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Nonadherence among pediatric transplant recipients is a significant problem that reduces graft survival and leads to poor kidney graft outcomes. It is, however, extremely difficult to detect during a regular follow-up. This study, therefore, aimed to investigate the risk factors involved in nonadherence, focusing on unexplained transient hyperuricemia in pediatric kidney transplant (KTx) recipients at a single pediatric center.This retrospective study included 167 patients who underwent KTx at our pediatric center. A Cox proportional hazards analysis was performed to evaluate the risk of nonadherence using the following factors: age, sex, body mass index SD score, transient hyperuricemia, hypertension, and follow-up period.Nonadherence was identified in 19 patients (11%), with the average (SD) age and post-KTx duration at diagnosis being 17.21 (4.73) years and 79.21 (38.77) months, respectively. Thirty-four patients (20%) were diagnosed with transient hyperuricemia at a median of 14 months after KTx. On multivariate Cox regression analysis, transient hyperuricemia was the only independent risk factor for nonadherence after KTx.Transient hyperuricemia was identified as one of the risk factors for nonadherence after KTx; therefore, careful monitoring for transient hyperuricemia may allow early detection of nonadherence.

Objective Radiofrequency, cryoablation and cut-and-sew technique have been used for surgical ablation to treat atrial fibrillation. Ultrasonicscalpel is a surgical instrument used to simultaneously cut and cauterize tissue by ultrasound vibration. This device causes minimal lateral thermal tissue damage and increases the tissue penetration depth linearly with time. These features are suitable for surgical ablation for atrial fibrillation. This study evaluated surgical ablation with ultrasonic scalpel for atrial fibrillation. Methods From October 2017 to February 2019, 46 patients (mean age: 71.8 years [46–86], 28 male) with mitral valve procedure underwent surgical ablation using ultrasonic scalpel for atrial fibrillation. The ablation lines were carried out with Cox maze procedure or pulmonary vein isolation (PVI) on cardiopulmonary bypass. Endocardial atrial wall was ablated by direct touch with blade in a few seconds at energy level 5. Pathological study of left atrial wall received ablation with ultrasonic scalpel was carried out. Results Type of preoperative atrial fibrillation was persistent in 33 and paroxysmal in 13 patients. Mean left atrial diameter was 49.0 mm (35–81). Surgical ablation using ultrasonic scalpel was carried out to left atrium only or PVI in 33 patients and both atria in 13 patients. Mean surgical ablation time was 4 minutes and 21 seconds. Mitral valve repair and replacement were performed in 33 and replacement in 13 patients, respectively. Simultaneous surgery included 43 tricuspid valve repairs, 11 aortic valve replacements, and 7 coronary artery bypass grafting. Cardiopulmonary bypass and aortic cross-clamp times were 142.6 (70–261) and 98.6 (47–202) minutes, respectively. No operative death or perioperative stroke were observed. Thirty-eight patients (82.6%) returned to sinus rhythm immediately after surgery. Sinus rhythm was maintained in 30 patients (65.2%) in the mid-term period with average 142.2 days after surgery (7–426 days). Pathological study showed the atrial walls were not ablated transmurally. No complications including bleeding and tissue injury were observed. Conclusion Surgical ablation with ultrasonic scalpel for atrial fibrillation was feasible and provided satisfactory outcomes immediately after surgery and at mid-term. This technique can be performed in a short time without complications. Interestingly, pathological study showed no transmural tissue ablation despite of successful outcomes. This may imply transmural ablation is not necessarily mandatory for surgical ablation. Long-term follow-up are required to evaluate this technique.

SUMMARYThe present study investigated the dry matter yield (DMY) and arbuscular mycorrhizal (AM) colonization (internal hyphae, arbuscules, and vesicles) of two genotypes of zoysia grass (Zoysia japonica strain Aso and cv. Asagake) at three rates (10, 20 and 40 g N/m2/year) of application of digested slurry (DS) or mineral fertilizer. Soil chemical properties (available phosphorus concentration, pH and electrical conductivity (EC)) were also measured as factors associated with AM colonization. The fertilizer type (DS v. mineral fertilizer) had an effect on DMY depending on the plant genotypes but had little or no effect on AM colonization, and soil chemical properties, indicating that DS can be used as a substitute for mineral fertilizer; however, it is necessary to apply it taking into account the ratio of inorganic nitrogen (N). However, heavy DS application decreased colonization by internal hyphae. Furthermore, even at the lowest rate, the continuous application of DS decreased colonization by arbuscules and vesicles in both genotypes, which were associated with decreasing soil pH and increasing EC. The results suggest that zoysia grass should be fertilized with DS at a rate of 2/year in order to achieve a continuous association with AM fungi, although this range of N application is sub-optimal for zoysia grass production.

Background Olanzapine (OLZ) 10 mg added to standard antiemetic therapy including aprepitant (APR), palonosetron (PALO), and dexamethasone (DEX) has been recommended for the prevention of chemotherapy-induced nausea and vomiting (CINV) caused by cisplatin. Guidelines suggest that OLZ at a dose of 5 mg should be taken into consideration in patients at risk of sedation. OLZ 5 mg showed an equivalent activity and favorable toxicity to somnolence in several phase II studies. We conducted a randomized, double-blind, placebo-controlled phase III trial to evaluate OLZ 5 mg in addition to standard antiemetic therapy for the prevention of CINV. Methods Patients receiving cisplatin (≥ 50 mg/m2) were randomly assigned to either OLZ 5 mg or placebo on days 1–4, combined with APR, PALO and DEX. The primary endpoint was complete response (CR), defined as no vomiting and no rescue medications in the delayed phase (24–120 h). As the secondary endpoints, frequency of sleepiness during daytime and appetite loss were assessed by patient reported outcome. Results A total of 710 patients were enrolled (OLZ 356 and placebo 354). CR in the delayed phase was significantly increased with OLZ than with placebo (79% vs. 66%, P Conclusions OLZ 5 mg can be considered a new standard antiemetic therapy in patients receiving cisplatin-based chemotherapy. Sleepiness during daytime due to OLZ 5 mg seems to be tolerable and addition of OLZ 5mg to the standard antiemetic therapy may reduce appetite loss. Legal entity responsible for the study Masakazu Abe. Funding Japan Agency for Medical Research and Development. Disclosure S. Iwasa: Honoraria (self): Taiho pharmaceutical; Honoraria (self), Research grant / Funding (institution): Lilly Japan; Honoraria (self), Research grant / Funding (institution): Chugai Pharma; Honoraria (self): Ono Pharmaceutical; Research grant / Funding (institution): Daiichi Sankyo; Research grant / Funding (institution): Bristol-Myers Squib; Research grant / Funding (institution): Eisai; Research grant / Funding (institution): Novartis; Research grant / Funding (institution): Merck Serono; Research grant / Funding (institution): Otsuka; Research grant / Funding (institution): Bayer. N. Yamamoto: Honoraria (self): AstraZeneca; Honoraria (self), Research grant / Funding (institution): Pfizer; Honoraria (self), Research grant / Funding (institution): Chugai Pharma; Honoraria (self), Research grant / Funding (institution): Bristol-Myers Squibb Japan; Honoraria (self), Research grant / Funding (institution): Ono Pharmaceutical; Honoraria (self), Research grant / Funding (institution): Lilly Japan; Research grant / Funding (institution): Taiho Pharmaceutical; Advisory / Consultancy, Research grant / Funding (institution): Eisai; Research grant / Funding (institution): Astellas Pharma; Research grant / Funding (institution): Novartis; Research grant / Funding (institution): Daiichi Sankyo; Advisory / Consultancy, Research grant / Funding (institution): Boehringer Ingelheim; Advisory / Consultancy, Research grant / Funding (institution): Takeda; Research grant / Funding (institution): Kyowa Hakko Kirin; Research grant / Funding (institution): Bayer; Research grant / Funding (institution): Janssen; Research grant / Funding (institution): IQVIA; Research grant / Funding (institution): MSD; Research grant / Funding (institution): Abbvie; Research grant / Funding (institution): Merck Serono. Y. Ohe: Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): AstraZeneca; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Chugai Pharma; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Lilly Japan; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution), Shareholder / Stockholder / Stock options, An Immediate Family Member : Ono Pharmaceutical; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Novartis; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Kyorin; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Takeda; Honoraria (self), Advisory / Consultancy: Celltrion; Honoraria (self), Advisory / Consultancy: Amgen; Honoraria (self), Research grant / Funding (institution): Bristol-Myers Squibb Japan; Honoraria (self): Boehringer Ingelheim; Honoraria (self): Bayer; Honoraria (self), Research grant / Funding (institution): Pfizer; Honoraria (self): MSD; Honoraria (self), Research grant / Funding (institution): Taiho pharmaceutical; Honoraria (self): Kyowa Hakko Kirin; Research grant / Funding (institution): Sumitomo Dainippon Pharma; Research grant / Funding (institution): Ignyta. All other authors have declared no conflicts of interest.

We propose a method to extract palette colors from an image and edit the image for palette-based photo recoloring. A previous study proposed an editing method that used a color palette. However, that method had some constraints in changing the palette color, and it was also necessary for the user to determine the palette size. Undesirable luminance changes during color editing can be avoided by performing color editing using intrinsic color decomposition. The palette size is estimated using the Bayesian information criterion for the palette colors extracted from the reflectance image; this can later be arbitrarily changed by the user. We evaluated our approach via a user study, showing that it is more precise and faster at matching the image to the target than a previously reported method.

This paper discusses what effects of magnetization saturation has on the cogging torques of 12-pole motors with 9-slot cores, using Nd-Fe-B ring magnets. The core flux density is changed with sintered, bonded and thermally demagnetized magnets. Cogging torques especially 36th harmonics, increase with the higher flux densities of the core at the teeth, and then magnetic saturation makes cogging torques larger. However, the harmonics of core flux densities are low although 36th cogging torques are related to the harmonics of core flux. Therefore, increasing cogging torques with magnetization saturations may be affected by the reduction in permeabilities due to magnetic saturations and the generation of core-flux density harmonics.

We herein report the case of a 12-year-old boy with dense deposit disease (DDD) evoked by streptococcal infection. He had been diagnosed to have asymptomatic hematuria syndrome at the age of 6 during school screening. At 12 years of age, he was found to have macrohematuria and overt proteinuria with hypocomplementemia 2 months after streptococcal pharyngitis. Renal biopsy showed endocapillary proliferative glomerulonephritis with double contours of the glomerular basement membrane. Hypocomplementemia and proteinuria were sustained for over 8 weeks. He was suspected to have dense deposit disease due to intramembranous deposits in the first and the second biopsies. 1 month after treatment with methylprednisolone pulse therapy, proteinuria decreased to a normal level. Microscopic hematuria disappeared 2 years later, but mild hypocomplementemia persisted for more than 7 years. Nephritis-associated plasmin receptor (NAPlr), a nephritic antigen for acute poststreptococcal glomerulonephritis, was found to be positive in the glomeruli for more than 8 weeks. DDD is suggested to be caused by dysgeneration of the alternative pathway due to C3NeF and impaired Factor H activity. A persistent deposition of NAPlr might be one of the factors which lead to complement dysgeneration. A close relationship was suggested to exist between the streptococcal infection and dense deposit disease in this case.

In this study, a novel electrode material, modified activated carbon aerogel, has been developed for electric double-layer capacitors (EDLCs). This novel material was produced by the activation of carbon aerogel under CO2 flow, followed by surface modification with a surfactant, sodium oleate. It has been characterized by BET measurement and BJH method for its surface area and pore-size distribution, and by constant-current charge–discharge technique, cyclic voltammetry and electrochemical impedance spectrum (EIS) for its specific capacitance, equivalent series resistance and power capability. It was found that, after the surface modification, the wettability of the organic electrolyte based on non-polar organic solvent (i.e., propylene carbonate) to the activated carbon aerogel was improved greatly, which resulted in a lower internal resistance and a higher usable surface area. As results, a higher specific capacitance, energy density and power capability were achieved for the capacitor using the modified activated carbon aerogel electrodes than those without the surface modification. The effects from the surface modification became more significant at higher charge–discharge rates, at which the wettability of the electrolyte to the electrode material usually becomes more important and critical.

A novel cylindrical battery which uses carbon fibres with high specific surface area as electrodes and a porous silica glass with high chemical stability as membrane has been fabricated. The results obtained from electrolysis of 0.5 M K3Fe(CN)6–0.5 M KCl and of 85 mM V(IV)–1 M H2SO4 indicate that the cell possesses excellent electrolytic efficiency. As a redox flow battery (RFB) its performance was investigated by employing all-vanadium sulfate electrolytes. The results of the cyclic voltammetry measurements indicate that at a glassy carbon electrode the electrochemical window for 2 M H2SO4 solution could reach 2.0 ∼ 2.4 V. Constant current charging–discharging tests indicate that the batteries could deliver a specific energy of 24 Wh L−1 at a current density of 55 mA cm−2. The open-circuit cell voltage, after full charging, remained constant at about 1.51 V for over 72 h, while the coulombic efficiency was over 91%, showing that there was negligible self-discharge due to active ions diffusion through the membrane during this period.

In this study, the electrochemical behavior of the Ce(III)/Ce(IV) redox couple in sulfuric acid medium with various concentrations and the influence of the operating temperature were investigated. A change of the concentration of sulfuric acid mainly produced the following two results. (1) With an increase of the concentration of sulfuric acid the redox peak currents decreased. (2) The peak potential separation for the redox reactions increased with rising concentration of sulfuric acid from 0.1 to 2 M and then decreased with further increase of the concentration. Elevated temperature was electrochemically favorable for Ce(III)/Ce(IV) couple, which caused an increase of the peak currents for the redox reactions and a decrease of the peak potentials separation. Constant-current electrolysis shows that the current efficiency was 73% for the oxidation process of Ce(III) and 78% for the reduction process at 298 K, and could be improved by elevating the temperature. The open-circuit voltage of the Ce–V cell, after full charging, remained constant at 1.870±0.005 V for more than 48 h, and is about 29% higher than that of the all-vanadium batteries. The coulombic efficiency was approximately 87%, showing that self-discharge of the Ce–V battery was small. The preliminary exploration shows that the Ce(III)/Ce(IV) couple is electrochemically promising for redox flow battery (RFB) application.

硝酸溶液中におけるベンズイミダゾール基を交換基とするアニオン交換体AR-01Rの耐熱および耐放射線性試験を行い, 交換容量の変化を中心に構造および形状の変化を調べ, 市販の4級アンモニウム基を有するアニオン交換体Amberlite IRA-900との安定性比較を行った。IRA-900に比べ, AR-01Rが優れた耐熱性および耐酸性を示し, 9mol・dm-3硝酸溶液中で72時間浸漬後の総交換容量低下率は10%以下であることが認められた。一方, γ線照射による交換容量の低下は, 両者がほぼ同程度であり, 室温にて9mol・dm-3硝酸溶液中で3.0MGy吸収線量により総交換容量の低下率は20～25%程度であった。AR-01交換体の劣化では, 熱ならびにγ線照射による強塩基性交換基の弱塩基化が顕著であることが認められた。

Compressive stress in ZnO thin film on a glass substrate deposited by radio frequency (rf) magnetron sputtering has been investigated. ZnO was deposited through a stainless mask with rectangular windows, which was placed directly on a glass substrate with Al electrodes. The electrodes called inter-digital transducers, were fabricated on the substrate before the deposition of ZnO. Depending on the sputtering conditions, the substrate was cracked from the triple point (T.P.), where the edge of an Al electrode and an edge of the ZnO were crossing. It has been made clear by X-ray diffraction analysis that the lattice spacing of the c -plane of ZnO on an Al electrode was about 0.27% longer than that on a glass substrate. Finite element method (FEM) analysis revealed that the residual tensile stress was concentrated at the edge of ZnO film. Moreover, owing to the crossing of the Al electrode and ZnO, the stress is extremely magnified. The crack is originated from the T.P. and grows along the edge of the ZnO. Electrically floating of the stainless mask from the earth reduces the c-lattice spacing difference from 0.27–0.02%, which reduces the formation of the crack.

Summary The thrombolytic and pharmacokinetic properties of scu-PA/MA-FU1-74 F(ab′)2 complex, an immunoconjugate of single-chain urokinase-type plasminogen activator (scu-PA) and the F(ab′)2 of a bispecific monoclonal antibody (MA-FU1-74) directed against human fibrin and against u-PA, were evaluated in humsters with pulmonary embolus. Bolus injection of scu-PA/MA-FU1-74 complex and scu-PA/MA-FU1-74 F(ab′)2 complex (each in a 1:2 molar ratio) showed 18- and 23-fold enhanced thrombolytic potency relative to that of scu-PA alone, respectively. Enhanced clot lysis by the scu-PA/MA-FU1-74 complex was accompanied by an increase in consumptions of fibrinogen and α2-antiplasmin by 3.7-and 6.5-fold, respectively, when compared to consumptions by scu-PA alone. Consumptions of fibrinogen and α2-antiplasmin by the scu-PA/MA-FU1-74 F(ab′)2 complex, however, was only marginally increased (1.2- and 1.8-fold, respectively) relative to that of scu-PA alone. Both complexes, scu-PA-FU1-74 and scu-PA/MA-FU1-74 F(ab′)2, showed a 10-fold decrease in plasma clearance when compared to unconjugated scu-PA. In monkeys, immune responses to MA-FU1-74 F(ab′)2 appeared to be lower than those to the whole MA-FU1-74 molecule. We conclude that the scu-PA/MA-FU1-74F(ab′)2 complex is more fibrin-specific and less immunogenic than the scu-PA-FU1-74 complex.

Targeting of plasminogen activators to the fibrin component of a thrombus with the use of monoclonal antibodies (MA) directed against human fibrin may enhance their thrombolytic potency and fibrin- specificity. The thrombolytic and pharmacokinetic properties of rscu- PA/MA-FU1–74, an immunoconjugate of recombinant single-chain urokinase- type plasminogen activator (rscu-PA) and a bispecific MA directed against u-PA and against the beta-chain of human fibrin (MA-FU1–74), were investigated in baboons with a [125I]fibrin-labeled autologous blood clot in the femoral vein. Continuous intravenous infusion of rscu- PA/MA-FU1–74 (1:1.2 molar ratio) over 2 hours showed a fivefold increased thrombolytic potency (lysis per unit dose) over that of unconjugated rscu-PA, as evidenced both by a higher maximal rate of lysis (380% +/- 68% v 78% +/- 25% lysis per mg u-PA equivalent of compound administered per kg body weight, P less than .001), and by a lower dose at which the maximal rate of lysis occurs (0.19 +/- 0.03 v 0.82 +/- 0.10 mg compound per kg body weight, P less than .001). The specific thrombolytic activity (percent lysis per unit steady-state plasma u-PA antigen level) was lower for rscu-PA/MA-FU1–74 than for rscu-PA, as shown by both a lower maximal rate of lysis (60% +/- 13% v 220% +/- 22% lysis per microgram/mL u-PA antigen level in plasma, P less than .001) and a higher plasma antigen level at which maximal lysis is achieved (1.2 +/- 0.17 v 0.20 +/- 0.01 microgram/mL, P less than .001). The thrombolytic potency of rscu-PA/MA-UK1–3, an immunoconjugate of rscu-PA with the parental anti-u-PA antibody was similar to that of unconjugated rscu-PA. Clot lysis was achieved without systemic fibrinogen or alpha 2-antiplasmin consumption, and with a minor transient prolongation of the bleeding time. After the end of the infusions, u-PA-related antigen disappeared from plasma in a biphasic manner, with an initial half-life of 3.3 +/- 0.4 minutes for rscu-PA, 13 +/- 1 minutes for rscu-PA/MA-FU1–74, and 13 +/- 1 minutes for rscu-PA/MA-UK1–3, with corresponding plasma clearances of 340 +/- 28, 10 +/- 1, and 37 +/- 4 mL/min, respectively (mean +/- SEM). rscu- PA/MA-FU1–74 has a fivefold higher thrombolytic potency than unconjugated rscu-PA, as a result both of fibrin targeting by the specific idiotype of the antibody and of a slower plasma clearance.

This paper describes the fabrication and performance of CMOS transistors featuring flash lamp annealing (FLA) for 45 nm node. We show, for the first time, applying FLA prior to spike RTA as S/D annealing is effective to enhance the channel stress in PFET with epitaxially grown SiGe (eSiGe) S/D. In NFET, FLA recovers the damaged layer in S/D extension caused by implantation and suppresses the transient enhanced diffusion (TED). These improvements result in 11% and 8% higher saturation drive current, and IDSAT=750muA/mum and 1160muA/mum for IOFF=100 nAmum at Vdd=lV in PFET and NFET, respectively. We also report the pattern density dependence of performance gain from FLA technique.

Cytokeratin (CK) 13 is an intermediate filament protein that is expressed in a cell-type-specific manner, in the tongue and occasionally in tongue squamous cell carcinoma (SCC). Correlations between the clinical features of patients with SCC and CK13 expression in the tumor are here investigated along with CK13's utility as a marker for tongue cancer status. Samples from 121 patients with SCC of the tongue were examined by immunohistochemistry with antibodies against CK13. Correlations between the expression level of CK13 in the tumor and the patients' clinical features were statistically analyzed by univariate and multivariate methods. Univariate analysis showed a more relevant number of local recurrence (P = 0.04) in CK13-negative staining patients. In addition, CK13-negative cases were associated with local recurrence by multiple logistic regression analysis (OR: 3.36; 95% CI: 1.044-10.78; P = 0.04). Our results suggest that the loss of CK13 expression indicates tumors with a high potential for recurrence, and thus CK13 could be useful for determining the best course of treatment.

The effect of stress memorization technique (SMT) in performance and power reduction is maximized by choosing the appropriate stressor with large stress change by spike RTA. 30% mobility enhancement and 60% reduction of gate leakage have been achieved simultaneously. Stress distribution in channel region for SMT is confirmed to be uniform, hence layout dependency is minimized and performance is maximized in aggressively scaled CMOS with dense gate pitch rule (190 nm) in 45 nm technology node.

We successfully developed a 0.246-μm2 embedded 6T-SRAM for high performance system LSIs. The 45-nm CMOS platform, which features reversed extension and S/D formation, achieves both high performance logic transistors (TV.) and SRAM integration. To take the worst case of process variations into consideration, cell layout is decided by a novel method using SRAM macros, which include over 100 sorts of parametrically designed cell layouts. As a result, the 0.246-μm2 SRAM has been successfully developed with 140 mV of static noise margin (SNM) at 0.6 V and Vccmin of 0.9 V.

A 10-day-old neonate with Darling type Ia of total anomalous pulmonary venous connection is presented. The left pulmonary vein entered the right thoracic cavity behind the right atrium and drained into the innominate vein together with the right lower, middle and upper pulmonary veins. The patient was treated with right-sided approach. The postoperative course was uneventful. To our knowledge, this case is the first successful correction of this subtype of anomaly in Japan.

We present the state-of-the-art 45nm high performance bulk logic platform technology which utilizes, for the first time in the industry, ultra high NA (1.07) immersion lithography to realize highly down-scaled chip size. Fully renovated MOSFET integration scheme which features reversed extension and SD diffusion formation is established to meet Vt roll-off requirement with excellent transistor performance of Ion=1100muA/mum for nFET and Ion=700muA/mum for pFET at Ioff=100nA/mum. Also, we achieved excellent BEOL reliability and manufacturability by implementing hybrid dual-damascene (DD) structure with porous low-k film (keff=2.7)

A 75-year-old man with dyspnea was admitted to our hospital in critical condition. Catheterization showed normal coronary arteries and good left ventricular function. Transesophageal echocardiography showed left ventricular hypertrophy and severe mitral regurgitation. We decided to perform mitral valve replacement because the patient was in critical condition and it was necessary to complete the operation smoothly. During the operation, we could see the dilated mitral valve annulus and hypertrophic mitral valve, which was restricted. The patient's hemodynamics showed improvement after mitral valve replacement with a mechanical prosthesis, and he was discharged on postoperative day 21. In conclusion, mitral valve replacement is a beneficial method for the treatment of patients with critical hypertrophic obstructive cardiomyopathy.

High performance CMOSFET technology for 45nm generation is demonstrated. The key device strategies for junction scaling, gate stack scaling and stress-induced mobility enhancement are discussed. Reversed-order junction formation improves short channel effect (SCE) drastically. Novel SiON with improved poly-Si gate depletion improves the drive current by 8%. The systematic study on the process-induced mobility enhancement is performed and it is confirmed that the new scheme such as eSiGe and stress liner techniques are suitable for 45nm technology CMOSFET. It is confirmed that the stress enhancement factors using multiple booster techniques remain valid, which proves that these techniques are scalable for future technology

An anastomosis assist mirror for off-pump coronary artery bypass (OPCAB) is described. This new device is designed to make a view of the circumflex coronary artery which is often troublesome to access during OPCAB. It is composed of 3 parts: a small circular mirror, a paper clip and a flexible arm between the mirror and the clip. The paper clip is situated at an edge of a sternal retractor. The mirror is positioned beside the sheer surface of the lateral wall of the heart by regulating the flexible arm. It shows a flat, reflective view of the anastomotic site and makes an anastomosis easy. The device enables us to avoid excessive manipulation on the heart and hemodynamic instability, thereby reducing unnecessary volume overload, inotropic drugs or mechanical cardiac assistance.

Many cases have been successfully treated by us with experimented nifekalant hydrocholoride to prevent ventricular tachycardia (VT) during cardiac surgery. The 13 patients who underwent cardiac surgery at our hospital from 1999 to 2002 were retroactively given nifekalant hydrocholoride against VT. Lidocaine hydrochloride was not effective for VT, and it was difficult for 3 patients to be weaned for cardio-pulmonary bypass, while 6 patients needed aortic balloon pumping or percutaneous cardio-pulmonary support. Nifekalant hydrochloride suppressed VT induction in 9 patients (69.2%). Blood pressure and heart rate did not change, but QTc intervals were significantly increased with nifekalant hydrochloride (p0.005). Proarrhythmic events (Torsades de pointes) occurred in 2 patients, but none of the cases showed drug-induced worsening of cardiac function. Nifekalant hydrochloride is a class III antiarrhythmic drug that has been found to be effective against VT and ventricular fibrillation. While class I antiarrhythmic drugs are usually ineffective and induce severe heart failure, nifekalant hydrochloride can be effective.

The Bi-Digital O-Ring Test has been very useful in the identification of bacterial and viral infections, as well as other etiological agents, in difficult clinical cases. Case report of a patient with multiple hepatic abscesses (pylephlebitis induced hepatic abscess is the most difficult abscess to treat), in which the etiological agent was suggested through Bi-Digital O-Ring Test with excellent clinical evolution after modification of previously ineffective multi anti-microbial treatment is presented. 45 years old, female with a history of pain at right hypochondria for 15 days, with jaundice, oscillating fever and shivering. Computerized tomography showed liver with multiples nodules in the parenchyma with additional appendicitis. An appendectomy was performed with drainage of intra abdominal abscesses. Treatment with metronidazol, ceftazidim and amicacine was performed with no improvement while the general condition of the patient was deteriorating progressively in the following 3 weeks. Bi-Digital O-Ring Test was then performed to determine the etiological agent and the drug compatibility test among effective antimicrobial agents. Based on the Bi-Digital O-Ring Test, the main etiological agent was found to be Enterobacter aerogenes. Amongst the three antibiotics that were being used, only metronidazol was effective and the other 2 was cancelled its effect. Based on Bi-Digital O-Ring Test findings two new antibiotics (cefadroxil and imipenen), were added to metronidazol and additional cilantro tablets by Hayashibara, Japan was given, and Selective Drug Uptake Enhancement Method performed, with excellent clinical, laboratory testing and tomography improvement within 10 days. Bi-Digital O-Ring Test suggested the etiological agent, and effective and mutually compatible antibiotics for treating the abscesses which resulted in a good clinical evolution, characterized by relief of fever and reduction of the hepatic abscesses in a short period and followed complete disappearance of hepatic abscess.

In the present study, the drainage system consisting of a silicon blake drain and a portable suction reservoir (J-vac system) was applied to the patients who received cardiac surgery (SD group). Postoperative drainage volume, postoperative pericardial effusion volume, and postoperative length of hospital stay in SD group were compared with those in the patients who received cardiac surgery and were applied a conventional chloroethlene drain (CD group). There were no significant differences in postoperative drainage volume, postoperative pericardial effusion volume, or postoperative length of hospital stay between SD and CD groups. Therefore, its was thought that a silicon back drain could be safely used as a drainage system after heart surgery. Recently the development of less-invasive cardiac surgery made the early hospital discharge possible, and J-vac system might be very useful in view of its portability under such clinical settings.

From January 2001 to January 2003, we performed 25 emergency off-pump coronary artery bypass grafting (CABG) procedures for patients with acute myocardial infarction (AMI) or unstable angina pectoris. During the same period, we also performed 2 emergency on-pump beating CABG procedures for patients with left main coronary trunk (LMT) shock syndrome. For the present study, we evaluated the operative results of the 25 cases of emergency or urgent off-pump CABG. The patients were divided into 3 groups, those with acute AMI with cardiogenic shock (group 1; n = 8), acute myocardial infarction without shock (group 2; n = 8), and unstable angina (group 3; n = 9). There were no differences between groups 1 and 2 with regard to age, number of diseased vessels, and preoperative use of an intraaortic balloon pump, however, patients in group 1 had a higher number of completely obstructed coronary arteries. Patients in groups 1 and 2 underwent off-pump CABG within 3.5 hours after a coronary angiography or coronary intervention procedure, while those in group 3 underwent off-pump CABG within 2 days of coronary angiography. The mean number of grafts per patient was 1.8, 2.1, and 2.3 in groups 1, 2, and 3, respectively. One group 1 patient with an LMT lesion was transferred to on-pump beating CABG because of hemodynamic instability. The 30-day mortality rate was 38% (3 of 8) in group 1, whereas it was 0% in groups 2 and 3. Intubation time, ICU stay, and postoperative stay were similar among the 3 groups. An early angiographic study was undertaken in all surviving patients and the results demonstrated patency in all of the examined grafts. Although our results are limited, emergency off-pump CABG was found to be safe and feasible for AMI without cardiogenic shock or unstable myocardial ischemia. However, the outcome of this procedure for patients with preoperative cardiogenic shock was not satisfactory, therefore, a combination therapy of appropriate mechanical circulatory support, prior revascularization by catheter intervention, and emergency surgical revascularization are considered to improve survival of those patients.

This study was undertaken to compare economic outcomes of off-pump coronary artery bypass grafting (off-pump CABG: OPCAB) and conventional CABG (CCABG). We reviewed the medical records of 5 patients with ischemic coronary disease (IHD) who underwent OPCAB and 5 patients with IHD who underwent CCABG. A hospital income which was based on a current Japanese health insurance system was indicated. There were significant differences in total cost (OPCAB = 208,200 +/- 7,383 yen versus CCABG = 324,300 +/- 10,290 yen, 35.8% decreased), costs of medical materials and transfusions (OPCAB = 14,760 +/- 3,270 yen versus CCABG = 87,540 +/- 3,326, 81.3% decreased) and charges of surgery and anesthesia (OPCAB = 130,400 +/- 1,853 yen versus CCABG = 147,650 +/- 4,167 yen, 12% decreased) OPCAB markedly reduces the cost of hospitalization. But charges of surgery and anesthesia of OPCAB seems to be valued properly in a current Japanese health insurance system.

An association between bicuspid aortic valve disease and ascending aortic aneurysma has long been recognized. Root replacement with a composite valve graft for such disease is a well-established technique. But it may involve serious technical difficulties, and may be a more time-consuming procedure than separate valve replacement and graft replacement. We performed an aortic valve replacement with Freestyle stentless valve using the modified subcoronary technique and hemiarch replacement for a 72-year-old man with severe aortic stenosis and ascending aortic aneurysma. Angiographic studies after surgery showed no residual aortic regurgitation (AR) and no deformity of aorta. This technique is an acceptable option for an aortic disease and ascending aneurysma in elderly patients.

This research evaluated the applicability of chlorination reaction treatment as processing technology to recover Zr metal which becomes reusable resources from radioactive Zr metal wastes. The typical waste generates from reprocessing facilities, and the main component of waste is a zirconium alloy containing 90–95% of Zr. At first, the volatility of ZrCl4 produced by the chlorination reaction of Zircaloy-2 was theoretically calculated with thermodynamic simulation code. The estimation showed that Zr could be effectively separated and recovered from this alloy by the difference of volatility in each element chloride. The chlorination reaction of metal proceeds as an exothermic reaction and the control of the reaction temperature is an important condition in order to perform optimal Zr separation recovery. The chlorination reaction of Zircaloy-2 was carried out in the low-temperature ranges of 220°C–320°C, and Zr separation performance was experimentally obtained. Zr and Sn (1.5wt% content in Zircaloy-2) volatilize 100% as chlorides at 270°C or higher temperature. The amounts of volatilization of Cr and Ni are 5% and 0.1% or less, respectively. Such volatile ability is well in agreement with the result of thermodynamic calculation quantitatively. The volatile behavior of Fe (0.2wt% or less content) in Zircaloy-2 is influenced by the product of FeCl2 which is due to the heat decomposition of FeCl3 with larger volatility, and the experimental volatility is smaller than the theoretical one. 60 Co produced in the radioactivated Co by neutron radiation is a highest radioactivity source in the hull waste and it should be completely separated and removed from the recovered Zr chloride. In this study, the metal powder of Co was used to measure the volatility, because the content of Co in Zircaloy-2 is very small quantity (20 ppm or less), The obtained volatility was a hundredth of the volatility of thermodynamics calculation. U and Cs also intermingle in the hull wastes by the solid solution or the adhesion of uranium fuel. The volatility of Cs and U in the chlorination reaction at 270°C was measured by using CsCl, and UO2 in the coexistence of Zircaloy-2. The volatility of UO2 and CsCl was 4times and thousand times higher than that without the alloy, respectively. The exothermic reaction in the chlorination of metal was inferred. However, the volatility did not influence the effective ability of decontamination for the recovered Zr chloride. In order to recover the high-level decontaminated Zr chloride from radioactive nuclides, it is necessary to efficiently remove radioactive nuclides, which are the sources of high radioactivity due to 60 Co, 63 Ni and 137 Cs. It was evaluated that a chemical addition treatment in which the amounts of radioactive nuclides relatively decreases by the amounts of radioactive nuclides relatively decreases by the amount of added stable isotopes of chemical compound was a effective treatment, on basis of the calculation of volatility of each element. The addition treatment of chemical compound performs in the distillation of Zr chloride obtained by the chlorination of hull waste. This study showed that a basic process of the high-level decontaminated Zr recovery consists of the two-step process of both chlorination reaction of the hull waste and distillation treatment of Zr chloride in addition of chemical compound.Copyright © 2003 by ASME

In this paper, we report for the first time on the mobility and reliability characteristics in 0.1 /spl mu/m gate MOSFET with RONO as gate dielectrics. The nand p-channel LDD FETs used in this study were fabricated on 6-inch (100) p-type silicon wafers. >

A new graft holding system for coronary artery bypass grafting was described. This system was an application of a memo-clip, which was composed of a flexible arm and 2 paper clips at both ends. A graft was wrapped by a piece of sponge and pinched indirectly by one of the clips. The other clip was fixed at an edge of the sternal retractor. Regardless of the size of the graft or the amount of the surrounding tissue, the graft can be fixed securely at one's pleased position due to a flexible arm of the device. Intimal injury can be avoided referring to the gentle holding of a piece of sponge. It enables us to place precise stitches and to minimize handling, anastomosis time, and leakage.

Development of a redundant macro-micro manipulator for compliant motion and its application to contour tasks are discussed. Redundant macro-micro manipulators under an appropriate control scheme could have numerous advantages: suitability to compliant motion using micro manipulators and a big motion range as a result of macro manipulators. However, we have to design these mechanisms carefully so as to get the desired merits of this system, because the performance of the control scheme is affected by the properties of this mechanism. In this report, development of a micro manipulator is presented for a given macro manipulator. The experimental results show that compliant motion of the developed mechanism is useful in contour tasks.

The development of a redundant macro-micro manipulator for compliant motion is discussed. Redundant macro-micro manipulators under an appropriate control scheme can have numerous advantages including: suitability to compliant motion using micro manipulators, and a wide motion range as a result of macro manipulators. However, we have to design these mechanisms carefully in order to obtain the desired merits of this system, because the performance of the control scheme is affected by the properties of this mechanism. In this paper, the development of a micro manipulator for a given macro manipulator is presented. The experimental results show how the developed mechanism produces compliant motion.

Bus-based shared-memory multi-processors (SM-MP) have successfully been used commercially, since implementation requires no drastic changes to the programming paradigm. In this paper we propose the memory structure called SSM-MP (Scalable shared-memory multi-processors), aimed to shorten the cache refill latency and to relax the bus bottle neck problem. In this machine, main memory consists of local memories dedicated to each of the processors and something called MTag. MTag is a small piece of hardware that filters out bus traffic headed to the system bus and maintains cache coherency. A popular UNIX (SVR4 ES/MP) was ported. Original OS code works well due to its natural locality. Furthermore, by allocating tasks to the local memory, we were able to reduce the system bus traffic to nearly a quarter. SSM-MP is an effective approach in building a multi-processor system with a medium number (4-32) of processors.

This paper proposes a cooperative control scheme of dual-arm robots, which produces a reasonable pair of the two endpoint motions of the arms for a given relative motion. A dual-arm system with a linear motion is discussed, and the principle of the control scheme is presented. The redundancy of the system and the problem of the motion distribution are explained. The concept of the absolute motion which represents the total motion of the system is introduced, and a cooperative control scheme of dual-arm robots is proposed, using this absolute motion. Basic equations are presented and a cooperative control scheme of dual-arm robots with six degrees of freedom is proposed. Finally, several simulation and experimental results are given to illustrate the validity of the proposed control scheme.

Interconnect delay is dominant in today's high speed VLSI circuits and there have been various studies on ways to resolve it. A repeater insertion tool "RePertory" has been developed to solve the interconnect timing problem on a 300 MHz 128-bit 2-way superscalar microprocessor. Because of its practical simple algorithm, the location of over 5700 repeaters distributed over 5 modules is calculated in 26 minutes on 5 UltraSPARC-II 360 MHz in parallel. This paper describes the goals of RePertory for this project, the timing improvement flow with RePertory, the results and analysis of this repeater insertion method.

The injectable cephalosporin cefpirome (CPR) was launched in Japan in 1993. It has widely been used in the various infectious diseases. We therefore studied the clinical and bacteriological efficacy of CPR against infections caused by Bacteroides species, Prevotella species and Porphyromonas species frequently isolated from the obstetric and gynecologic infections. Thirteen institutions were involved in this study which ran from March 1994 to January 1999. The administration dosage of CPR was 2 to 4 gram per day administered by drip infusion or intravenous infusion. The duration of treatment was from 3 to 15 days. The evaluations were performed before and after the treatment. CPR was administered to 194 patients with obstetric and gynecologic infections, and 146 of 194 cases were acceptable for the evaluation of drug efficacy. Bacteroides species were identified in 102 patients. Clinical efficacy in 146 cases was excellent in 12 patients, good in 110, fair in 9 and poor in 15 patients. The eradication rate for Bacteroides species could be in 37 cases out of 54 evaluable cases; Prevotella species in 38 out of 49; and Porphyromonas species in 5 out of 5. The overall assessment of bacteriological efficacy was "eradicated" in 91 cases out of 133 (68.4%). Adverse reactions including abnormal findings in laboratory tests were seen in 8 patients (4.76%). Based on these results, CPR promises efficacy and safety in the treatment of obstetric and gynecologic infections due to Bacteroides species.