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Background Poor preoperative nutritional and immunological status are major risk factors for postoperative complications in patients with various malignancies. Lower preoperative prognostic nutrition index (PNI) is associated with higher rates of postoperative complications and poorer prognosis in those patients. The aim of this study was to analyze the predictive value of the PNI for post-hepatectomy complications in patients with hepatocellular carcinoma (HCC), and evaluate its utility in the surgical procedure. Methods This retrospective study included 510 patients who underwent open hepatectomies for HCC. The predictive value of the preoperative nutritional and immunological status for postoperative complications was assessed using the PNI. Postoperative complications were defined as grade II or higher per the Clavien-Dindo classification. Postoperative complication rates were compared according to surgical procedure (major hepatectomy vs minor hepatectomy). Results Patients with postoperative complications had significantly lower PNIs than those without (43.1 ± 5.5 vs 47.0 ± 5.7, P < 0.001). In the multivariate analysis, low preoperative PNI (< 45) was an independent risk factor for postoperative complications after hepatectomy (hazard ratio, 3.85). When patients were classified per their PNI (high vs low) and extent of surgical procedures (major vs minor), there were more complications among patients with low PNI than those with high PNI, regardless of the extent of surgical procedures. Specifically, the group of patients with low PNI who underwent major hepatectomy had significantly higher rates of postoperative complications than the other groups. Conclusions Adding the resection range to the PNI is useful for predicting the postoperative morbidities of hepatectomy patients.

In the autonomous driving era, automotive architecture has been rapidly progressing toward electronic control unit (ECU) integration and centralization. Advanced vehicle control is becoming increasingly important for safe driving. It requires microcontroller unit (MCU) integration, the highest automotive safety integrity level (ASIL), and network performance improvement. A 28-nm 600-MHz automotive flash MCU has been developed for next-generation automotive architecture. The MCU for vehicle control integrates three key features: a virtualization-assisted processor (VAP) for functional safety, a built-in self-test in the field (field-BIST) at a sleep resume (SR) BIST for functional safety, and a serial gigabit media independent interface (SGMII) for the in-vehicle network. The VAP helps the hypervisor to realize real-time virtualization to execute several different virtual machines without interference. The SR-BIST realizes random hardware failures per hour of 10−8 in various automotive applications. In the SGMII circuit, we used 5-V transistors for high reliability despite their narrow bandwidth. The automotive MCU satisfies the ISO26262 ASIL D system requirements with a low power consumption of 0.52 W. The VAP can realize the severe automotive control hard real time capability.

Case report A 75-year-old man who underwent nivolumab as the third-line chemotherapy for advanced gastric cancer had chylous ascites (CA) after the primary tumor shrank remarkably. Total parenteral nutrition and subcutaneous octreotide were initiated, and CA disappeared. Nivolumab was continued for a total of 23 courses. Computed tomography showed lymph node swelling; however, staging laparoscopy showed that peritoneal metastasis had disappeared. Therefore, conversion surgery and distal gastrectomy with D1+ dissection were performed. Results The pathological diagnosis was type IV, poorly differentiated adenocarcinoma (por2) with signet ring cells, ypT2 (muscularis propria), without lymphatic or venous invasion, and no involvement of the proximal and distal margins. After the operation, no recurrence was observed over 7 months with no adjuvant chemotherapy. Conclusion Nivolumab has the potential to lead to R0 resection for patients with peritoneal carcinomatosis gastric cancer. To our knowledge, this is the first report of successful conversion surgery after nivolumab-related chylous ascites.

Automotive architecture has been rapidly progressing toward integration and centralization [1]. Integration of multiple electronic control units (ECUs) reduces vehicle weight by deleting the wire harness between ECUs and the cooperative control of multiple functions, resulting in energy savings. The power consumption of automotive MCUs must be single-digit Watts under thermal constraints, and many functions have to be squeezed into one MCU. Adoption of a 28nm process is necessary for speed, power and density, because a conventional 40nm embedded flash process is insufficient on these axes. Furthermore, the integration of ECUs also mixes software components with varying safety integrity levels in one MCU. Resource isolation is inevitable for functional safety to avoid latent faults. In the autonomous driving era, data size and performance requirements will increase owing to the number and complexity of sensors requiring fusion in real time. Fast networks within vehicles are vital. With the evolution of sensor fusion, information centralization, and control decentralization, automotive architectures have been progressing toward increased integration and centralization.

We report tunnel experiments on Bi 2 Sr 2 Ca 1-x Y x Cu 2 O 8+δ (Y-Bi2212) crystals with x=0, 0.01, 0.05, 0.1, 0.11, and 0.12. The results are discussed about Cooper pairs existing. Tunneling spectra were measured for Y-Bi2212 crystal-SiO-Ag planar junctions. For superconducting samples the V-shaped gap structure and zero bias conductance peaks (ZBCP) were observed. While neither superconducting gap nor ZBCP was observed for insulator samples. These results suggest that Cooper pairs break up on the insulating side of superconductor-insulator transition (SIT). We also measured tunneling spectra on (Bi 1-y Pb y ) 2 Sr 2 Ca 1-x Y x Cu 2 O 8+δ samples. In their spectra there were also several characteristic behaviors.

症例は67歳，男性．2009年10月自転車で走行中に車と衝突．下腹部打撲にて当院へ救急搬送された．バイタルサインは安定しており腹部CTでも臓器損傷は認めず，腹部打撲と診断し自宅での安静を指示した．しかし2日後に腹痛，嘔吐にて再受診．臍下部正中に膨隆を認め，同部に著明な圧痛を訴えた．腹部CTで皮下組織内に小腸が脱出しており，さらに口側腸管の拡張を伴い，外傷性腹壁ヘルニア嵌頓と診断し緊急手術を施行した．手術所見では白線部において筋膜から腹膜まで断裂しており，嵌頓小腸は壊死していた．他の腹腔内臓器には損傷は認めず小腸切除を行い，ヘルニアの修復は直接縫合閉鎖を行った．術後に創部感染を生じたが経過は良好であり，第39病日に退院した．

症例は75歳，男性．平成6年9月に小腸腫瘍の診断にて空腸切除術を施行．病理組織検査で平滑筋肉腫の診断（当時）を得た．以後定期的に腹部CT検査などを施行し，経過観察を行っていた．平成19年4月に臍部の皮下腫瘤を自覚し来院．精査にて腹腔内，臍部の皮下に多発する腫瘍を確認．臍部の病変に対し摘出生検を行い，併せて初回手術時の病理組織を新たに切り出して検索．類似した紡錘形，多角形細胞の束状の増殖を確認．免疫染色ではc-kitが瀰漫性に陽性であり，小腸GISTの再発と診断した．摘出手術は不能であり，直ちにメシル酸イマチニブ300mg/日の投与を開始．その後400mg/日まで増量したが腫瘍の縮小効果は得られず，全身状態が悪化し死亡した．手術後13年目での再発は稀であり，再発形態を含め若干の文献的考察を加えて報告する．

Membrane computing, which is a computational model inspired by the structures and behaviors of living cells, has considerable attention as one of non-silicon based computing. In the present paper, we propose EN P systems for basic operations, and sorting. We first propose three EN P systems for computing three logic operations, OR, AND, and EX-OR functions. All of the EN P systems work in a constant number of steps. Next, we propose two EN P systems that operates as a half adder and a full adder, and then, propose two EN P system for additions of two binary numbers and n binary numbers. We show the EN P systems for two additions work in O(m) steps and O(nm) steps, respectively. Finally, we propose two EN P systems for sorting. We propose an EN P system for compare-and-exchange operation. Then, using the EN P system as sub-systems, we propose an EN P system for sorting n numbers, and show that the EN P system works in O(n) steps.

腎細胞癌膵転移切除後の残膵再発に対し残膵全摘術を施行した1例を経験した.症例は56歳,男性. 1993年2月左腎細胞癌にて腎摘出術, 1995年12月膵頭部転移に対し膵頭十二指腸切除術を受け経過観察中, 2001年7月残膵に再発を疑われ当科紹介された.腹部CTで残膵体尾部と右腎に腫瘍陰影を,腹部血管造影では残膵に腫瘍濃染像を認めた. 2001年7月残膵全摘,脾摘術を, 9月右腎部分切除術を施行した.術後,病理組織学的に膵,腎ともに転移性腎細胞癌と診断した.術後経過は良好で, 2年6月経過した現在まで再発徴候は認めない.残膵に再発した腎細胞癌でも積極的な切除が予後の改善につながると考えられた.

The purpose of our present study is to understand the Superconductor-Insulator Transition. In this paper we report tunnel experiments on Bi2Sr2Ca1-xYxCu2O8+δ (Y-Bi2212) crystals with x = 0, 0.01, 0.05, 0.1, 0.11 and 0.12. The results are discussed about Copper pairs existing. Tunneling spectra were measured for Y-Bi2212 crystal-SiO-Ag planar junctions. For superconducting samples the V-shape gap structure and zero bias conductance peaks (ZBCP) were observed. While neither superconducting gap nor ZBCP was observed for insulating samples. These results suggest that Cooper pairs break up on the insulating side of SIT. In our spectra there were also several characteristic behaviors.

胃癌の手術を契機に超音波検査で発見された腹腔動脈起始部圧迫症候群 (celiac axis compressionsyndrome: 以下, CACSと略記) の1例を報告する.症例は50歳の男性.既往歴として幼少時より月に1～2度腹部仙痛を自覚.主訴は嚥下困難で, 噴門部癌の診断のもとに当科に紹介入院-術前の超音波検査にて, 腹腔動脈起始部の狭窄と総肝動脈の遠肝性血流を認めCACSと診断した.左開胸開腹下に胃全摘術, 摘脾術を施行した.術中に内側弓状靱帯による腹腔動脈起始部の圧迫を確認し, 靱帯を切離した.電磁流量計により測定した総肝動脈血流量は靱帯切離前後で40ml/分から115ml/分に増加した.術後に腹痛の発生を認めず, また術後の超音波ドプラ検査にて総肝動脈の求肝性血流を確認した.超音波検査はCACSの診断および治療効果判定に有用と思われた.

An experimental research program consisting of 12 infill wall specimens was undertaken to investigate the effectiveness of several new and existing anchorage systems for fibre-reinforced polymer (FRP) strengthening of infill masonry walls. Specimens were loaded out-of-plane using an airbag to apply uniformly distributed pressure to the masonry. Test results indicate that the anchorage system had a significant effect on the failure mode, ductility, and load carrying capacity of strengthened walls. The increase in strength is between 1.6 and 7.2 times the capacity of the unstrengthened wall. The effectiveness of the anchorage was found to be closely related to its ability to resist shear sliding of the infill panel out of the supporting reinforced concrete frame and the subsequent debonding of the FRP in the anchorage region.