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To elucidate the relationship between embryo grade and ART outcomes and determine how to decrease multiple pregnancy rates by assigning patients to single embryo transfer (SET) instead of dual embryo transfer (DET) according to embryo grade and/or availability.Retrospective medical record review.IVF fertility center.247 women undergoing day 5 DET after in vitro fertilization or intracytoplasmic sperm injection treatment.We retrospectively investigated embryo grade and outcomes on day 5 DET and calculated theoretical multiple pregnancy rates by assigning patients to SET instead of DET according to a combination of embryo grades and availability.Implantation, pregnancy, multiple pregnancy, expected pregnancy and expected multiple pregnancy rates.Embryo grade affects implantation rates so that embryo transfer of at least one embryo with gradeor = 3BB resulted in high multiple pregnancy rates as well as high pregnancy rates. By performing DET, the clinical pregnancy rate was 39.9% with a multiple pregnancy rate of 33.3%; however, had SET been performed with an embryo graded 3BB or better, theoretical calculated pregnancy rates would have dropped to 35.8% but with a multiple pregnancy rate of 7.2%.Our model showed that cases having at least one embryo with gradeor = 3BB might serve as suitable candidates for SET.

The role of resistin in human biology remains uncertain. We measured serum resistin levels in Japanese patients with (n=111) and without (n=98) type 2 diabetes mellitus and investigated the significance of this hormone in the pathophysiology of diabetes. The levels of serum adiponectin and leptin were also measured. Resistin levels were increased significantly in patients with type 2 diabetes compared with non-diabetic subjects (24.7+/-2.6 vs. 15.0+/-1.2 ng/ml, p=0.0013). However, there was no correlation in either patient group between serum resistin levels and markers of insulin resistance, obesity or hyperlipidaemia. These results were in direct contrast to the data of leptin or adiponectin, both of which were closely related to these clinical markers of diabetes. Multivariate regression analysis on the combined data of the two groups demonstrated that the presence of diabetes and HDL cholesterol levels were significant predictors of serum resistin levels (diabetes: beta=0.159, p=0.035; HDL: beta=-0.172, p=0.039). No correlation was observed between C-reactive protein and resistin adjusted for BMI. Taken together, these findings demonstrate that serum resistin levels are increased in patients with type 2 diabetes, but this increase is not linked to markers of insulin resistance or adiposity. Further studies are necessary to elucidate the significance of serum resistin concentration in human pathophysiology.

This paper proposes a multiple space vector control strategy for self-commutated power converters. The strategy makes it possible to realize a significant reduction in power losses with the lowest possible switching frequency in the steady-state, continuous operation with high speed tracking of commands in the transient state and flexible controls with the utilization of degrees of freedom in the assignment of voltage vectors to the power converters. High efficiency of the strategy is confirmed by experiments in which two pulse switching mode and the speed of response in 5(ms) with one side model of the power converter terminals of self-commutated HVDC (high voltage direct current). The continuous operation is verified by simulations in a one-line ground fault. Another simulation based on the unbalanced DC voltages shows the balance control of DC voltages to be effective in HVDC transmission with self-commutated power converters connected in series on the AC and the DC sides.

To evaluate the influence of aging on bronchial hyperreactivity (BHR) during the childhood period, age-related changes in bronchial reactivity to methacholine (BRm) in children from 2 to 13 yr of age were studied using the same method, employing a methacholine inhalation challenge with transcutaneous oxygen pressure (tcPO2) monitoring. Three hundred and thirty-nine asthmatic subjects (male:female = 200:139, aged [mean +/- SEM] 7.2 +/- 0.2 yr) and 107 age-matched controls (male:female = 55:52, aged 5.3 +/- 0.3 yr) were enrolled in this study. TcPO2 was measured by a tcPO2 monitor, and subsequent doses of methacholine were then doubled until a 10% decrease in tcPO2 from its baseline value was reached. The cumulative dose of methacholine at the inflection point of tcPO2 (Dmin-PO2) was considered to represent the BRm. For the sake of comparison, respiratory resistance (Rr) in subjects more than 6 yr old was measured by the oscillation technique during methacholine inhalation challenge, and the threshold point of Rr (Dmin-Rr) was also considered to represent the BRm. In the asthmatic children aged 2 to 7 yr, Dmin-PO2 decreased significantly from 12.2 +/- 2.1 to 3.1 +/- 0.8 units, but after age 8 yr the values gradually increased from 3.1 +/- 0.7 to 6.4 +/- 1.6 units. In children aged 6 to 13 yr, Dmin-Rr showed the same increase as Dmin-PO2, from 2.0 +/- 0.5 to 5.8 +/- 1.4 units. These age-related changes in BRm reflected in both Dmin-PO2 and Dmin-Rr were also seen in the age-matched controls.(ABSTRACT TRUNCATED AT 250 WORDS)

The extent to which respiratory muscles are exerted during partially supported ventilation is difficult to differentiate, because these muscles and the ventilator work simultaneously to produce ventilation. We have developed a new method for determining the pressure developed by the respiratory muscles in partially supported ventilation. In seven patients on pressure-support ventilation (PSV), pressure, flow, and lung volume change were measured at the airway opening. Various PSV levels (0–15 cmH2O) were applied to each patient in random order. By utilizing a model of respiratory mechanics, we calculated the pressure developed by the respiratory muscles and the inspiratory work performed by the muscles from the measured parameters by use of the resistance and elastance of the respiratory system obtained during controlled ventilation. Increasing PSV from 0 to 15 cmH2O modulated the resultant breathing pattern, i.e., increasing tidal volume and decreasing respiratory rate. The respiratory muscle pressure, although less negative, had a shape that corresponded to the shape of airway occlusion pressure at each PSV level, and both pressures decreased concomitantly with increasing PSV. The respiratory muscle work progressively decreased with increasing PSV. This analysis enabled clear and continuous quantifications of the respiratory muscle force generation and inspiratory work during partially supported ventilation.

Optical properties of MBE-grown GaAs/AlAs quantum wells (QW's) on GaAs(100) channeled substrates with submicron slope facets are reported for the first time. Quantum wells were prepared on GaAs(100) substrates with 2.2 μm wide (311)A slope facets under the MBE condition of an almost normal incident angle of the Ga beam to the slope facet, which results in 18% larger Ga flux intensity in the slope region than in the (100) flat region. During MBE growth, the (311)A facet disappeared and 0. μm wide (211)A and 1.6 μm wide (411)A facets emerged. The thickness of the GaAs layer on (211)A is 20% larger, while the thickness of the GaAs layer on (411) is almost the same as that on (100) flat region. The cathodoluminescence spectra from the QW's in the slope region shows the red shift from that of the QW's in the (100) flat region (787 nm → 797 nm), indicating the possible lateral confinement of carriers in the submicron wide (211)A slope region on the GaAs channeled substrates.

Photoluminescence measurements (4.2 K) were carried out for pseudomorphic InxGa1−xAs/AlAs quantum wells (x = 0.155, well width Lw = 56, 84, 169 A) grown by MBE on GaAs(100) channeled substrates which have the (100) flat region and the (111)A slope region on their surface. Effective band-gap energies(Eg) of the InGaAs/AlAs QW's on the (111)A slope region was investigated for the first time. When Lw is small (56 and 84 A in the (100) region), Eg values of the (111) region are large than those of the (100) region, but when Lw is large (Lw = 169 A in the (100) region), Eg of the (111) region becomes smaller than that of the (100) region because of the effect of piezoelectric field induced by the strain in the (111)A region, indicating the possibility of the lateral confinement of carriers not only in the (100) flat region but also in the (111)A slope region for pseudomorphic InGaAs/AlAs QW's grown on (100) GaAs channeled substrates.

A third measurement of the electron antineutrino mass by tritium beta decay at INS was carried out after making some improvements for enhancing the counting rate. Langmuir-Blodgett film beta -ray sources with a 5-times larger area (60*200 mm2) than those used in previous measurements were prepared, and a new position sensitive beta -detector with a 6-times larger sensitive area was developed. Using this modified equipment, about 150000 events, more than one order of magnitude higher numbers than in previous measurements, were accumulated in the last 100-eV region below the end-point energy.

Molecular beam epitaxy of GaAs doped with Si on a vicinal surface of (111)A, (211)A and (311)A have been examined. The variations of the impurity concentrations are dependent on the growth conditions and are affected by the angle of the substrates. The impurity concentrations are compared with a model calculation which is based on microscopic surface structures and kinematical surface reactions. Growth modes are monitored by reflection high-energy electron diffraction intensity oscillations. A doping mechanism of Si atoms into GaAs films is proposed.

Overgrowth of GaAs and GaAs/AlAs heterostructures on GaAs channeled substrates by MBE was studied. Grooves along [01 1 ] were made on a (100) GaAs substrate by selective etching. There are two kinds of crystal planes on the substrate: a (100) plane (flat region) and a (111)A plane (slope region). We first demonstrated the resonant tunneling of electrons preferentially through a small (111)A slope region (12 μm wide) of GaAs/AlAs double-barrier structures grown on the channeled substrates.

A new upper bound ofmv < 13 eV at 95% CL has been obtained on the electron anti-neutrino mass. Thus results is based on a more than tenfold improvement in data relative to our previous measurements of the β-spectrum in 3H decay, and its in conflict with the finite mass of 17

The ability of thermal carbon analysis to determine CNTs was evaluated in the presence of a polymer (Polystyrene, PS). Samples placed in an Au (Pt) foil boat were measured using a thermal-carbon analyzer, and the results were compared with gravimetric measurements of sample masses obtained using an ultra-microbalance. First, debris from the polymer without CNTs (i.e., PS debris) was analyzed. The amount of PS debris detected in the organic carbon (OC) fraction was found to be in good agreement with the gravimetrically measured mass of the PS debris, while the amount of pyrolyticallygenerated carbon soot detected in the elemental carbon (EC) fraction was negligible. Next, single-wall CNT (AIST/TASC Super-Growth) powder was analyzed, and the amount of the CNT powder detected in the EC fraction was found to be 95-96% of the gravimetrically measured mass of the CNT powder. Subsequently, a mixture of the PS debris and the CNT powder was analyzed, and the amounts of detected OC and EC were found to be comparable to the gravimetrically measured masses of the PS debris and the CNT powder, respectively. Finally, debris from 5 wt% CNT-PS composites was analyzed, and amounts of OC and EC detected were found to be approximately comparable to the estimated masses of the PS and the CNTs in the debris of CNT-PS composite, respectively. The results therefore indicate thermal carbon analysis is capable of determining CNTs in the presence of PS.

The aerosol particles released during the grinding of polystyrene (PS)-based composites with well- and poorly dispersed single-wall carbon nanotubes (CNTs) and multiwall CNTs were measured using real-time aerosol measuring instruments. Increases in the concentration of aerosol particles were recorded during the grinding of the samples. However, similar increases were observed even when CNT-free polystyrene was ground. Electron microscopic analysis of the released particles revealed that particles with protruding CNTs were observed for the well-dispersed CNT-PS composites, but free-standing CNTs were not found. On the other hand, particles like agglomerated CNTs were found for the poorly dispersed CNT-PS composites.

We developed a bipolar transistor of VCBo = 2500V and IC = 0.3A as a device for high voltage (low current) control. Using this transistor for a high voltage stabilizing circuit to improve picture quality of a large screen TV set, we could make tilt distortion of the picture about one seventh that of a conventional circuit.

Summary form only given. Nanoparticle synthesis with RF thermal plasmas has been proposed as an attractive material process since RF thermal plasmas have several advantages such as high enthalpy, high chemical reactivity, variable properties, large plasma volume and long residence/reaction time due to the comparatively low velocity. Furthermore, they are inherently clean since they can be generated without internal electrodes. RF thermal plasmas are intensively useful to synthesize intermetallic nanoparticles of borides and silicides providing high electrical conductivity, heat/wear resistance and hardness. However, the synthesis includes difficult processes with vapor pressure differences. Only a few studies about the synthesis of boride and silicide nanoparticles in RF thermal plasmas have been conducted up to the present. The growth mechanisms of Ti-based intermetallic nanoparticles of borides and silicides in RF thermal plasmas are still poorly understood. Therefore, numerical investigation was conducted for the synthesis of Ti-based intermetallic nanoparticles in an RF thermal plasma to clarify the growth mechanism for Ti-B system and Ti-Si system. In Ti-B system, nuclei of boron are produced and grow in the upstream position, and titanium vapor subsequently condenses on the boron nanoparticles. On the other hand in Ti-Si system, silicon nucleates, and the vapors of titanium and silicon condense on the silicon nuclei simultaneously. Critical diameters as well as homogeneous nucleation rates are strongly dependent on the supersaturation ratios and the surface tensions. The fewer nuclei with the larger sizes are produced in Ti-Si system. An amount of the vapors consumed per one nucleus to grow is larger since a smaller number of the larger nuclei are produced in Ti-Si system. As the result, the obtained particle diameters in Ti-Si system show larger than those in Ti-B system. The boron content in the boride nanoparticles shows a wide range since condensations of titanium and boron occur at the different positions. The silicon content in the silicide nanoparticles shows a narrow range since condensations of titanium and silicon occur simultaneously

Large cell neuroendocrine carcinoma (LCNEC) is a rare type of lung cancer and it has the least favorable prognosis. We describe our experience with a patient in whom LCNEC was diagnosed. A 65-year-old man who was pointed out abnormal shadow on a chest X-ray film in the health screening was admitted to the hospital. Chest X-ray film and computed tomography (CT) scan showed a 4 x 3 cm mass in the left-S2. Poorly differentiated adenocarcinoma of the left lung was suspected based on CT guided cytology. An upper lobectomy of the left lung and dessection of the mediastinal lymph nodes were performed. This tumor showed light microscopic and immunohistochemical evidences of neuroendocrine differentiation. Further it showed positive responses in neuronspecific enolase (NSE), synaptophysin, and chromogranin-A stainings. Pathological diagnosis was stage IB (pT2N0M0) LCNEC. There have been no findings of tumor recurrence 22 months after the operation.

This paper proposes a 48 V DC power supply system utilizing a new 18-pulse rectified active DCL and a resonant DC/DC converter. This system consists of rectifier and DC/DC converter units. The rectifier unit includes an 18-pulse rectifier and an active DCL, and realizes high efficient rectification and mitigation of harmonics. The 18-pulse rectifier consists of a main diode rectifier, two sub diode rectifiers and an 18-pulse transformer. The outputs of the main rectifier and two sub ones are connected with each other at DC side terminal in parallel. The capacity of the 18-pulse transformer is decreased to one-third to a conventional 12-pulse rectification. The efficiency of the rectifier unit is increased by means of the passive circuit against the conventional PVM converters. The main circuit of the active DCL includes the voltage source single bridge circuit, RC filter and small capacity of reactance. The voltage source single bridge circuit includes capacitors and MOSFET switching devices. The active DCL realizes the mitigation of harmonics by generating of a compensating ripple voltage by PWM switching of power devices. The resonant DC/DC converter consists of a voltage source half-bridge circuit, high frequency transformers, diodes for rectification and LC filter. The switching frequency of the IGBTs is controlled so as to maintain the DC voltage 48 V. The DC link capacitor and the leak reactance of the high frequency transformers determine the frequency of the resonance. The power losses are decreased by soft switching scheme. The efficiency of the rectifier unit is measured at 98 % with a load of 4.8 kW. The efficiency of the DC/DC converter is 95 %. Consequently the total efficiency of the system is 93 %. By utilizing the 18-pulse rectified active DCL, the total harmonic distortion (THD) of current is improved to 8.6 % by mitigating harmonics.

This paper describes a new attitude control system of a super-high speed elevator car based on magnetic guides. Using a conventional roller guide system for attitude control of a super-high speed elevator car (810 m/min class) will result in serious horizontal vibration caused by the winding guide rails which are installed in the hoist way to guide the elevator car. The new control system proposed realizes acceleration control to suppress the car vibration at high speed running. The system is based on a magnetic guide controlling the attractive power between the guide rails and electro-magnets which are fixed to the elevator car frame. The effectiveness of the proposed method is confirmed by computer simulation and experimental results obtained using full scale equivalent testing equipment. >

We performed surgery for distal arch aneurysm in 22 patients; through a mediansternotomy in 11 patients (group M), and through a left thoracotomy approach in 11 patients (group L). If the distal position of an aneurysm was located at the pulmonary hilus without severe calcification of the ascending aorta, the mediansternotomy approach was chosen, whereas if we suspected that distal anastomosis would be difficult due to severe calcification of the descending aorta or aortic dissection type B, the left thoracotomy approach was selected. The mean cardiopulmonary bypass time (min.) was 229 +/- 56 in group M and 225 +/- 47 in group L, the mean circulation arrest time (min.) was 39 +/- 19 in group M and 31 +/- 5 in group L, and the mean lowest temperature (degree C) was 22 +/- 1 in group M and 20 +/- 2 in group L. No severe cerebral or cardiac complications developed in any patients. The hospital mortality was 9% (1/11) in group M and 9% (1/11) in group L. Following discharge, 8 (73%) patients from group M and 9 (92%) from group L resumed a normal lifestyle. There were no significant differences between the 2 groups and the operative results of both approaches proved satisfactory. Therefore our indications for each surgical approach to treat distal arch aneurysm seemed appropriate.

Multicystic dysplastic kidneys (MCDK) and obstructive renal dysplasia (ORD) are two different phenotypes of dysplasia commonly associated with urinary tract obstruction. However, the mechanisms whereby obstruction in the developing kidney leads to each dysplasia are unknown. In the present study, 16 fetal MCDKs and 3 fetal ORDs (18-35 weeks of gestation) were analyzed with light microscopy, point-counting morphometry, immunohistochemistry with a podocyte marker, and scanning electron microscopy. Additionally, reconstructions of dysplastic nephrons were done via serial section analysis. Early stages of MCDK and ORD similarly revealed numerous cyst formations, predominantly in the subcapsular nephrogenic zone. Occasionally, glomerular tuft remnants with mature podocyte phenotypes were observed in cysts, suggesting the acquisition of filtration. Three dimensionally, basic nephron structures were installed in the cystic nephrons, namely the macula densa with a primary loop structure. Cysts developed in the once-induced nephrons due to fluid retention in both MCDK and ORD. In utero urinary tract obstruction may cause urine retention in functioning nephrons and lead to glomerular cysts in the nephrogenic zone. These findings were common to MCDK and ORD, albeit at different sites of obstruction. Expansion of glomerular cysts with tubular dilatation (cysts) disturbs the subsequent nephrogenesis and may contribute to the misdevelopment of fetal kidneys.

We report the successful formation of lateral p-n junctions by molecular beam epitaxy (MBE) of Si-doped GaAs on (111)A substrates patterned with equilateral triangles. The idea of lateral p-n junctions with a triangular p-type region encircled with three crystallographically equivalent n-type slopes is based on the three-fold symmetry of the (111)A surface and the acceptor nature of the dopant Si on the (111)A surface in contrast to the donor nature on surfaces with the other orientations. Bad surface morphologies of layers grown on the (111)A surface have been a barrier against practical applications of this surface. We have successfully improved the (111)A surface morphology by pre-growth thermal cleaning, at both higher temperatures and higher As pressures. The formation of lateral p-n junctions is confirmed by spatially resolved cathodoluminescence measurements. This lateral p-n junction can be applied to structures that demand lateral carrier confinement, such as surface emitting laser diodes.

Using an experimental in vitro culture system, we investigated the effect of clarithromycin on biofilm formation by a leucine-requiring Pseudomonas aeruginosa mutant strain (HU1). Biofilm formation on celldesks in a chemically defined medium was assessed by viable cell count as well as by measurement of glycocalyx production and scanning electron-microscopic observation. Cells proliferated exponentially until day 3 and remained stationary afterwards. The amount of glycocalyx, simultaneously semiquantified, showed a linear increase from day 1 to day 12. Scanning electron microscopy revealed firm biofilms on day 5. Three different concentrations of Clarithromycin (CAM) (minimum inhibitory concentration MIC 64 microg/ml) were added continuously at the early and late phases of biofilm formation, and the antibiofilm effect of CAM was evaluated by the changes in cell count and glycocalyx production. CAM was effective on biofilms at 100 microg/ml but neither at 1 nor at 10 microg/ml. It is suggested that glycocalyx production started following bacterial multiplication and continued even after the cells had entered the stationary phase to form mature biofilms. No antibiofilm effect of CAM was observed at sub-MIC.

Intracytoplasmic sperm injection (ICSI) has been validated as a useful treatment in severe male-factor patients who could not achieve fertilization and live births by conventional in vitro fertilization treatment. To examine the impact of male factors on ICSI outcome, clinical laboratory data were retrospectively analyzed.One hundred two cycles of ICSI treatment indicated by severe male-factor infertility were entered into this study. Sperm parameters including sperm motility, sperm concentration, and sperm motility index assessed by the Sperm Quality Analyzer were evaluated.Five hundred seventy-six metaphase II oocytes retrieved were manipulated. The normal fertilization (2 PN) rate per oocyte was 64.9 +/- 26.0% (mean +/- SD). Of the 99 transfers, 31 clinical pregnancies were obtained, yielding an average pregnancy rate of 31.3% per transfer. The mean sperm motility, sperm concentration, and sperm motility index were 20.3 +/- 16.1% (range, 0 to 50%), 18.2 +/- 25.1 x 10(6)/ml (range,1 to 150 x 10(6)/ml), and 31.2 +/- 45.0 (range, 0 to 220), respectively. Sperm concentration did not have a significant impact on fertilization rate by ICSI. In four cases, ICSI was performed using totally immotile sperm and the fertilization rate was 43.5%, which was significantly lower than that of some of the other sperm motility groups, and no pregnancy could be achieved. In 14 cases in which the sperm motility index assessed by the Sperm Quality Analyzer was 0, the fertilization rate (50.0%) was significantly lower than in most of the other sperm motility index groups.These findings suggest that in severe male-factor cases with totally immotile sperm or a sperm motility index of 0, the selection of good-quality sperm should be verified before injection.

The growth rate of biofilm bacteria of a leucine-requiring mutant Pseudomonas aeruginosa HU1 was regulated by the leucine concentration in a chemically-defined medium. The semiquantitative measurement of glycocalyx and scanning electron microscopy revealed that the kinetics of HU1-biofilm formation were dependent on the incubation time and the leucine concentration in the medium. The effect of the growth rate of biofilm cells on their susceptibility to antimicrobial agents, three beta-lactams and four fluoroquinolones, was evaluated. beta-Lactams showed weak bactericidal activity to biofilm cells; the activity was greater in younger biofilm cells growing in high concentrations of leucine. Fluoroquinolones revealed strong bactericidal activity to biofilm bacteria regardless of the growth rate. The following is suggested: the bactericidal action of beta-lactams against biofilm cells is affected by the cell growth rate, while that of fluoroquinolones is considerably greater and independent on the growth rate.

Our previous studies showed that porcine zona pellucida (pZP) was composed of three major glycoproteins (pZPl, pZP3 α, pZP3β) and that pZPl was separated into two components of pZP2 and pZP4 under reducing conditions. Gene analysis of pZPl revealed that it consists of 681 amino acids and that pZP4 and pZP2 correspond to the NH2 terminal portion of pZPl (1–133) and the COOH terminal portion of pZPl (134–681) respectively. A monoclonal antibody (MAb-5H4) produced in mice against pZP4 had a strong blocking effect on pig in vitro fertilization and human sperm binding and penetration into human ZP and was found to react with a recombinant protein, pZPl (1-198), produced in E. coli. The recombinant pZPl (1– 198) could bind specifically to acrosome-reacted, but not acrosome-intact, pig and human spermatozoa. For analysis of the B cell epitope for MAb-5H4, three peptides (A, B, C) corresponding to 50–67, 60–79 and 70–100 of pZPl were chemically synthesized. It was found that the peptide A was exclusively reactive with MAb-5H4 and the minimum binding motif was mapped to 8 mer (54–61) peptide (LDPENLTL) by a polypropylene pin assay method. The reactivity was lost by the replacement of a single amino acid at the position of 56 (P→L) or 59 (P→F) residue. Rabbit and human 8 mer peptide corresponding to pZP4 (54–61) showed the same amino acid sequence but differed from the pig peptide at one residue 58(N→K). Antisera produced in mice and rabbits against synthetic 18 mer peptide of pZP4 (50–67) had a strong blocking effect on fertilization in pigs but not in humans. Auto and hetero antibodies produced in rabbits and mice against a synthetic rabbit 18 mer peptide corresponding to pZP4 (50–67] showed a strong blocking effect on fertilization in humans. From these results, we concluded that the core peptide of pZP4 including the epitope sequence recognized by MAb-5H4 plays an important role for the secondary sperm binding to ZP and the antibodies produced to the synthetic peptide corresponding to the epitope sequence could block the fertilization in the species homologous to the synthetic peptide origin.p

To evaluate the reproducibility of the Ultrafast CT (UFCT) scoring system and assess its usefulness in monitoring clinical severity in infants with bronchopulmonary dysplasia (BPD).UFCT scoring was done in 22 infants (15 boys and 7 girls aged 1 to 37 months) with BPD. A total of 258 lung fields were evaluated for the presence of hyperaeration, linear opacities, triangular subpleural opacities, and bronchovascular bundle distortion or thickening, and UFCT scores were given. Intraobserver and interobserver agreement and reproducibility of UFCT scores were statistically analyzed. In 12 patients, UFCT scores were linearly correlated with clinical severity scores based on respiratory dysfunction and complexity of care."Hyperaeration," which was the most frequent (18 of 22, 81.8%) finding, showed high concordance (kappa = 0.73, p0.001, kappa = 0.59, p0.001), and its UFCT scores significantly correlated with intraobserver and interobserver analyses (r = 0.94, p0.001, r = 0.82, p0.001, respectively). UFCT scores for hyperaeration significantly correlated with clinical scores (r = 0.75, p0.01), whereas those for the others did not.UFCT is useful for assessing BPD. Hyperaeration was the most common and reproducible finding, and its extent significantly correlated with clinical severity.

We report a case of sero-negative tsutsugamushi disease diagnosed by polymerase chain reaction (PCR). A 54-year-old man who worked in Nagano prefecture presented with flu-like symptoms that did not respond to cephalosporin therapy. On admission to another hospital, chest roentgenography revealed abnormal shadows; liver dysfunction was also present. Despite therapy, the patient's condition gradually worsened and he was transferred to our intensive care unit. Erythema on all extremities and scabs on the right medial femoral region and the dorsum of the left foot suggested a diagnosis of tsutsugamushi disease. We administered minocycline and gave percutaneous cardiopulmonary support for adult respiratory distress syndrome. Despite all efforts, the patient died. Although serologic tests were not positive, Karp strains of R. tsutsugamuschi were identified on PCR amplification. Autopsy revealed evidence of acute hemorrhagic pancreatitis, which has not been reported previously in tsutsugamushi disease. We conclude that PCR techniques may be useful in confirming a diagnosis of early tsutsugamushi disease.

In this study, we evaluated the permeation of piperacillin (PIPC), imipenem (IPM), amikacin (AKM), gentamicin (GM), ofloxacin (OFLX), levofloxacin (LVFX), ciprofloxacin (CPFX) and sparfloxacin (SPFX) through Pseudomonas aeruginosa biofilm with a simple new method. Bacteria used were a leucine-requiring mucoid mutant. Bacteria were grown on the membrane of a cell culture insert in chemically defined medium and incubated at 37 degrees C for 5 days. At days 0, 1, 3 and 5, the penetration rates through the biofilms were measured. PIPC and IPM demonstrated relatively high permeation both with penetration rates at day 5 of 50%, whereas AMK and GM, which are aminoglycosides, showed low permeation both with penetration rates after day 1 of less than 25%. Among the 4 fluoroquinolones, LVFX and SPFX demonstrated excellent permeation with penetration rates that reached 100% from day 0 to 5, while OFLX and CPFX showed almost the same permeation as IPM. This method of measuring penetration rates of antimicrobial agents through biofilm is very simple and useful for the evaluation of antibiotics against biofilm-forming bacteria.

The growth rate of biofilm cells of a leucine-requiring mutant Pseudomonas aeruginosa HU1 was regulated by the leucine concentration in the chemically defined medium, and the effect of the growth rate of biofilm cells on the antimicrobial activities of the antimicrobial agents piperacillin (PIPC), imipenem (IPM) and ofloxacin (OFLX) were evaluated. PIPC showed little effect on the biofilm bacteria regardless of the leucine concentration in the medium. IPM showed weak bactericidal activity to biofilm cells; activity was greater in younger biofilm cells growing in high concentrations of leucine. On the other hand, OFLX revealed strong bactericidal activity to biofilm bacteria regardless of the growth rate. Our data suggest that the bactericidal action of antimicrobial agents to biofilm bacteria is different from that to planktonic bacteria. The bioassay using mutants with regulated growth is useful for the evaluation of the efficacy of antimicrobial agents against biofilm bacteria.

We investigated the particle release caused by the grinding of polystyrene-based composites with and without single-wall carbon nanotubes (CNTs). In the results of real-time aerosol monitoring, considerable increases in the number concentration of nano-sized aerosol particles were observed during the grinding of both CNT-containing and CNT-free polystyrene. When a thermodenuder was used, the number of released nanoparticles was reduced by over 99.9%, indicating that the nanoparticles were presumably volatile particles released by the friction heat produced by grinding the composite. In an electron microscopic analysis of the aerosol particles, micron-sized particles with protruding fibers (probably CNTs) were observed, whereas free-standing CNTs were not observed.

The blocking effects of complement-dependent sperm immobilizing antibodies in the sera of infertile women and monoclonal antisperm antibodies against humans and mice on fertilization were investigated. The hemizona assay (HZA) and sperm penetration assay (SPA) were used to study the inhibitory effects of sera from 22 infertile patients positive for sperm immobilizing antibodies. Use of these tests allowed us to differentiate whether the antibody blocked sperm-zona pellucida tight binding and/or sperm penetration into the ooplasm. The zona pellucida penetration assay (ZPA) was also used to study the effects of four monoclonal antibodies (mAbs) on human sperm penetration into the zona pellucida. Seven mAbs against murine spermatozoa were tested for their inhibitory effects on in-vitro fertilization (IVF) and HZA in mice. Of 22 patient sera with sperm immobilizing antibodies, 21 (95.5%) inhibited HZA attachment and penetration, whereas this did not occur in any of 13 patient sera without these antibodies. However, 19 of 22 (86.4%) patient sera with sperm immobilizing antibodies and eight of 13 (61.5%) patient sera without these antibodies inhibited the SPA. Two (2C6, 1G12) of four mAbs against human spermatozoa showed strong inhibitory effects in all the assays (HZA, ZPA and SPA). One mAb (3B10) did not inhibit HZA but blocked ZPA and SPA. Another mAb (H6-3C4) seemed to have no inhibitory effects on fertilization. Two (Vx 5 and Vx 8) of seven mAbs against murine spermatozoa inhibited IVF in mice but did not block mouse HZA. These findings suggest that antisperm antibodies block fertilization at specific stages. Some of them may inhibit sperm capacitation and thus prevent all processes of fertilization that follow. Some other antibodies may not affect capacitation and sperm binding to zona pellucida but inhibit the acrosome reaction, followed by the blocking of sperm penetration through zona pellucida and ooplasm.

Between February 1988 and March 1993, 24 patients with locally advanced bladder cancer (stages T2-4N0-3M0) were included in this study. Combination chemotherapy consisting of methotrexate, vinblastine, epirubicin (doxorubicin) and cisplatin (M-VAC) was given to the patients in a neoadjuvant setting. The clinical stage was T2N0M0 in eight patients, T3aN0M0 in three, T3bN0M0 in seven, T4N0M0 in five and T4N3M0 in one. After chemotherapy, total cystectomy was performed in 20 patients and partial cystectomy 4. Of 24 patients, one (4%) showed a pathological complete response, and eight (33%) had a pathological partial response, for an overall response rate of 38% (95% confidence limits 20 to 57%). Nine patients who achieved a pathological response to chemotherapy had a significantly higher survival rate than the nonresponders (p0.01). In the relationship between the clinical stage and the response to chemotherapy, clinical T2 and T3a diseases were more likely to respond to chemotherapy than clinical T3b and T4 diseases, with a response rate of 64% and 15%, respectively. While a positive relationship between the pathological response and survival was observed, adequate follow-up is needed to assess the ability of neoadjuvant chemotherapy to improve the prognosis of patients with locally advanced bladder cancer.

PSV has been increasingly used as a partial ventilatory support for various types of respiratory failure. We experienced premature breath termination and double triggering in a patient with ARDS during PSV, and investigated the cause of this phenomenon using respiratory muscle pressure (Pmus). The analysis confirmed that the respiratory muscles and the ventilator did not coordinate synchronously in the patient with very low compliance of the respiratory system. The limitation of synchronization was attributable to fixed flow termination criteria in the present PSV algorithm. When dissynchronization is not manageable, other ventilatory modes (eg, APRV, PCV) allowing spontaneous ventilation should be considered as an alternative.