or junction with the accessory pancreatic duct were significantly longer in cases of pancreaticobiliary maljunction cases with the long- or short-type accessory pancreatic duct than in controls (p0.01). Lengths of the main pancreatic duct from first inferior branch to junction with the accessory pancreatic duct were roughly equivalent in pancreaticobiliary maljunction and controls.Long common channels in pancreaticobiliary maljunction might be formed embryologically with adhesion of the right ventral pancreatic duct and the terminal portion of the bile duct.

Aim: To assess the validity of the measurement of pepsinogen I and II as a screening test for gastric cancer and pre-malignant lesions, namely low-grade dysplasia, both in the general population and in selected groups of patients. Methods: A meta-analysis of sensitivity and specificity results from individual papers on the use of the pepsinogen test. An intrinsic cut-off effect was assumed and a random effect model was used for pooling. Results: Forty-two data sets were included: 27 (64%) population-based screening studies (n=296,553) and 15 (36%) sets of selected individuals (n=4385). Homogenous sensitivity and diagnostic odds ratio (DOR) estimates were found in studies using both pepsinogen I levels and pepsinogen I/II ratio calculations. Pooled pairs of sensitivity and false positive rates (FPr) for pepsinogen I ≤ 70; pepsinogen I/II ratio ≤ 3, pepsinogen I ≤50; pepsinogen I/II ratio ≤ 3, and pepsinogen I ≤ 30; pepsinogen I/II ratio ≤ 2, were sensitivity 77%/FPr 27%, sensitivity 68%/FPr 31%, and sensitivity 52%/FPr 84%, respectively. Positive predictive values (PPV) varied between 0.77% and 1.25%, and negative predictive values (NPV) varied between 99.08% and 99.90%. In selected groups, pooling was only possible when considering pepsinogen I ≤ 70; pepsinogen I/II ratio ≤ 3: giving sensitivity 57%, specificity 80%, PPV 15% and NPV 83%. As for the diagnosis of dysplasia, studies considering pepsinogen I 95%. Conclusion: Pepsinogen test definition should include pepsinogen I/II ratio as consistency was obtained, both in population based studies and in selected groups for those studies that used pepsinogen I serum levels together with pepsinogen I/II ratio for screening for gastric cancer in high-incidence regions other than Japan. Further studies of this test in the management of high-risk patients seem to be worthwhile.

Objective We have previously demonstrated that reactive oxygen species (ROS) are involved in cartilage degradation. Decreased size of hyaluronan (HA), the major macromolecule in synovial fluid, to which it imparts viscosity, is reported in patients with arthritis. The purpose of this study was to determine the alteration in the molecular weight range of HA as a result of mechanical deformation loaded on the chondrocytes, as well as the involvement of ROS in this action. Methods ROS were generated via the oxidation of hypoxanthine by xanthine oxidase. Cyclic tensile stretch was loaded using a vacuum-operated instrument. Levels of HA were measured using a sandwich enzyme-binding assay. Superoxide dismutase (SOD) activity and ROS were measured using water-soluble tetrazolium and a chemiluminescent probe, respectively. Results ROS depolymerized HA molecules. Cyclic tensile stretch depolymerized HA and induced ROS. SOD inhibited not only ROS induction but also HA depolymerization caused by the mechanical stress. Conclusion ROS play an important role in mechanical stress–induced HA depolymerization.

Mechanical stress is an essential factor in the pathogenesis of osteoarthrosis. We sought to determine whether the strain-mediated alteration in proteoglycan (PG) synthesis was modulated by nitric oxide (NO) synthesis.Cyclic tensile strain was applied to bovine articular chondrocytes. PG and NO synthesis were determined by [35S] sulfate incorporation and chemiluminescence analysis, respectively. To determine the expression of inducible NO synthase (iNOS), quantitative RT-PCR was used.Enhanced PG and NO synthesis were evident when cyclic tensile strain was applied to chondrocytes seeded on fibronectin-coated plates. When NO production was inhibited, PG synthesis was further enhanced.Cyclic tensile strain loaded on the chondrocytes enhanced NO synthesis and this enhanced NO inhibited PG synthesis.

High current switching technology is required for protection of large superconducting coil in the field of nuclear fusion research. The temperature rise of the contacts and temperature distribution along the current feeding electrodes were measured. The contact diameter was 25 mm, and the tested material was Cu-Cr with different mixing ratios. Effect of a heat pipe was investigated as well. Measurements revealed that for the heat pipe installed case the temperature at the contact reached about 130/spl deg/C after the current conducting test of 2000 A for 120 min, while for the no heat pipe case the temperature reached 185/spl deg/C.

Fast pressure gauges were installed in the JT-60 (JAERI Tokamak-60) to monitor the pressure near a plasma. They are Penning configuration gauges. A Penning discharge in the cell is sustained by the magnetic field which confines the plasma. The gauges are controlled by a personal computer. The response time of the system is fast ( >

This paper describes the General Tokamak Circuit Simulation Program (GTCSP) developed for designing the power supply system of a large nuclear fusion device JT-60. GTCSP can deal with synchronous generators, phase delayed transformers connected to thyristor converters, inductively coupled passive coils and their combination. Since the GTCSP code is designed for limited purposes, it has the advantages of a smaller number of input parameters and shorter computation time. The time step of the simulation is automatically adjusted according to the change of power converter switching mode, and this function suppresses switching noises. A program overview and some application results are presented.

An overview of the present design of the ITER coil power supply system is presented, along with brief descriptions of the main components including the AC/DC converters, switching networks, and discharge circuits.

The scope of this paper is to present the ITER poloidal field (PF) system and its nominal operation scenario. Detailed description of the system was given previously.

This paper describes the development of a vacuum switch carrying a continuous current of 36 kA DC. This switch consists of three vacuum interrupters connected in parallel. Generally, it is required to reduce the resistive loss and to increase the heat removal capability for increasing the current carrying capability of VCB. Then, maximizing the cross section of the conductor, and shortening the current path are principally important. However, a coil structure which produces an axial magnetic field to extinguish the arc stably, makes it difficult due to the geometric complexity. Then, the authors adopted unique design of the coil structure to solve this difficulty. The newly developed vacuum interrupter is possible to carry a current of 8 kA without any cooling, which is twice that of the largest VCB available at present in the world. Moreover, introducing the forced-air cooling enhanced the performance up to 12 kA by improving the cooling efficiency. They are verified through a heat running test.

The bacteria (Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa) isolated from patients diagnosed as having urinary tract infections (UTIs) in 9 institutions in Japan were supplied between the period of August 1999 to July 2000. Then, the susceptibilities of these bacteria to various antimicrobial agents were examined and the results were compared with those obtained between 1991 and 1998. Comparison was made by classifying strains isolated from patients into those with uncomplicated UTIs and those with complicated UTIs (including with or without indwelling catheter). About E. faecalis, increase of low sensitive strains noted in the former year showed a decreasing tendency, however, one strain each with MIC of 4 micrograms/ml to vancomycin (VCM) was detected in patients with both uncomplicated and complicated UTIs. As for S. aureus, many sensitive strains to cephems, imipenem (IPM) and VCM were noted, and each MIC50 was better than that in the former years. S. aureus strains showing low susceptibility to arbekacin (ABK) were detected in patients with complicated UTIs in this year as well as in the former year, and one strain each with MIC of 16 micrograms/ml and 32 micrograms/ml was detected. Susceptibilities of E. coli were effective to all drugs except for penicillins and minocycline (MINO). Decrease of low sensitive strains was also noted in all drugs except for quinolones. Each MIC90 of ciprofloxacin (CPFX) and sparfloxacin (SPFX) in patients with complicated UTIs against E. coli was 3 degrees classes lower than that in patients with uncomplicated UTIs. As for Klebsiella pneumoniae, decrease of low sensitive strains to cephems was noted in patients with uncomplicated UTIs in 1998. In 1999, low sensitive strains decreased also in patients with complicated UTIs, and few were detected. Susceptibilities of K. pneumoniae to quinolones were effective as compared with those in the former years with the MIC80s of 0.125 microgram/ml or below without detection of low sensitive strains. One low sensitive strain of K. pneumoniae with MIC of 8 micrograms/ml was detected for gentamicin (GM). Susceptibilities of P. aeruginosa to carbapenems were notable. The MIC90 of meropenem (MEPM) and IPM was 4 micrograms/ml each which was 2 degrees better than that in 1998. Resistant P. aeruginosa strains to other drugs except for monobactams decreased in 1999.

Five-hundred forty four bacterial strains isolated from 412 patients diagnosed as having urinary tract infections (UTIs) in 9 institutions in Japan were supplied between the period of August 1999 to July 2000. Then, the clinical background of patients were investigated such as sex, age and type of infections, infections and kind of bacteria, frequency of isolation of bacteria by age and infections, bacteria and infections by timing of administration of antibiotics, and bacteria and infections by surgical procedures. About the relationship between age and sex of patients and type of infections, the number of male patients aged less than 50 years was few, and complicated UTIs without indwelling catheter was the most frequent. In females, the number of patients aged less than 20 years was few. Complicated UTIs without indwelling catheter was the most frequent among female patients aged between 40 to 59 years, in other age groups, uncomplicated UTIs was most frequent. As for type of infections and kind of bacteria, Escherichia coli decreased when the infections became complicated, and Pseudomonas aeruginosa and Enterococcus faecalis increased when the infection became complicated. Considering this result by age of patients, isolation frequency of E. coli was gradually decreased with aging in patients aged more than 20 years with uncomplicated UTIs or complicated UTIs without indwelling catheter. The isolation frequencies of E. faecalis and Staphylococcus aureus were gradually increased with aging in complicated UTIs without indwelling catheter. In patients with complicated UTIs with indwelling catheter, there was no difference between age group, and P. aeruginosa and E. faecalis were frequently isolated. As for type of causative organisms in UTIs before and after the administration of antibiotics, the isolation of bacteria was remarkably decreased after administration in patients with uncomplicated UTIs and complicated UTIs without indwelling catheter. E. coli decreased after administration of antibiotics, and P. aeruginosa and E. faecalis increased after administration in patients with all infections. As for type of causative organisms in UTIs and surgical procedures, E. coli were more frequently isolated in patients with uncomplicated UTIs when surgical procedures were experienced. Also, Klebsiella spp. and E. faecalis were more frequently isolated in patients with surgical procedures. However, in complicated UTIs, type of causative organisms had no relationship with surgical procedures.

The bacterial strains isolated from patients diagnosed as having urinary tract infections (UTIs) in 9 institutions in Japan were supplied between the period of August 1999 to July 2000. Then, the susceptibilities of them to many kinds of antimicrobial agents were investigated. The number of them were 499 strains. The breakdown of these strains was Gram-positive bacteria as 31.3% and Gram-negative bacteria as 68.7%. Susceptibilities of these bacteria to antimicrobial agents were as follows; vancomycin (VCM), ampicillin (ABPC) and imipenem (IPM) showed strong activities against Enterococcus faecalis. The increase of low-susceptible strains which was noticed in the former year showed a slight recovery in this year. VCM showed a strong activity against MRSA preventing growth of all strains with 1 microgram/ml. In addition, the activity of arbekacin (ABK) was also strong with the MIC90 of 2 micrograms/ml against MRSA. However, MSSA and MRSA showing low susceptibilities were detected in one strain each (MIC: 16 micrograms/ml and 32 micrograms/ml, respectively). Carbapenems showed high activities against Citrobacter freundii and Escherichia coli. Meropenem (MEPM) prevented growth of all strains within 0.125 microgram/ml. Quinolone resistant E. coli decreased in this year compared with those in the last year, that percentage was less than 5%. Almost all drugs showed strong activities against Klebsiella pneumoniae and Proteus mirabilis. MEPM and carumonam (CRMN) prevented growth of all strains within 0.125 microgram/ml. On the other hand, one strain of K. pneumoniae showing resistance to cefaclor (CCL) and one strain of P. mirabilis showing low susceptibility to most of cephems were detected. Against Pseudomonas aeruginosa, almost drugs were not so active. The MIC90s of carbapenems were 8 micrograms/ml and those of all other drugs were more than 16 micrograms/ml.

Recent reports indicate the alteration of nitric oxide (NO) synthesis with mechanical stress loaded on the osteoblast and NO is considered to have a significant role in mechanotransduction. We found the involvement of guanine-nucleotide-binding regulatory proteins (G proteins), especially Gi, in stress-inhibited NO release of osteoblast-like cells (JOR:17;593–597, 1999). To determine further the mechanism involved in this process, we measured c-Jun N-terminal kinase/stress-activated protein kinase (JNK/SAPK) activity under cyclic tensile stretch loaded on osteoblast-like cells. Cyclic stretch significantly enhanced JNK/SAPK activity and pertussis toxin clearly reversed stress-enhanced JNK/SAPK activity. Cytochalasin D, actin microfilament disrupting reagent, also abolished the stress activation of JNK/SAPK. We propose a model for signaling events induced by cyclic tensile stretch, namely a transmembrane mechanosensor which couples Gi-protein, actin cytoskeleton and finally activates JNK/SAPK activity of osteoblasts.

The world's largest pulsed superconducting coil was successfully tested by charging up to 13 T and 46 kA with a stored energy of 640 MJ. The ITER central solenoid (CS) model coil and CS insert coil were developed and fabricated through an international collaboration, and their cooldown and charging tests were successfully carried out by international test and operation teams. In pulsed charging tests, where the original goal was 0.4 T/s up to 13 T, the CS model coil and the CS insert coil achieved ramp rates to 13 T of 0.6 T/s and 1.2 T/s, respectively. In addition, the CS insert coil was charged and discharged 10 003 times in the 13 T background field of the CS model coil and no degradation of the operational temperature margin directly coming from this cyclic operation was observed. These test results fulfilled all the goals of CS model coil development by confirming the validity of the engineering design and demonstrating that the ITER coils can now be constructed with confidence.

Susceptibilities to various antimicrobial agents were examined for Enterococcus faecalis, Staphylococcus aureus, Echerichia coli, Klebsiella spp. and Pseudomonas aeruginosa that were isolated from patients with urinary tract infections (UTIs) in 9 hospitals during June 1998 to May 1999, and the results were compared with those obtained during the same period from 1990 to 1997 in uncomplicated UTIs and complicated UTIs. Among E. faecalis strains, those with low susceptibilities to almost drugs have increased in the latest period. All 5 S. aureus strains isolated from uncomplicated UTIs were the most susceptible to gentamicin (GM). Over 50% of S. aureus strains isolated from complicated UTIs were susceptible to GM, and on the contrary the resistant strains have increased with the MIC90 of 256 micrograms/ml or above. Among S. aureus strains isolated from complicated UTIs, those with low susceptibilities to arbekacin (ABK) have increased in the latest period compared to those during period of 1996-1997, and the MIC90s of them have changed into the lower state from 1 microgram/ml in 1996-1997 to 4 micrograms/ml in 1998. S. aureus strains have continued high susceptibilities to vancomycin (VCM). The susceptibilities to minocycline (MINO) of E. coli showed MIC90: 4 micrograms/ml in 1997, but those have returned in the latest period in uncomplicated UTIs. The MIC90s of ofloxacin (OFLX) to E. coli isolated from uncomplicated and complicated UTIs have been lower 2-3 classes in the latest period than those in 1997. Among Klebsiella spp. strains isolated from uncomplicated UTIs, those with low susceptibilities to almost cephems had increased in 1997, but few of them were detected in the latest study. The sensitive strains of P. aeruginosa to almost drugs have increased during the latest period. The MIC50s of cefozopran (CZOP) and OFLX against P. aeruginosa were the best in our history. The sensitive strains of P. aeruginosa to ceftazidime (CAZ) have increased and its percentage was 30%. Piperacilline (PIPC), cefoperazone (CPZ), GM and OFLX resistant P. aeruginosa strains have increased in the latest period.

Clinical background was investigated on 449 patients with urinary tract infections (UTIs) from whom 591 bacterial strains were isolated in 9 hospitals during the period from June, 1998 through May, 1999. About distribution of age and sex of patients and type of infections, among males, patients less than 50 years old were few, and uncomplicated UTIs without indwelling catheters was most frequent. Among females, patients less than 20 years old were few, and uncomplicated was most frequent. Escherichia coli was the most frequently isolated in uncomplicated UTIs, and the higher the ages of patients, the higher were became the isolation frequencies of Enterococcus faecalis, Proteus spp. and Klebsiella spp. In complicated UTIs with indwelling catheters and without indwelling catheters, the types of pathogens had no relation with ages. The complication of infections had decreased E. coli but that had increased Proteus spp., Pseudomonas aeruginosa and Staphylococcus aureus. Until last year, use of antibiotics had decreased pathogens isolated from patients with uncomplicated UTIs drastically in our study. But, pathogens isolated after antibiotics had increased in 1998. As for surgical procedures and types of causative organisms in UTIs, E. faecalis were more isolated when surgical procedures were experienced, and E. coli were more isolated when they were not in uncomplicated and complicated UTIs without indwelling catheters. In complicated UTIs with indwelling catheters, types of causative organisms had no relationship with surgical procedures.

The frequencies of bacterial isolation and susceptibilities to antimicrobial agents were investigated on 538 bacterial strains isolated from patients with urinary tract infections (UTIs) in 9 hospitals during the period of June 1998 to May 1999. Of the above bacterial isolates, Gram-positive bacteria accounted for 30.3% and Gram-negative bacteria accounted for 69.7%. Susceptibilities of several isolated bacteria to antimicrobial agents were as follows; against Enterococcus faecalis isolated from patients with UTIs, vancomycin (VCM), ampicillin (ABPC) and imipenem (IPM) had strong activities. Among E. faecalis strains, those with low susceptibilities to all drugs have increased in 1998, compared with those in 1997. VCM showed the highest activity against MRSA isolated from patients with UTIs. The MICs of VCM for all 34 strains were equal to or lower than 2 micrograms/ml. Arbekacin (ABK) was also active against MRSA with the MIC90s of 2 micrograms/ml. Against Escherichia coli and Klebsiella pneumoniae, all drugs except penicillins were active. Particularly, meropenem (MEPM) showed the highest activity with the MICs of 0.125 micrograms/ml or below. Almost all the drugs except minocycline (MINO) showed high activities against Proteus mirabilis. Against Pseudomonas aeruginosa, all drugs were not so active, with the MIC90s of 16 micrograms/ml or above. MEPM, IPM and gentamicin (GM) showed high activities against Serratia marcescens. Generally, it seemed that resistant strains of S. marcescens had decreased since 1996.

Two patients with advanced colorectal cancer were consecutively administered two different chemotherapeutic regimens. The first patient showed an initial response to combination treatment with irinotecan plus cisplatin, but then progressed. He subsequently responded to treatment with a novel thymidylate synthase (TS) inhibitor, raltitrexed. The second patient, who progressed after exhibiting a response to raltitrexed, subsequently responded to irinotecan/cisplatin combination therapy. In conclusion, no clinical cross resistance between the regimens of irinotecan/cisplatin combination therapy and raltitrexed was observed in these patients with advanced colorectal cancer.