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Background: Older adults compose the significant proportion of patients undergoing minor oral surgery to restore oral function worldwide; however, these procedures possess certain risks of late complications, particularly delayed healing. Therefore, this study mainly aims to assess the frequency of this type of adverse effects and identify the predictors of delayed healing among patients aged over 65 years. Methods: A total of 106 participants aged over 65 years who underwent minor oral surgical interventions at the Department of Oral Medicine, Hokkaido University Hospital from 2015 to 2022 were selected from the database and were divided into two healing groups: the non-delayed (n = 87) and delayed (n = 19). The delayed healing was defined as lack of healing for more than 10 days. The clinical parameters for comparison included those of clinical examination and laboratory tests assessed before surgery. Fisher’s exact test, the Wilcoxon rank-sum test, and logistic regression analysis were used to evaluate the results. Results: Delayed healing was the most frequent postsurgical complication (17.9%) among all the patients. Serum albumin level (odds ratio, 10.0; 95% confidence interval, 2.15–46.6) significantly differed between the groups of patients with and without delayed healing. The multivariate logistic regression analysis demonstrated that serum albumin level of Conclusions: This study revealed that the level of serum albumin can predict delayed healing among patients aged over 65 years who undergo minor oral surgery. Trial registration: Retrospectively registered.

A 57-year-old Japanese female was considered for living donor liver transplantation (LDLT) due to end-stage liver cirrhosis caused by primary biliary cholangitis with portal vein thrombosis (PVT) formation. A 26-year-old daughter of the patient was selected as a living donor; however, a computed tomography examination revealed trifurcated-type portal vein anomaly (PVA). Preoperative liver volumetry showed that the right lobe graft was necessary for the recipient; therefore, reconstruction of the portal vein bifurcation during LDLT was necessary. We planned to extract the recipient's own hepatic vein grafts after total hepatectomy, and these would be attached with anterior and posterior portal branches as jump grafts. We performed laparoscopic donor hepatectomy as usual, and the recipient's hepatic vein grafts were anastomosed on the bench. Then, the liver graft was inserted, and the hepatic vein reconstruction was routinely performed. We confirmed the alignment between the recipient's portal vein and the bridged hepatic vein graft of the liver graft's posterior branch, and anastomosed these two vessels. Moreover, we confirmed the front flow and expansion of the reconstructed posterior branch by declamping only the suprapancreatic side of the portal vein. The decision regarding the punch-out location was crucial. We confirmed the alignment between the reconstructed posterior branch and the bridged hepatic vein graft of the anterior branch, and anastomosed these two vessels employing the punched-out technique. In LDLT, liver transplant surgeons occasionally encounter living donors with PVA or recipients with PVT. Our contrivance may be useful when the liver graft needs reconstruction of portal vein bifurcation.

This study reports the commissioning methodology and results of a respiratory gating system [AZ – 733 V/733 VI (Anzai Medical Co., Japan)] using a pressure sensor in carbon‐ion scanning radiotherapy. Commissioning includes choosing a location and method for pressure sensor installation, delay time measurement of the system, and the final flow test. Additionally, we proposed a methodology for the determination of a threshold level of generating an on/off gate for the beam to the respiratory waveform, which is important for clinical application. Regarding the location and method for installation of the pressure sensor, the actual person's abdomen, back of the body position, and supine/prone positioning were checked. By comparing the motion between the pressure sensor output and the reference LED sensor motion, the chest rear surface was shown to be unsuitable for the sensor installation, due to noise in the signal caused by the cardiac beat. Regarding delay time measurement of the system, measurements were performed for the following four steps: (a). Actual motion to wave signal generation; (b). Wave signal to gate signal generation; (c). Gate signal to beam on/off signal generation; (d). Beam on/off signal to the beam irradiation. The total delay time measured was 46 ms (beam on)/33 ms (beam off); these were within the prescribed tolerance time (

Purpose Laparoscopic left lateral sectionectomy (LLLS) is a feasible and safe procedure with a relatively smooth learning curve. However, single-incision LLLS requires extensive surgical experience and advanced techniques. The aim of this study is to report the standardized single-incision plus one-port LLLS (reduced port LLLS, RPLLLS) technique and evaluate its safety, feasibility, and effectiveness for junior surgeons. Methods Between January 2008 and November 2020, the clinical records of 49 patients who underwent LLLS, divided into the conventional LLLS (n = 37) and the RPLLLS group (n = 12), were retrospectively reviewed. The patient characteristics, pathologic results, and operative outcomes were evaluated. Results A history of previous abdominal surgery in the RPLLLS group was significantly high (56.8% vs. 91.7%, p = 0.552). Notably, junior surgeons performed 62.2% of the conventional LLLSs and 58.4% of the standardized RPLLLSs. There were no significant differences between the two groups in terms of median operative time (121.0 vs. 113.5, p = 0.387), median blood loss (13.0 vs. 8.5, p = 0.518), median length of hospital stays (7.0 vs. 7.0, p = 0.408), and morbidity rate (2.7% vs. 0%, p = 0.565), respectively. Conclusion This standardized RPLLLS is a feasible and safe alternative to conventional LLLS and may become the ideal training procedure for both junior surgeons and surgeons aiming to learn more complex procedures.

Projective symmetry groups are applied to Raman observations of the Kitaev quantum spin liquids in spherical lattice geometries realized by Platonic and Archimedean polyhedra. Parton single excitations in Kitaev spin polyhedra are characterized by double-valued irreducible representations of their belonging projective symmetry groups, whereas parton geminate excitations relevant to Raman scattering are decomposed into single-valued irreducible representations of the corresponding point symmetry groups. We combine a standard point-symmetry-group analysis of the Loudon-Fleury vertices and an elaborate projective-symmetry-group analysis of itinerant spinons against the ground gauge fields to reveal $hidden$ $selection$ $rules$ for Raman scattering in $\mathbb{Z}_2$ spin liquids., 23 pages including 5 figures and 10 tables, to be published in Phys. Rev. B

Perfect deporalization of the Loudon-Fleury inelastic visible-light scattering in the Kitaev honeycomb model is well known. Though it happens in Heisenberg Kagome and triangular antiferromagnets as well, yet we prove it to be of geometric origin rather than peculiar to quantum spin liquids. A Kitaev spin liquid in the square planar geometry indeed exhibits polarized Raman spectra containing defferent symmetry species, each brought by symmetry-compatible spinon geminate excitations, i.e. arising from symmetry-compatible direct-product representations made of double-valued irreducible representations of mediating-spinon-belonging gauged $\bm{k}$-point symmetry groups. We combine a standard point-symmetry-group analysis of the Raman vertex in the real space and an elaborate projective-symmetry-group analysis of Raman-scattering-mediating Majorana spinons in the reciprocal space to identify emergent spinons singly., Comment: 13 pages including Supplemental Material, 8 figures

Introduction In the 7 years since our facility opened, we have treated >2000 patients with pencil-beam scanned carbon-ion beam therapy. Methods To summarize treatment workflow, we evaluated the following five metrics: i) total number of treated patients; ii) treatment planning time, not including contouring procedure; iii) quality assurance (QA) time (daily and patient-specific); iv) treatment room occupancy time, including patient setup, preparation time, and beam irradiation time; and v) daily treatment hours. These were derived from the oncology information system and patient handling system log files. Results The annual number of treated patients reached 594, 7 years from the facility startup, using two treatment rooms. Mean treatment planning time was 6.0 h (minimum: 3.4 h for prostate, maximum: 9.3 h for esophagus). Mean time devoted to daily QA and patient-specific QA were 22 min and 13.5 min per port, respectively, for the irradiation beam system. Room occupancy time was 14.5 min without gating for the first year, improving to 9.2 min (8.2 min without gating and 12.8 min with gating) in the second. At full capacity, the system ran for 7.5 h per day. Conclusions We are now capable of treating approximately 600 patients per year in two treatment rooms. Accounting for the staff working time, this performance appears reasonable compared to the other facilities.

We demonstrate a Kitaev spin liquid in a polyhedral cluster and propose detecting its fractional excitations—Majorana spinons—by magnetic Raman scattering. While little polarization dependence of the Raman spectra at sufficiently low temperatures is usual with quantum spin liquids, the present observations are primarily of geometric origin. The Raman scattering intensity peaks melt with increasing temperature, to be more precise, with increasing number of background gauge-flux excitations.

The installation of a very high frequency (VHF) radiotelephone is required for ships with more than 100 tons of gross tonnage. However, in the case of the other small ships it was arbitrary. For that reason, it was difficult to install a VHF radiotelephone easily with a small ship, and to establish a mutual understanding by using a VHF radiotelephone between all ships. By partial revision of the Radio Law etc. in October, 2009, a VHF radiotelephone can be installed easier than before. In this study, first of all, these data were clarified and the actual condition by the field survey in a fishery cooperative association and a marina investigated the actual condition of the issue of radio operator license and radio station license using databases of Ministry of Internal Affairs and Communications. Secondly, these data were acquired by conducting the experiment which used handy type of a VHF radiotelephone between GINGAMARU and TOBAMARU, NIPPONMARU and a personal water craft (for leisure). As a result, these revealed that the range which can communicate a VHF radiotelephone of handy type, and some remaining regulatory issues etc. are presented.

Canine embryos (8-cell to blastocyst stages) frozen-thawed using the slow-freezing method with glycerol (four recipients) or dimethyl sulfoxide (three recipients) as a cryoprotectant and vitrified-warmed using the Cryotop method (five recipients) were surgically transferred into the unilateral uterine horn of recipient bitches. As a result, the morphology of embryos frozen-thawed using the slow-freezing method was judged to be normal, but no conception occurred in any of the recipient bitches. Two of the five bitches that received transferred embryos (morula to early blastocyst stages) vitrified-warmed using the Cryotop method became pregnant and produced normal pups (1/9 embryos, 11.1% and 1/6 embryos, 17.0%). It was concluded that the Cryotop method was more appropriate for canine embryo cryopreservation than the slow-freezing method, which is used for the cryopreservation of embryos of other mammalian species.

We determined the susceptibilities of recent clinical isolates of Streptococcus pneumoniae to 19 antibiotics. The frequency of erythromycin nonsusceptibility was high, i.e. 8/13 (61.5%), 10/14 (71.4%) and 11/11 isolates (100%) from 13 penicillin-susceptible, 14 penicillin-intermediate and 11 penicillin-resistant S. pneumoniae, respectively. Macrolide resistance was detected by polymerase chain reaction (PCR) and disk diffusion methods. Of these erythromycin-nonsusceptible pneumococcal isolates, 13/29 (44.8%) isolates contained genomic copies of mefA and showed non-‘D’-shaped zones of inhibition observed around rokitamycin and/or clindamycin disks. Sixteen out of 29 isolates (55.2%) contained copies of ermB and showed typical ‘D’-shaped zones of inhibition, except one isolate. Although the macrolide resistance determinants, mefA and ermB, could be identified by PCR and disk diffusion methods, PCR methods were more reliable in elucidating these determinants. The susceptibility pattern to 14-, 15- and 16-membered macrolides and clindamycin differed between the mefA+ and ermB+ isolates. All isolates were susceptible to levofloxacin, sparfloxacin and vancomycin. The MICs of sitafloxacin were lowest among the fluoroquinolones examined for 38 isolates.

The Etest (AB Biodisk, Solna, Sweden), a susceptibility testing method, was used for fosfomycin and was evaluated by comparison with the agar dilution method for 73 clinical isolates of Escherichia coli, including two resistant strains, and an optimal Etest method for fosfomycin was determined. Media and culture conditions greatly affected the minimum inhibitory concentrations (MICs) determined by the Etest for fosfomycin, as shown for the agar dilution methods. Our results showed that the most favorable conditions for the Etest for fosfomycin were with Mueller-Hinton agar (Becton-Dickinson Japan, Tokyo, Japan) under aerobic conditions. However, the MICs for the resistant strains were much higher than those determined by agar dilution methods, using Nutrient agar (Becton-Dickinson Japan) under anaerobic conditions. The addition of glucose-6-phosphate did not significantly affect the Etest results.

The Pleistocene Ashigara Basin and adjacent Tanzawa Mountains, Izu collision zone, central Japan, are examined to better understand the development of an arc–arc orogeny, where the Izu–Bonin – Mariana (IBM) arc collides with the Honshu Arc. Three tectonic phases were identified based on the geohistory of the Ashigara Basin and the denudation history of the Tanzawa Mountains. In phase I, the IBM arc collided with the Honshu Arc along the Kannawa Fault. The Ashigara Basin formed as a trench basin, filled mainly by thin-bedded turbidites derived from the Tanzawa Mountains together with pyroclastics. The Ashigara Basin subsided at a rate of 1.7 mm/year, and the denudation rate of the Tanzawa Mountains was 1.1 mm/year. The onset of Ashigara Basin Formation is likely to be older than 2.2 Ma, interpreted as the onset of collision along the Kannawa Fault. Significant tectonic disruption due to the arc–arc collision took place in phase II, ranging from 1.1 to 0.7 Ma in age. The Ashigara Basin subsided abruptly (4.6 mm/year) and the accumulation rate increased to approximately 10 times that of phase I. Simultaneously, the Tanzawa Mountains were abruptly uplifted. A tremendous volume of coarse-grained detritus was provided from the Tanzawa Mountains and deposited in the Ashigara Basin as a slope-type fan delta. In phase III, 0.7–0.5 Ma, the entire Ashigara Basin was uplifted at a rate of 3.6 mm/year. This uplift was most likely caused by isostatic rebound resulting from stacking of IBM arc crust along the Kannawa Fault which is not active as the decollement fault by this time. The evolution of the Ashigara Basin and adjacent Tanzawa Mountains shows a series of the development of the arc–arc collision; from the subduction of the IBM arc beneath the Honshu Arc to the accretion of IBM arc crust onto Honshu. Arc–arc collision is not the collision between the hard crusts (massif) like a continent–continent collision, but crustal stacking of the subducting IBM arc beneath the Honshu Arc intercalated with very thick trench fill deposits.

Optically active Diels–Alder adducts were prepared using a one-pot preparative method and enantioselective Diels–Alder reaction with optically active hosts in a water suspension medium.

Staphylococcus sciuri and Escherichia vulneris were isolated concurrently in a blood sample from a patient with septic shock, which was probably associated with an indwelling catheter. Our results also showed that S. sciuri is an important reservoir of genetic determinants of beta-lactam resistance as a human pathogen carrying the mecA and beta-lactamase genes.

We applied an American medical necessity scale, Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS), to psychiatric practice in Japan. This is an exploratory analysis of empirical data of 272 patients. We examined the relationships between levels of care of LOCUS and clinical variables, contribution of care levels on admission decision, and changes in care levels over time. Inpatients showed significantly higher levels of care than outpatients. Levels of care showed significant strong inverse correlations to Global Assessment Scale (GAS) scores, and significant moderate correlations to admission types, care environment, and diagnostic subgroups in almost all groups. Levels of care contributed as much to the admission decision as GAS scores. Levels of care significantly decreased from the time of admission to discharge. Our preliminary evidence indicates that LOCUS is valid and sensitive to change, and applicable for clinical use in Japan.

We determined the susceptibilities of recent clinical isolates of Streptococcus pneumoniae to 19 antibiotics. The frequency of erythromycin nonsusceptibility was high, i.e. 8/13 (61.5%), 10/14 (71.4%) and 11/11 isolates (100%) from 13 penicillin-susceptible, 14 penicillin-intermediate and 11 penicillin-resistant S. pneumoniae, respectively. Macrolide resistance was detected by polymerase chain reaction (PCR) and disk diffusion methods. Of these erythromycin-nonsusceptible pneumococcal isolates, 13/29 (44.8%) isolates contained genomic copies of MEFA and showed non-'D'-shaped zones of inhibition observed around rokitamycin and/or clindamycin disks. Sixteen out of 29 isolates (55.2%) contained copies of ERMB and showed typical 'D'-shaped zones of inhibition, except one isolate. Although the macrolide resistance determinants, MEFA and ERMB, could be identified by PCR and disk diffusion methods, PCR methods were more reliable in elucidating these determinants. The susceptibility pattern to 14-, 15- and 16-membered macrolides and clindamycin differed between the MEFA+ and ERMB+ isolates. All isolates were susceptible to levofloxacin, sparfloxacin and vancomycin. The MICs of sitafloxacin were lowest among the fluoroquinolones examined for 38 isolates.

Background. Recent study has demonstrated that β-lactamase inhibitors including clavulanate, sulbactam and tazobactam have an vitro antibacterial effect on Helicobacter pylori. Here we describe the relationship between viability and cell profiles of H. pylori exposed to β-lactamase inhibitors and some antibiotics in a short-time course. Materials and methods. The antibacterial effects of β-lactamase inhibitors including clavulanate, sulbactam and tazobactam on the bacterial viability of and morphological changes in H. pylori ATCC43504 were examined. Results. The β-lactamase inhibitors such as clavulanate and sulbactam alone decreased the viable counts of H. pylori, depending on the antibiotic concentrations. Exposure to these β-lactamase inhibitors resulted in morphological changes of cell shape, cell-wall disintegration and cell lysis. Among these β-lactamase inhibitors, clavulanate was the most active, causing a decrease in viable counts and morphological changes such as short filamentous to sphaeroplast formation and lysis. One × minimum inhibitory concentration (MIC) of amoxicillin plus 1 × MIC of clavulanate decreased viable counts effectively compared with 1 × MIC of amoxicillin or 1 × MIC of clavulanate alone, and induced morphological changes of cell shape and cell wall. Conclusion. Our results suggest that the β-lactamase inhibitors alone have concentration-dependent antibacterial activities against H. pylori and affect the morphology of the cell shape and the cell wall in vitro.

Objective: To evaluate the propensity of lincomycin and clindamycin to induce release of endotoxin, the authors investigated endotoxin release in Escherichia coli isolated from a patient who developed septic shock following lincomycin treatment. Methods: Endotoxin release from the E. coli isolate exposed to lincomycin, clindamycin, and ceftazidime were determined in vitro and in vivo. Results: In vitro, this E. coli released significantly larger amounts of endotoxin after exposure for 6 hours to lincomycin or clindamycin versus no antibiotic; however, endotoxin release with these antibiotics was significantly less than with ceftazidime. There was no significant difference in in vitro endotoxin release between small (8 mg/L) and large (0.5 minimum inhibitory concentration [MIC]) doses of these antibiotics, and 0.5 MICs of lincomycin and clindamycin were 1024 and 256 mg/L, respectively. These results were supported by scanning electron microscopic observations, which demonstrated that lincomycin, clindamycin, and ceftazidime induced formation of filamentous cells. In addition, plasma endotoxin concentrations after treatment for 4 hours with lincomycin, clindamycin, and ceftazidime (5 mg/kg) were at least 20-fold higher than with no antibiotic in an E. coli sepsis rat model. Conclusion: Results of this study suggest that the bacteriostatic antibiotics, lincomycin and clindamycin, induce endotoxin release in the treatment of E. coli infections.

A new method to determine the concentration of the defect centers in photostimurable luminescent materials is demonstrated. The method is representatively applied to BaFCl:Eu2+ and KCl:Eu2+ single crystals, which exhibt the photostimulable luminescence. Thereby the values of the oscillator strength, f, are calculated utilizing the results of the defect center concentrations as well as the measured refractive indices and the corresponding absorption bands by using the Smakula's formula. The values obtained are f=0.80 for the F(Cl-) centers in BaFCl:Eu2+ and f=0.60 for the F centers in KCl:Eu2+.

Time and temperature dependence of afterglow intensity and of the F-band in the optical absorption spectra are studied for BaFCl:Eu2+ and KCl:Eu2+. Afterglow reveals a single emission band with a peak around 420 nm and 400 nm in BaFCl:Eu2+ and KCl:Eu2+, respectively. Decay curves of afterglow and the F-band intensity are analysed using a recombination probability depending on temperature and the distance between electron and hole centers. The theoretical curve with three reasonable parameters, is found to be in good agreement with the experimental data of BaFCl:Eu2+ as well as of KCl:Eu2+. Surviving probability of the centers in these crystals is also discussed on the basis of the proposed recombination model.

Angle-resolved photoemission measurements have been made on the recently discovered high-T/sub c/ superconductor Bi/sub 2/Sr/sub 2/CaCu/sub 2/O/sub x/. From the results, E vs k/sub X/ dispersion curves have been obtained along two principal symmetry directions in the two-dimensional Brillouin zone. Compared to results of one-electron band calculations, the observed bands are shifted and distorted by strong correlation effects. One band intersects the Fermi level. This band is assigned to the renormalized ''heavy-electron'' band.