Search

BACKGROUND The efficacy of oral appliance (OA) varies greatly in patients with obstructive sleep apnoea (OSA). OBJECTIVE(S) The purpose of this cross-sectional study was to investigate the success rate of OA for OSA patients. METHODS This study was based on a cross-sectional multicentre survey of OA therapy for the management of OSA called the JAMS (Japanese Cross-sectional Multicenter Survey) Study performed at 10 medical institutions. A total of 442 patients fulfilled the selection criteria, which patients had worn OA, and undergone overnight polysomnography to assess both the pre-treatment baseline and follow-up for OA. Age, sex, BMI and apnoea-hypopnea index (AHI) at the time of diagnosis and follow-up for OA were extracted. RESULTS After OA treatment, the mean AHI decreased from 22.6 ± 13.8 to 10.0 ± 10.2/h, and the mean rate of decrease in the AHI was 52.5 ± 38.4%. Regarding the success rate to OA therapy, criterion 1 (AHI

A new piezoelectric sensor was developed in the shape of a traditional Japanese braided cord known as a Kumihimo by weaving piezoelectric poly-l-lactic acid (PLLA) fibers (piezoelectric PLLA braided cord). We found that the piezoelectric PLLA braided cord tied in various decorative knots, and worn as an accessory such as a choker or necklace, can detect pulse waves, swallowing, and coughing in a systematic way in one's daily life. To demonstrate this, we developed a system for measuring pulse waves with a Wi-Fi communication system using a piezoelectric PLLA braided cord with decorative knots.

Dual-gate organic thin-film transistors (DGOTFTs), which exhibit better electrical properties, in terms of on-current and subthreshold slope than those of single-gate organic thin-film transistors (OTFTs) are promising devices for high-performance and robust organic electronics. Electrical behaviors of high-voltage (&gt, 10 V) DGOTFTs have been studied: however, the performance analysis in low-voltage DGOTFTs has not been reported because fabrication of low-voltage DGOTFTs is generally challenging. In this study, we successfully fabricated low-voltage (&lt, 5 V) DGOTFTs by employing thin parylene film as gate dielectrics and visualized the charge carrier distributions in low-voltage DGOTFTs by a simulation that is based on finite element method (FEM). The simulation results indicated that the dual-gate system produces a dual-channel and has excellent control of charge carrier density in the organic semiconducting layer, which leads to the better switching characteristics than the single-gate devices.

Laser welding requires much capital investment comparing with generally employed arc welding. However, the laser welding enables to join very small objects with high accuracy because the laser has high energy density and high controllability. In addition, it is possible to suppress welding deformation due to low heat input. Therefore, the laser welding is employed for various joining processes. This study aims to clarify formation mechanism of weld pool in laser cladding in order to improve incomplete fusion through numerical simulation on laser welding considering deformation of weld pool surface and convective heat transfer in it. Consequently, it was found that the gas pressure plays important role for improve incomplete fusion in laser welding. The higher pressure of gas increases penetration depth by pushing away molten metal at center of the weld pool without changing direction of convection.

Background The pathway consisting of the receptor programmed cell death 1 (PD-1) and its ligands plays a crucial role to escape T cell-mediated immunity. Antibodies targeting PD-1 and its ligands have beneficial antitumor effects on many cancers, and some cases show long-time survival. Methods We retrospectively reviewed medical records of non-small cell lung cancer (NSCLC), head and neck cancer, and renal cancer patients who received subsequent therapy (chemotherapy or targeted therapy) after the administration of anti PD-1 or PD-L1 antibody between January 2016 and December 2018 at Okazaki City Hospital. Subsequent therapy included S-1, Pemetrexed (PEM), Cisplatin (CDDP) +PEM +Bevacizumab (BV) and PEM +BV maintenance, Carboplatin (CBDCA) +PEM and PEM maintenance, weekly Paclitaxel (wPTX), Docetaxel (DTX), Everolimus and Pazopanib. The latest analysis was performed in June 2019. Results Of the 13 patients who had received anti PD-1 antibody (NSCLC/head and neck cancer/renal cancer, 7/3/3; Nivolumab/Pembrolizumab, 10/3), 2 had partial response and 7 had stable disease for the 1st line subsequent therapy (overall response rate, 15%; disease control rate, 69%). Duration of median progression free survival (PFS) at the therapy was 10.9 m (S-1 in NSCLC), 16.0 m (CDDP+PEM+BV and PEM+BV maintenance), NE (PEM), 6.2 m (CBDCA+ PEM and PEM maintenance), 5.0 m (wPTX), 0.5 m (DTX), 6.0 m (Everolimus) and 14.1 m (Pazopanib) each. Median overall survival was 14.0 m, and 7 of the 13 patients were still alive. Two patients with Grade 2 interstitial lung disease due to Everolimus and PEM were successfully treated. Conclusion PFS of S-1 in NSCLC after the administration of anti PD-1 antibody was longer than that of the East Asia S-1 Trial in Lung Cancer. Interstitial lung disease due to targeted therapy was successfully managed.

We conducted a multicenter survey for oral appliance (OA) therapy to grasp and analyze the current situation of OA therapy, including efficacy, side effects, and follow-up, in Japan. The Japanese cross-sectional multicenter survey (JAMS) for obstructive sleep apnea (OSA) was undertaken by patients in 10 institutions associated with oral appliance therapy during two years, from 2014 to 2015, retrospectively. Age, sex, body mass index (BMI), baseline apnea&ndash, hypopnea index (AHI), OA type, adjustment, adverse reactions with OA, and AHI with OA were elicited from the patient clinical record. The number of included OSA patients was 3217. The number of patients with OA therapy was 2947. We evaluated 1600 patients for the OA treatment. The patients treated with OA, both male and female, were most commonly in their 50s. In terms of OSA severity, snoring was 2.3%, mild was 38.5%, moderate was 39.9%, and severe was 19.3%. The use of mono bloc appliance was 91.8%, bi bloc appliance was 7.9%, and tongue-retaining device (TRD) was 0.3%. After OA treatment, AHI decreased from 22.4/h to 9.3/h. The AHI reduction rate with OA was 52.0%. The rate of AHI &lt, 5 with OA was 35.6%. Adverse reactions developed in 14.7% of the subjects. OA reassessment was conducted for 54.3%. This study revealed the current situation of efficacy and side effects of OA therapy, and the problem that the reassessment rate of OA was low in Japan.

A 20 liters chamber which is standardized in JIS A 1901:2003 “Small chamber method - Determination of the emission of volatile organic compounds and aldehydes for building products” has been popularly used for measurement of volatile organic compounds (VOC) emission factors from coating materials. A 3 liters chamber which was newly developed for measurement of VOC emission factors from coating materials was evaluated and compared with the 20 liters chamber in the study. Air tightness, recovery and mass transfer coefficient of the 3 liters chamber were evaluated in accordance with JIS A 1901:2003. Further, correlation between VOC emission factors obtained by the 20 liters chamber method and the 3 liters chamber method was examined through measurement of acrylic enamel paint and a textured coating material.The results can be summarized as follows;1) Air tightness of the 3 liters chamber meets the requirement of ENV13419-1:1999 “Building products, Determination of the emission of volatile organic compounds - Part1: Emission test chamber method.”2) Recovery and mass transfer coefficient of the 3 liters chamber satisfy the requirements of JIS A 1901:2003.3) VOC emission factors obtained show high correlation between the 20 liters chamber method and the 3 liters chamber method.

The authors have developed underwater laser processing, namely welding and peening, to enhance surface properties of metallic components. The process developed could significantly reduce radiation dose to workers in nuclear facilities due to the shielding effect of water from radiation as well as due to remote operation attainable by laser technologies. Laser welding or cladding makes corrosion-resistant layers on the surface of components underwater, which reduces stress corrosion cracking (SCC) susceptibility. Various metallurgical and mechanical tests were performed to prove that the laser cladding made sound layers even if the surface had been degraded. Laser peening imparts compressive residual stress in near-surface layers by irradiating intense laser pulses without any surface preparation. High pressure plasma generated through ablative interaction underwater impinges on the surface and induces plastic strain to make compressive residual stress. Both processes are used to enhance surface properties, such as resistance to SCC, fatigue or wear of various metal materials.

Short-term compliance of nasal continuous airway pressure (nCPAP) therapy in elderly patients (65 years or older; n = 115) with moderate to severe obstructive sleep apnea was investigated. When nCPAP therapy was offered to elderly patients with an apnea-hypopnea index greater than 20/h, the acceptance rate of nCPAP therapy was 70%. Of those, the short-term tolerance rate of nCPAP therapy (usage over 3 months after initial trial) was 83%. The patients who refused or abandoned nCPAP therapy were less severe (in terms of the apnea-hypopnea index), less sleepy and there were a lower number with hypertension. Considering the short-term compliance of nCPAP therapy reported for middle-aged patients in the literature, it is found that acceptance and short-term tolerance of nCPAP therapy in elderly patients is high, especially in patients with hypertension and excessive daytime sleepiness.

A new super-multilayer alternating laminated film in the shape of a rectangle with round corners has been developed. The super-multilayer film, which comprised piezoelectric poly(l-lactic acid) (PLLA) and poly(d-lactic acid) (PDLA) films, was wound with the number of turns on the order of from 100 to 1000 to form piezoelectric rolls. These piezoelectric rolls could generate an induced voltage of more than 95% of the initial voltage for over 10 s when a constant load was applied. The desired duration and magnitude of the piezoelectric response voltage were realized by adjusting the number of turns of the piezoelectric rolls. Similarly to many other conventional piezoelectrics, the piezoelectric rolls enable instantaneous load-dependent voltage generation and attenuation. The piezoelectric rolls are also lighter than conventional piezoelectric ceramics and can be used as a novel pressure sensor.

ダウン症で精神発育遅延を認める52歳女性の白内障手術を,全身麻酔下に施行した.手術室入室時よりSpO2が93%とやや低値だった.気管挿管は容易であったが,挿管後気管内から血液を混じた喀痰が吸引された.術中は,気道内圧の上昇,皮下の異常膨隆,循環変動,チアノーゼの発現等は認めず,術後覚醒も良好であった.患者は手術終了210分後より胸部痛を訴え,約6時間後に,頸部から前胸部にかけての腫脹を呈した.単純胸部X線撮影で,縦隔気腫及び皮下気腫と診断された.縦隔気腫が生じた機序は不明であるが,高齢のダウン症患者は組織の脆弱性を有し,これが発症に関係した可能性が示唆された.

A computer-aided interactive system for coating design has been developed, which enables to analyze conveniently the reaction diffusion of bonded materials. The object of this study is the overlay coatings of MCrAlY alloy sprayed by a low-pressure-plasma spray (LPPS) process for protection against high-temperature corrosion and oxidation in the field of gas turbine components. However, the reaction diffusion behavior at the interface between the MCrAlY coating and the substrate, which has an important effect on coating degradation, has not always been clarified. Three kinds of substrate, such as equiaxis IN738LC, directional solidified CM247LC and single-crystal CMSX-2, and four kinds of low-pressure-plasma sprayed MCrAlY coating were selected for the experiments.The experimental results showed that the reaction diffusion layers consisted of aluminum compound layer and aluminum decrease layer, basically. However, the aluminum decrease layer could not be observed in the cases of CoNiCrAlY and NiCoCrAlY coatings. It was also indicated that each diffusion thickness changed in parabolic time dependence. And the order of reaction diffusion rate was NiCrAlY>CoCrAlY>CoNiCrAlY>NiCoCrAlY independent of the kind of substrate. It was also clear that the estimation of long time diffusion behavior by simulation analysis was possible in comparison with the experiments.

A computer-aided interactive system for coating desing has been developed, which enables to analyze coveniently the reaction diffusion of bonded materials. The object of this study is the overlay coatings of MCrAlY alloy sprayed by a low-pressure-plasma spray (LPPS) process for protection against high-temperature corrosion and oxidation in the field of gas turbine components. However, the reaction diffusion behavior at the interface between the MCrAlY coating and the substrate, which has an important effect on coating degradation, has not been fully clarified. Four kinds of low-pressure-plasma sprayed MCrAlY alloys, namely CoCrAlY, NiCrAlY, CoNiCrAlY and NiCoCrAlY, and single-crystal CMSX-2 were selected for the experiments.The experimental results showed that the reaction diffusion layers consisted of aluminum compound layer and low aluminum layer. In case of the NiCoCrAlY and CoNiCrAlY coatings, the aluminum compound layer could not be observed clearly. It was also indicated that each diffusion thickness could be expressed by the parabolic time dependence. The order of reaction diffusion rate was NiCrAlY>CoCrAlY>CoNiCrAlY>NiCoCrAlY. It was also clarified by the simulation analysis that the diffusion distance during heating process can not be ignored in comparison with the total diffusion distance, and the estimation of long time diffusion was made.

A computer-aided interactive system for coating design has been developed, which enables to conveniently analyze the reaction diffusion of bonded materials. The object of this study is to examine the overlay coating of MCrAlY alloy sprayed by a low-pressure-plasma spray (LPPS) process for protection against high-temperature corrosion and oxidation in the field of gas turbine components. However, the reaction diffusion behavior at the interface between the MCrAlY coating and the substrate, which gives an important effect on coating degradation, has not always been clarified. Three kinds of substrate, such as equiaxis IN738LC, directional solidified CM247LC and single-crystal CMSX-2, and the low-pressure-plasma sprayed CoCrAlY coating are selected for the experiments.The experimental results showed that the reaction diffusion layers consisted of aluminum compound layer and CoAl decrease layer. It also indicated that the diffusion thickness changed according to the parabolic time dependence. The reaction diffusion rates of the CM247LC and CMSX-2 were faster than the IN738LC. It was also clear from the simulation analysis that the diffusion distance during heating process should not be ignored in the total diffusion distance.

Toshiba has developed underwater laser beam welding (ULBW) technology as a maintenance measure for stress corrosion cracking.For an application to reactor vessel nozzles of PWR, ambient temperature temper bead welding technique and actual welding tools were developed. The ambient temperature temper bead welding technique can mitigate the degradation of toughness of low alloy steel of the nozzle due to high heat input of welding. Applicability of welding tools to actual PWR plants was confirmed through full-scale mockup tests in water tank at the depth of 10m. As ULBW dose not need to seal up and drain the work area, the new system can reduce the work period to less than half of the conventional system which needs draining.For an application of core shroud support of BWR, a prototype welding tool was developed to seal cracks and its performance was confirmed through mockup tests.ULBW enables significant reductions in radiation dose associated with maintenance efforts and also reduces impact on nuclear plant outage schedules. We will utilize this cutting-edge technology at nuclear plants both in Japan and abroad.Copyright © 2012 by ASME

In repair welding for nuclear reactor vessel, low alloy steels are affected by heat input during welding process. The conventional repair welding for wall steel constructions requires post weld heat treatment (PWHT) to achieve the desired microstructure properties. However, post weld heat treatment is very difficult for some structures in operating plants. In such case, temper-bead welding technique is available as a repair welding method. Temper-bead welding employs a multi-pass deposition of welding metal. Each layer of beads provides heat for thermal treatment of the previous weld bead or layer, which lowers hardness of the heat affected zone (HAZ) and improves mechanical properties like the toughness. Toshiba has developed underwater laser cladding and laser seal welding techniques for reactor components repair welding. In this report, some experimental results of laser based underwater temper-bead welding are presented.

Recently, stress corrosion cracking (SCC) has been observed at aged components of nuclear power plants under water environment and high exposure of radiation. Toshiba has been developing both an underwater laser welding directly onto surface of the aged components as maintenance and repair techniques. This paper reports underwater laser cladding and seal welding using INCONEL 52/52M.

The penetration in GTA welding is affected by the convective fluid flow in molten pool and the fluid flow is strongly influenced by the minor elements such as sulfur, oxygen and chlorine in base metal. The purpose of this work is to make clear the mechanism of the minor element effect on the fluid flow in GTA welding.In the first, the influence of the element on anode configuration on molten pool surface has been discussed experimentally under the condition of He-shielding, where the anode mode can be observed clearly. As the result of the experiment, it is made clear that the anode size is very sensitive to the elements and these elements such as sulfur, oxygen and chlorine depress the evaporation of metal vapor from the molten pool surface and make the anode zone constricted.In the second part of this paper, a defocused electron beam has been used as a heat source to discuss the influence of the minor element on the surface tensional convection, i.e. the influence of sulfur content in base metal on the penetration by the defocused electron beam has been discussed. It is clarified that the penetration shape by defocused electron beam is insensitive to the sulfur content in base metal. This result of electron beam melting, where the electromagnetic force is negligible as the driving force of covection, suggests that the minor element effect is peculiar to arc weld pool.From these experimental results, the minor element effect may be explained as follows, the element influences the anode size on molten pool surface and it causes the change of fluid flow mode in molten pool, because the convective flow by electro-magnetic force is directly dependent on the anode size.

Stress corrosion cracking (SCC) is one of the major reasons to reduce the reliability of aged reactor components. Toshiba has been developing underwater laser welding onto surface of the aged components as maintenance and repair techniques. Because most of the reactor internal components to apply this underwater laser welding technique have 3-dimensional shape, effect of welding positions and welded shapes are examined and presented in this report.Copyright © 2006 by ASME

Microgrooves (width 4-8 μm. depth 4.5 μm. length 10-100 μm. number 2600-8736 in parallel) formed on the surface of a single-crystal silicon substrate were converted to leak-proof microchannels by tightly covering them with an optically flat glass plate. The microchannels were used as a model of physiological capillaries to measure erythrocyte deformability, leukocyte adhesiveness, and platelet aggregability. An apparatus named MCFAN (Micro Channel array Flow Analyzer) is now commersially available.

Stress corrosion cracking (SCC) is the major factor to reduce the reliability of aged reactor components. Toshiba has developed various laser-based maintenance and repair technologies and applied them to existing nuclear power plants. Laser-based technology is considered to be the best tool for remote processing in nuclear power plants, and particularly so for the maintenance and repair of reactor core components. Accessibility could be drastically improved by a simple handling system owing to the absence of reactive force against laser irradiation and the flexible optical fiber. For the preventive maintenance, laser peening (LP) technology was developed and applied to reactor components in operating BWR plants. LP is a novel process to improve residual stress from tensile to compressive on material surface layer by irradiating focused high-power laser pulses in water. We have developed a fiber-delivered LP system as a preventive maintenance measure against SCC. Laser ultrasonic testing (LUT) has a great potential to be applied to the remote inspection of reactor components. Laser-induced surface acoustic wave (SAW) inspection system was developed using a compact probe with a multi-mode optical fiber and an interferometer. The developed system successfully detected a micro slit of 0.5mm depth on weld metal and heat-affected zone (HAZ). An artificial SCC was also detected by the system. We are developing a new LP system combined with LUT to treat the inner surface of bottom-mounted instruments (BMI) of PWR plants. Underwater laser seal welding (LSW) technology was also developed to apply surface crack. LSW is expected to isolate the crack tip from corrosive water environment and to stop the propagation of the crack. Rapid heating and cooling of the process minimize the heat effect, which extends the applicability to neutron-irradiated material. This paper describes recent advances in the development and application of such laser-based technologies.

Behaviors of the plasma, the emission intensity, distribution, source and species were evaluated using a high-speed video camera, a color CCD camera, and a spectrum multi-channel analyzer. It was found that a strong blue radiation from iron atoms of workpiece, nitrogen molecules or ions of a gas jet, when the cut surface quality was not acceptable. As cutting speed increased, plasma formation region where a laser beam was focused was more extended. It was found that flow speeds of molten material at bottom in which the plasma was induced became slower than those of top and middle points. Also, scattering angles of molten material droplets at a bottom exit of a kerf became larger and, at the same time, reattachment of molten material at the bottom was observed. Moreover, it was found that additional branches of the flows of molten material with smaller and darker droplets were formed intermittently, and that parts of the branches of the flowing droplets were being attached as dross to the bottom edges. From these results, it was confirmed that the plasma formation (region) and sizes and angles of striations (cut surface quality) were strongly correlated. Possibilities of the in-process evaluation of the cut surface quality by monitoring the plasma sizes and/or brightness in laser beam cutting were discussed.