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Takotsubo cardiomyopathy (TCM) is a transient acute cardiac disorder often associated with QT prolongation, but this rarely leads to torsades de pointes (TdP). Additionally, it is a rare complication of catheter ablation. Here we report a case of TCM that developed after catheter ablation for common atrial flutter, which led to TdP. The patient was an 85-year-old male who had persistent supraventricular tachycardia, which was considered atrial flutter. The patient was hospitalized for congestive heart failure. Although the response to diuretic administration was unfavorable, heart failure improved with the combined use of rate control by landiolol. Catheter ablation was performed because of the possibility of tachycardia-induced cardiomyopathy. Tachycardia disappeared following ablation to the cavotricuspid isthmus, but the patient complained of severe pain during the ablation. Approximately 2 h after the treatment, the patient's heart failure re-exacerbated. The next day, electrocardiogram confirmed a marked QT prolongation, and TdP occurred. Although the phenomenon we experienced is rarely reported, it should be considered a complication following catheter ablation. Adequate analgesia, care for anxiety about treatment, and evaluation of cardiac condition after treatment are considered important.

Background Although rare, angiosarcoma is the most common type of cardiac primary malignancy. This disease can cause life-threatening complications and the prognosis remains poor. There is no standard approach to care, and clinical judgement is exercised on a case-by-case basis. Tumour progression causes serious complications, such as heart failure and vascular disruption. Case summary A 64-year-old Japanese woman presenting with a right atrial tumour was referred to our department. Tumour biopsy revealed that the patient suffered from angiosarcoma. We performed a lumpectomy to excise the tumour, but due to tissue adhesions in and around the right atrium, the malignancy could not be completely removed. After 3 years of chemotherapy, the patient was admitted to our hospital with increased chest pain. Emergency coronary angiogram revealed severe stenosis of the ostial right coronary artery. Intravascular ultrasound (IVUS) and computed tomography suggested coronary compression due to cardiac angiosarcoma. In this study, we report a unique case of advanced cardiac angiosarcoma, presenting as unstable angina, which was successfully treated with percutaneous coronary intervention using stent implantation. Discussion Due to the rarity of cardiac primary angiosarcoma, many symptoms are misdiagnosed until mechanical complications arise, such as coronary compression. The clinical course and various imaging modalities are useful for differentiating angiosarcomas from coronary stenosis.

The locomotion experience in early childhood is very important for child in development. We are developing the electric mobility support device to promote the physical and mental development of physically handicapped children. In this study, we propose a system recording the locomotion experience using electric mobility support device and evaluating the development of the children. The record system is constructed by an omnidirectional camera and a micro-computer. From the recorded data, the video evaluating children is generated by offline processing using personal computer and we propose two methods indicating the improvement of the operation ability. By these methods, we were able to confirm how to improve the operation of the device and how to interact with the surrounding environment.

The standing-up movement from chair and/or bed is important and necessary in life for all parson, in order to start the locomotion, et al. However, some elderly or handicapped persons cannot stand up by themselves with their remaining ability, and they need the help to stand up. For care-receivers and care-givers both, in the early stage of standing-up movement, their physical burden is the biggest. Therefore, we have developed a prototype of the assist system for early stage of standing up with a pneumatic actuator. In order that the care-receiver himself operates the proposed assist system, the micro-computer control system is constructed. Furthermore, the system can provide slow and safe sitting. In this paper, a developed assist system is mounted on a wheelchair and helps the transfer between the wheelchair and bed, or between the wheelchair and the toilet seat.

In recent years, with the aging of the population, home health care using a home blood pressure monitor has been emphasized. I think that more measurements during the day are needed for people to observe blood pressure more accurately and use it to manage their physical condition. Therefore, in order to reduce the number of measurement procedures as much as possible, the purpose is to reduce the number of measurement procedures in a compact size by performing the measurement only by placing the wrist from above. In this study, we manufactured a device that restrains, compresses, and measures the wrist using a soft actuator made of film. We designed three types of triangular prism type soft actuators with active mechanisms, and constructed a drive sequence using solenoid valves. A pulsation measurement experiment was conducted using the manufactured device, and I was able to measure accurate pulsation by myself.

Robot fingers with many joints driven by a small number of motors are useful for low-cost, light and highperformance robot hands. We propose a robot finger with many joints driven by one motor. Many kinds of motion of the finger can be selected using shape memory gel and tendon-driven mechanism. The rotation of one joint, two joints and many joints of the finger are shown in this paper. Rotatable joint can be selected from many joints. The rolling motion of the finger can be done when many joints rotate in the same direction. The routes of the tendon strings are designed so that the number of required motors can be reduced. The new robot finger has a skeleton while our previous finger does not have a skeleton. The advantages and disadvantage of the skeleton are also discussed in this paper. Experiments of one finger shows its ability of various motion. We also design a prototype robot hand using three fingers and show the motion for some kinds of objects.

The wheelchair is a useful tool providing an aid to mobility for the elderly and handicapped. There exist various researches concerned with wheelchairs (Bourhis, G. et al., 2001; Veeger, H. E. J. et al., 2002; Boninger, M. L. et al., 2002; Adachi, Y. et al., 2003; Miura, H. et al., 2004; Urbano, J. et al., 2005). In order to improve the mobility of persons who can use only one hand for the manipulation of a wheelchair, for example, due to the hemiplegia, various one hand drive wheelchair, such as a lever type and a double ring type, are marketed. These equipments are extremely useful and are utilized in various welfare facilities or homes, because these equipments are effective in moving a short distance on the flat ground with comparatively little rolling resistance. However, because of a heavy physical load on the rough surface and on the slope, many users of these one-hand drive wheelchairs have to transfer to electric wheelchairs at the outdoors. Hence, users of one hand drive wheelchair often give up moving a long distance alone in the outdoors. In order to enjoy life and to maintain the remained ability by rehabilitation effect, it is effective to use the remained ability for moving oneself. Therefore, we consider that various assist functions, such as power assist function and so on, are required to the one-hand drive wheelchair in order to use it in the outdoors. Our research group have been produced a onehand drive wheelchair with newly proposed manipulation mechanism and some assist functions (Yasuda, T. et al. 2006). Figure 1 shows the developed one-hand drive wheelchair. Dimensions of the wheelchair are presented in Table 1. In this investigation, we demonstrate a one-hand drive wheelchair with the power assist function, the maximum velocity limiting function on the downward slope, the reverse prevention function on the upward slope and the function for turning on the spot. In order to realize these assist functions, we first developed new manipulation mechanism with a triple ring on a side of the wheelchair. Secondely, we made an assist system, which is constructed by sensing device for human’s intention and wheelchair’s running speed, micro

This paper presents the prototype of a robot hand using shape memory gel (SMG) and tendon-driven mechanism based on our concept. The finger of the robot hand can be designed to have many bendable parts which can be considered as joints. The number of the motors can be smaller than that of bendable parts. We can select a bending part of the finger as desired. Bending part of the SMG finger is heated by nichrome wires and becomes soft enough to be easily bent by tendon-driven mechanism. An efficient driver circuit for heating many parts of SMG by many nichrome wires is proposed. Examples of finger motion and grasping an object are performed to show the effectiveness of our concept.

Many soft actuators have been studied for use in robots that come into contact with humans, including communication, entertainment, and medical/health care robots. One reason for this is that soft robots are expected to exhibit intrinsic safety in case an accident occurs. This paper proposes a plastic-film pneumatic actuator with a pleated structure that do not undergo the elastic deformation typical of rubber materials. By utilizing thin plastic films, the mass of an actuator can be significantly reduced, even if the actuators are the same size as a human arm. If the mass of the actuator is reduced, the kinetic energy when contacts with humans mechanically can be reduced considerably without reducing the working speed. More specifically, we propose a pleated structure made of plastic to achieve structural deformation generated from a two-dimensional pleated film. The pleated structure easily generates various bending motions. In this paper, a design method for determining the shape parameters of ...

Aim Although distal embolization during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) deteriorates cardiac function, whether distal protection (DP) can improve prognosis is still controversial. We investigated whether a filter-type DP device, Filtrap®, could improve long-term outcomes after PCI for AMI. Method We studied 164 patients (130 men, mean age: 65.7 years) who underwent PCI. Patients were divided into two groups based on the use of Filtrap®. The occurrence of congestive heart failure (CHF) and major adverse cardiac events (MACE) defined as cardiac death, recurrent AMI, and target vessel revascularization were compared. Result Between DP (n=53, 41 men, mean age: 65.5 years) and non-DP (n=111, 89 men, mean age: 65.8 years) groups, although there was significantly greater plaque area in the DP group than in the non-DP group, there were no significant differences in coronary reperfusion flow after PCI. Interestingly, patients with CHF in the non-DP group exhibited a higher CK level than those in the DP group. During a 2-year follow-up period, cumulative CHF was significantly lower in the DP group than in the non-DP group (log-rank p=0.018), and there was no significant difference in the MACE rate (log-rank p=0.238). The use of DP device could not predict MACE, but could predict CHF by multivariate analysis (odds ratio=0.099, 95% CI: 0.02-0.42, p=0.005). Conclusion These results demonstrate that favorable clinical outcomes could be achieved by the filter-type DP device in AMI, particularly in patients with CHF.

Some people with physical disabilities have difficulty transferring alone. Many of them want to transfer by themselves without depending on caregivers. We have been advancing research on “self-transfer assistance robot” based on the concept that a care receiver can transfer alone. However, since the self-transfer assistance robot helps transfer from the sitting position to the sitting position, it is difficult for people who cannot take a sitting position alone to use the robot for transferring by themselves. In this research, we propose a transfer from the supine position by “self-transfer assistance system” composed of “self-transfer assistance robot”, newly added “leg assistance robot” and “electric bed assisting the postural change”. In order to realize this system, a part of the self-transfer assistance robot, the leg assistance robot, and the pneumatic soft actuator arranged on the bed were prototyped. Experiments of assistance using them were conducted and it was shown that the transfer from the supine position using this system was feasible.

Recent years, height of percentage of the person who has subjective symptom of such lower back pain is presented as a problem in aging society. Brace therapy is one of the methods of treatment for lower back pain. However, the method of treatment has possibility to cause muscle deterioration by wearing invariably for a corset. On the other hand, it is difficult for such senior citizens and handicapped person to do removable the corset. Therefore, this paper proposed development of the corset that built pneumatic soft actuators and has on/off switching function in order to solve the problem. So we manufactured the corset and the actuators to the corset. And we instituted the EMG experiment to show the performance evaluation of the corset. We found the problem about the responsiveness and we solved the problem by improving a new structure of the actuator. This structure was able to raise the responsiveness.

Recently, studies of entertainment and communication robots have been conducted. These robots require intrinsic safety features because of the many opportunities to contact humans. For example, conventional robot hands that can grasp an object often consist of metal frames, electrical motors, and gears in order to maintain accuracy. These mechanisms are inevitably complex, high weight, and stiff. If the robot hand heavy, the moment of the elementary part of the manipulator is increased. When these robots operate near people, it is also necessary to perform tasks at low speed to ensure the safety of the people. This has the potential of decreasing work efficiency. Therefore, it is desirable for robot hands to be lightweight and soft. We propose extremely lightweight and supple mechanisms using a pneumatic driven thin plastic-film actuator based on pleated structures. In this paper, the structure of a soft gripper with a bending type actuator and a soft parallel joint with a contraction/extension type actuator are proposed. As a basic characteristics of these mechanisms, generating force are experimentally shown. Although this mechanism is lightweight, high output can be expected.

In acute coronary syndrome (ACS) patients with deterioration of coronary flow during percutaneous coronary intervention (PCI), a scattered necrotic core pattern (SNC) is observed by intravascular ultrasound virtual histology (VH-IVUS). The purpose of this study was to evaluate the impact of SNC on deterioration of coronary flow during PCI in ACS. A total of 38 ACS patients were imaged using VH-IVUS before PCI. In addition to conventional definitions of thin-cap fibroatheroma by VHIVUS (ID-TCFA), the SNC was defined as necrotic core foci with a maximum diameter of < 14 pixels on a 400 9 400 VH-IVUS image in the presence of > 50% plaque burden except in the ID-TCFA frame. Patients were divided into deterioration of coronary flow group (n = 15) and normal-reflow group (n = 23). The incidence of residual thrombus and plaque rupture, the external elastic membrane, plaque and fibrous volumes, the incidence of IDTCFA and the average number of SNC per frame was significantly greater in deterioration of coronary flow group than in normal-reflow group (all parameters P < 0.05). Multivariate analysis revealed that the average number of SNC per frame was independently associated with deterioration of coronary flow in ACS patients (odds ratio 1.18, P < 0.05). In conclusion, an increased number of SNC is associated with deterioration of coronary flow during PCI in ACS patients. © Springer 2011.

We have developed the sewage sludge drying and pelletizing process that transforms sewage into low water content (less than 10%) and spherical pellet. This report introduces the description of the sewage sludge drying and pelletizing process, quality of dried sludge pellets, the basic results of the co-firing test of dried sludge pellets with coal in pulverized coal-fired furnace and municipal solid waste incinerator. It is concluded that dried sludge pellets had low water content and about 1/2～2/3 of heat value of coal. Also, co-firing of dried pellet results in good operation in pulverized coal-fired furnace and municipal solid waste incinerator.

1 Shin-ei Sangyo Co. Ltd., Shinden-nishimati, Daito City, Osaka 574-0057 2 Shin-ei Japan Co. Ltd., Shinden-nishimati, Daito City, Osaka 574-0057 3 Department of Life Science, Graduate School of Life Science, University of Hyogo, Harima Science Park City, Hyogo 678-1297 4 Department of Physics, Kansai Medical University, 18-89, Uyamahigashi-cho, Hirakata City Osaka 573-1136 Received December 07, 2011; Accepted March 09, 2012