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Objective: The optimal revascularization modality following complete resection of aortic graft infection (AGI) without enteric involvement remains unclear. The purpose of this investigation is to determine the revascularization approach associated with the lowest morbidity and mortality using real-world data in patients undergoing complete excision of AGI. Methods: A retrospective, multi-institutional study of AGI from 2002 to 2014 was performed using a standardized database. Baseline demographics, comorbidities, and perioperative variables were recorded. The primary outcome was infection-free survival. Descriptive statistics, Kaplan-Meier survival analysis, and univariate and multivariable analyses were performed. Results: A total of 241 patients at 34 institutions from seven countries presented with AGI during the study period (median age, 68 years; 75% male). The initial aortic procedures that resulted in AGI were 172 surgical grafts (71%), 66 endografts (27%), and three unknown (2%). Of the patients, 172 (71%) underwent complete excision of infected aortic graft material followed by in situ (in-line) bypass (ISB), including antibiotic-treated prosthetic graft (35%), autogenous femoral vein (neo-aortoiliac surgery) (24%), and cryopreserved allograft (41%). Sixty-nine patients (29%) underwent extra-anatomic bypass (EAB). Overall median Kaplan-Meier estimated survival was 5.8 years. Perioperative mortality was 16%. When stratified by ISB vs EAB, there was a significant difference in Kaplan-Meier estimated infection-free survival (2910 days; interquartile range, 391-3771 days vs 180 days; interquartile range, 27-3750 days; P < .001). There were otherwise no significant differences in presentation, comorbidities, or perioperative variables. Multivariable Cox regression showed lower infection-free survival among patients with EAB (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.6-3.6; P < .001), polymicrobial infection (HR, 2.2; 95% CI, 1.4-3.5; P = .001), methicillin-resistant Staphylococcus aureus infection (HR, 1.7; 95% CI, 1.1-2.7; P = .02), as well as the protective effect of omental/muscle flap coverage (HR, 0.59; 95% CI, 0.37-0.92; P = .02). Conclusions: After complete resection of AGI, perioperative mortality is 16% and median overall survival is 5.8 years. EAB is associated with nearly a two and one-half-fold higher reinfection/mortality compared with ISB. Omental and/or muscle flap coverage of the repair appear protective. © 2022 Society for Vascular Surgery

We propose an S-band active phased array antenna (APAA) with analog phase shifters (PSs) that use double-balanced mixers (DBMs). The quadrature phase shift keying modulator integrated circuits (ICs) used as the phase shifters can control both the amplitude and phase of the input signal continuously and independently by using the control voltages. The phase and amplitude errors during phase rotation were 0.5/spl deg/ rms (max=1.7/spl deg/) and 0.3 dB rms (max=0.7 dB), respectively. The range in which the amplitude could be linearly changed was 7 dB. The proposed antenna exhibited sufficient performance for mobile vehicles to handle satellite communications: beam-pointing resolution of 0.04/spl deg/, beam-pointing accuracy in the null pointing of 0.4/spl deg/ rms, and sidelobe suppression with an amplitude taper achieved by setting the amplitude of the PS using two DBMs. Comparison between the analog PS and a reflection-type four-bit digital PS showed that although the analog one is unsuitable for use in a passive PAA, it is suitable for use in an APAA.

Background:The Global Burden of Diseases Study 2010 reported that hypertension is worldwide the leading risk factor for cardiovascular disease, causing 9.4 million deaths annually. We examined to what extent self-measurement of home blood pressure (HBP) refines risk stratification across increasing categories of conventional blood pressure (CBP).Methods and Findings:This meta-analysis included 5,008 individuals randomly recruited from five populations (56.6% women; mean age, 57.1 y). All were not treated with antihypertensive drugs. In multivariable analyses, hazard ratios (HRs) associated with 10-mm Hg increases in systolic HBP were computed across CBP categories, using the following systolic/diastolic CBP thresholds (in mm Hg): optimal

A new communication and radio determination system has been developed and experiments to evaluate the positioning accuracy of the system have been made. Theoretical estimates of the positioning accuracy and the results of experimental data analysis are presented. The relationship between the positioning error and the satellite ephemeris error while considering the dynamics of orbital motions are the main topics of discussion. Estimated improvements in positioning accuracy using benchmark stations are also described.

Magnetization Curie temperature and magnetovolume effects of amorphous (Gd x Fe 1- x ) 80 Si 12 B 8 alloys (0.1 ⩽ x ⩽ 1.0) were investigated. Gd 80 Si 12 B 8 is an asperomagnet having the Curie temperature of 129 K. The large susceptibility of the asperomagnet enhances the forced volume magnetostriction for x more than 0.7, which reaches about 100 × 10 -10 Oe -1 at x = 1.0 and T = 30 K. The Mossbauer study revealed a decrease of the Fe magnetic moment with an increase of Gd content. Exchange interactions J FeFe and J FeGd evaluated by the fitting of σ - T curves are discussed and compared with those of crystalline GdFe compounds.

A new type of protected mesoionic triazoline nucleoside was synthesized by the reaction of protected 1,2-dideoxy-hydrazino-D-ribose or 1-deoxy-hydrazino-D-ribose with isothiouronium compounds. The three compounds obtained 10a, 10f and 16a were deprotected with tetrabutylammonium fluoride. They showed no activity against HSV-1 virus.

To investigate the efficacy of long-term lamivudine (3TC) and adefovir dipivoxil (ADV) combination therapy in 3TC-resistant chronic hepatitis B virus (HBV) infected patients, we analysed 28 3TC-resistant patients treated with the combination therapy during 47 months (range, 9-75). At 12, 24, 36, and 48 months, the rates of virological response with undetectable HBV DNA (≤ 2.6 log copies/mL) were 56, 80, 86, and 92%, respectively. Among 17 hepatitis B e antigen (HBeAg)-positive patients, HBeAg disappeared in 24% at 12 months, 25% at 24 months, 62% at 36 months, and 88% at 48 months. When HBV genotypes were compared, patients with genotype B achieved virological response significantly more rapidly than those with genotype C (P=0.0496). One patient developed virological breakthrough after 54 months, and sequence analysis of HBV obtained from the patient was performed. An rtA200V mutation was present in the majority of HBV clones, in addition to the 3TC-resistant mutations of rtL180M+M204V. The rtN236T ADV-resistant mutation was observed in only 25% clones. In vitro analysis showed that the rtA200V mutation recovered the impaired replication capacity of the clone with the rtL180M+M204V mutations and induced resistance to ADV. Moreover, rtT184S and rtS202C, which are known entecavir-resistant mutations, emerged in some rtL180M+M204V clones without rtA200V or rtN236T. In conclusion, 3TC+ADV combination therapy was effective for most 3TC-resistant patients, especially with genotype B HBV, but the risk of emergence of multiple drug-resistant strains with long-term therapy should be considered. The mutation rtA200V with rtL180M+M204V may be sufficient for failure of 3TC+ADV therapy.

This paper describes a Ka-band active phased array antenna for mobile SATCOM stations. The active phased array is a fully electronic beam-scanning antenna system and is the most technically challenging component in the system development of the Japanese engineering test satellite, COMETS. The hardware components of the antenna, such as antenna element, LNA, and MMIC phase shifter, are described. Antenna tracking performances were measured and analyzed using a land mobile station and an aeronautical mobile station.

This paper describes the development of the slot array antenna system for the COMETS advanced mobile satellite communication experiments. COMETS is a Japanese engineering test satellite for Ka/Q-band mobile satellite communications, and is-scheduled for launch into geostationary orbit in the summer of 1997. The Communications Research Laboratory (CRL) has developed a compact mechanically steered antenna system for the COMETS mobile terminal. System performance with a high efficiency antenna and control electronics are discussed.

Using the Engineering Test Satellite-Five (ETS-V), L-band (1.5 GHz) propagation measurements of land mobile satellite communication channels on ordinary roads and expressways in Japan have been carried out, The total distance of the experiments is about 4,000 km. A continuous wave from the ETS-V, is received by a directional phased array antenna (Gain: 12 dBi) installed on the roof of a test van. The experimental results show that expressways and ordinary roads in rural and suburban areas are very suitable for land mobile satellite communication services. The paper describes the field experiments and statistical characteristics of the received signal levels, non-fade/fade duration distributions, fade depth and non-fade/fade state transition frequency. >

The Communications Research Laboratory is now developing mobile and personal earth station terminals for an experimental advanced mobile satellite communication system using COMETS, which is scheduled for launch in 1997. The terminals under development are a briefcase-sized handy terminal for low bit-rate voice and a mobile terminal for voice and data. The system used the extremely high frequencies of the Ka-band (31/21 GHz) and the Q-band (47/44 GHz) and one-hop communication links between the terminals. Because of this, the terminal antennas, and countermeasures to rain fall attenuation will play key roles in the system hardware. An on-board regenerative transponder, the world's first SCPC/TDM type, will also be a key component of the system.

This paper describes recent results in a project at KUBOTA to develop an efficient CFC-free multifunctional heat supply system. A heat pump in the system is a gas engine driven Stirling heat pump. The heat pump is mainly driven by engine shaft power and is partially assisted by thermal power from the engine exhaust heat. By proportioning two energy sources to match the heat balance of the driving engine, this heat-assisted Stirling heat pump can be supplied with the maximum share of the original energy fueling the engine and can be operated at the most efficient point. The authors have developed a system heat pump composed of 6 cylinders, the doubled E-3 prototype. This prototype uses helium gas as a working gas and is constructed as two sets of three-cylinder machines, each a combination of two Stirling sub-systems (one a power producer and one a heat pump). Design and performance simulations of the prototype are presented in conjunction with the driving engine characteristics. This heat supply system is expected to produce cooling and heating water at high COP. Developing the system will provide a CFC-free thermal utilization system technology that satisfies both wide heat demands and various fuel systems.

A 58-year-old man was referred to our hospital because of painful swelling in the left lower leg and leukocytosis in January 1999. Moderate hepatosplenomegaly but no lymph node swelling was observed. Marked leukocytosis (leukocytes 44.9 x 10(4)/microliter with 95% morphologically prolymphocytes) and thrombocytopenia were detected. The surface phenotype of the leukemia cells was CD1-2+3+5+7+4+8+25+. Magnetic resonance imaging revealed dilated veins in the left lower leg. An abnormal 47XY, +22 karyotype was detected in 1/20 cells. Tests for HTLV-I antibody were negative. A diagnosis of T-cell prolymphocytic leukemia (T-PLL) was made on the basis of data including cytochemical and electron microscopic findings. Although 2 courses of chemotherapy comprising vincristine, cyclophosphamide, and prednisolone improved the venous thrombosis in the leg, the leukemia cells were refractory to chemotherapy. To prevent the recurrence of venous thrombosis due to leukostasis, the patient underwent repeated leukapheresis. The leukocyte count was maintained at around 20.0 x 10(4)/microliter after total 7 courses of leukapheresis, one course of which comprised 7l of extracorporeal circulation. In addition to the rare presentation of venous thrombosis, the CD4+8+25+ phenotype observed in this case is rare in patients with T-PLL.

Advanced mobile satellite communication experiments on the Communications and Broadcasting Engineering Test Satellite (COMETS) will be carried out mainly by the Communications Research Laboratory (CRL). A torus reflector antenna is being developed for a mobile millimeter-wave antenna of the COMETS. The CRL developed a prototype of the torus reflector antenna, and it seems that the prototype worked normally as expected from the calculated design. This was shown by the results of measuring its performance. The objectives of the experiments are to develop basic technology and to assess the feasibility of future mobile and personal satellite communications in the Ka-band (31/21 GHz) and millimeter-wave (47/44 GHz).

In the early 21st century, the demand for fixed and mobile satellite communications for personal communications will increase rapidly. The Communications Research Laboratory plans to study an advanced mobile satellite communication system in the Ka-band and millimeter wave band by using the experimental satellite COMETS (Communications and Broadcasting Engineering test Satellite). The satellite has been developed in conjunction with NASDA and will be launched in the summer of 1997. This paper describes the outline of the COMETS project and the experimental system for the advanced mobile satellite communication mission.

Intravenous (iv) pretreatment of muscimol, a GABAA receptor agonist, inhibited the convulsive effect of bicuculline but not that of picrotoxin, whereas phenobarbital, a Cl ion channel blocker, exhibited both effects. These results suggest that the bicuculline-induced convulsion may be due to Cl ion channel blockade secondary to the direct inhibition of GABAA receptors. CPP and MK-801, competitive and noncompetitive NMDA antagonists, respectively, inhibited both the bicuculline- and picrotoxin-induced convulsion, suggesting that these convulsive effects may also involve activation of the NMDA-Ca ion channel complex, which might link to the GABA-Cl ion channel system. Anticonvulsants phenytoin, carbamazepine and diazepam as well as phenobarbital inhibited the convulsive responses of bicuculline and picrotoxin. Therefore, the anticonvulsive effects of these drugs may involve an activation of the GABA-Cl ion channel function. On the other hand, neither the GABA agonist nor anticonvulsants affected NMDA-induced convulsion. These results also provide evidence that the convulsive effects of bicuculline and picrotoxin may be mediated by indirect activation of NMDA systems through their Cl ion channel-blocking action, whereas the convulsive effects of NMDA may involve the activation of NMDA-Ca ion channel function without the GABA-Cl ion channel activities.

In this study, cocaine (5-20 mg/kg), an indirect dopamine agonist, increased locomotor activity and rearing accompanied with head circling and body shaking in a dose-dependent manner. A high dose of cocaine (40 mg/kg), meaning a toxic dose, slightly induced sniffing and licking. Both SCH23390, a D-1 receptor antagonist, and raclopride, a D-2 antagonist, inhibited all behaviors induced by cocaine, suggesting that the behavioral actions of cocaine may involve the activation of D-1 and D-2 receptors. Selective D-2 agonist quinpirole (0.1 and 1.0 mg/kg) inhibited hyperlocomotion induced by cocaine (20 mg/kg), but was replaced by the typical stereotyped behaviors such as sniffing at low dose (0.1 mg/kg), and licking and gnawing at high dose (1.0 mg/kg). SKF38393, a selective D-1 agonist, in combination of cocaine did not induce these stereotyped behaviors which resulted in synergistic interaction of D-1 and D-2 receptor stimulation. These results suggest that the indirect stimulation of postsynaptic D-2 receptors by cocaine (20 mg/kg) was insufficient to induce stereotyped behaviors. The actions of cocaine on dopamine D-1 receptors seem to be more potent than that on D-2 receptors.

The K-band fade statistics in Tokyo were measured using an antenna (beamwidth of 19.5/spl deg/ in elevation and 6.5/spl deg/ in azimuth) at elevations ranging from 37 to 80/spl deg/. The results show that line-of sight communication is possible only /spl sim/33% of the distance at elevations

Fade statistics were measured along 4095 km of expressways using a 12 dBi gain antenna with an automatic tracking system. The results show that the line-of-sight statistics, which were available for more than 90% of total distance, can be described by a Rician distribution with Rician factors of 15 to 25 dB.

A new type of protected mesoionic triazoline nucleoside was synthesized by the reaction of protected 1,2-dideoxy-hydrazino-D-ribose or 1-deoxy-hydrazino-D-ribose with isothiouronium compounds. The three compounds obtained 10a, 10f and 16a were deprotected with tetrabutylammonium fluoride. They showed no activity against HSV-1 virus.

1. The Tugaru Zyuniko Lake Group is situated in the small valleys and small basins on the marine terraces at the southwestern corner of Aomori Prefecture. The lake group consists of 33 lakes, including small ponds. 2. The topography of the region is hilly. The water system is rather abnormal. The formation of the region is pearlitic tuff in which the lake basins have been excavated. 3. All the lakes are very small. There are only 12 lakes whose areas exceed 1 hectare. Even the largest lake, Oike has an area of only 9.1 hectare. These water surfaces total 46 hectares. 4. These lakes were sounded in the summer of 1934 from a portable rubber boat. They are very deep in spite of their small water surfaces. The maximum depth (27-3m) was found in Oike. The bottom configuration was fairely complex in some lakes. 5. Half of the lakes have no outlet. 6. The northern and southern lakes (Kosiguti-ike and the Oike hake Groups) and the middle lake group (ItobatakeRike and the Menkozaka-ike Lake Groups) are distinguished for their peculiar morphology and hydrology as seen in a table at following page. _??_

The topography of nerves and first molar tooth germs in 11-14-day embryos was studied using silver-impregnated serial sections. Nerve fibers growing toward the developing tooth germ became visible on the 12th day, while the first sign of molar tooth differentiation was found as a thickening of the oral epithelium in 11-day embryos. From the 12th to 13th day the nerve fibers spread, forming a plexus close to the base of the tooth bud, and on the 14th day some entered into the dental follicle of the tooth germ at the early cap stage. However, no nerve fiber was found growing into the dental papilla during the observation period. The observations showed that the earliest nerve fibers running toward the tooth forming area appeared after the histogenesis of the tooth germ started, and the timing and pattern of the innervation of the tooth germs revealed that tooth germs are a useful model for investigating the mechanism of nerve growth into developing peripheral organs.

A 41-year-old male patient underwent transurethral resection for multiple bladder tumors in January, 1979. The pathological examination of the specimen revealed non-invasive transitional cell carcinoma G 2. Thereafter, transurethral coagulation and vesical instillation of various antitumor agents were carried out several times for tumor recurrence during the following eight months. X-ray examination for evaluation of macrohematuria, 15 months following the above treatment, showed left renal pelvic tumor. Left total nephro-ureterectomy was performed in July, 1981. However, microhematuria and class V in urine cytology were continuously observed postoperatively. Right total nephroureterectomy, followed by surgery of the internal shunt, was performed in January, 1982, after diagnosis of renal pelvic tumor by further investigation. Under maintenance hemodialysis, vagotomy and pylorus plastic operation were performed for gastroduodenal bleeding after the above surgery. Total cystectomy and urethrectomy along with irradiation during and after surgery were performed for tumor recurrence in November, 1982 and July, 1983 respectively. Unfortunately, the patient died of multiple liver metastasis and gastro-intestinal bleeding in September, 1983. All the tumor specimens showed the same histological characteristics, i.e., transitional cell carcinoma G 3. Twenty six Japanese cases of epithelial tumors of the bilateral upper urinary tract are reviewed.

This study seeks to determine whether hpGRF-(1-44) stimulates pituitary growth hormone (GH) secretion and cAMP accumulation in a manner that is consistent with the concept of cAMP as an intracellular mediator of GH release. Addition of 10 nM hpGRF-(1-44) to rat anterior pituitary cell cultures stimulated a rapid elevation of intracellular cAMP that preceded or coincided with increases in GH and cAMP secretion. A dose-related increase in GH and cAMP release and in intracellular cAMP accumulation was observed in response to increasing concentrations of hpGRF-(1-44). Stimulation of cAMP accumulation and release, however, occurred over a hpGRF-(1-44) concentration range that was approximately one order of magnitude higher than required for dose-related GH release. Simultaneous addition of 0.05 nM hpGRF-(1-44) and 0.2, 0.5, or 1.0 mM 3-isobutyl-1-methylxanthine (MIX) to the cultures resulted in a significant potentiation of intracellular cAMP accumulation and release. Potentiation of GH release was not observed, however, probably due to attainment of maximal or near maximal GH release by MIX alone. The addition of increasing doses of exogenous N6-O2'-dibutyryladenosine 3',5'-cyclic monophosphate (DBcAMP) to cell cultures resulted in a dose-related increase in GH secretion. The results of this study are consistent with the concept of cAMP as a second messenger for hpGRF-(1-44) in stimulating GH release. Additionally, a novel method for cAMP extraction that utilizes trifluoroacetic acid is described.

A new spironucleoside structural type and two new bicyclic nucleoside structural types were synthesized from the reaction of ribose nitrile oxide with dimethyl acetylenedicarboxylate. Next, a synthetic method for novel meso-ionic nucleoside structual type is presented.

The hypophysiotropic activities of a synthetic human pancreatic growth hormone releasing factor (hpGRF) with 40 residues was examined in vitro using rat pituitary halves. At concentrations from 10(-10) M to 10(-7) M the peptide stimulated GH release in a dose-dependent manner with the ED50 being 1.2 x 10(-9) M. The concentration of 10(-10) M hpGRF is comparable to the basal hypophyseal portal blood levels of other known hypothalamic hypophysiotropic hormones. However, GH release was enhanced three-fold by concentration as low as 10(-12) M, though no dose-response relationship was observed up to 10(-10) M. Thus, this peptide not only stimulates the release of GH in a dose-dependent manner, but at lower concentrations also maintains elevated GH levels. The release of ACTH, beta-endorphin, LH, and FSH was not affected by hpGRF at any of the concentrations tested. At hpGRF concentrations less than 10(-7) M, the release of TSH and PRL were unaffected. However, at 10(-6) M, TSH release was enhanced about 2.5 fold and prolactin release was elevated slightly.