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A 78-year-old man presented with back pain and shock and was transferred to our hospital. Computed tomography showed a ruptured aortic dissection in which the false lumen was thrombosed with an ulcer-like projection, and the mid-esophagus was shifted to the right due to a mediastinal hematoma. He underwent emergency thoracic endovascular aortic repair of the descending thoracic aorta. One week later, esophageal necrosis occurred, and he died of mediastinitis and sepsis on postoperative day 16. Although esophageal necrosis is a rare and fatal complication after thoracic endovascular aortic repair, a management strategy has not yet been established.

A 53-year-old man underwent thoracic endovascular aortic repair for persistent false lumen perfusion and limb salvage because of type A aortic dissection, severe lower-limb ischemia, and bleeding (mediastinal hematoma, bilateral lung contusion, liver injury, and splenic injury) caused by blunt trauma. We embolized the left supreme intercostal artery to control active mediastinal hemorrhage. Acute hemorrhage and leg ischemia were well controlled; however, residual blood flow in the false lumen persisted. We performed a Zone 2 thoracic endovascular aortic repair and discharged the patient on day 67. Thoracic endovascular aortic repair is a practical option for treating traumatic type A dissection.

Membrane type 1-matrix metalloproteinase (MT1-MMP) plays a key role in endothelial cell migration, matrix remodeling, and angiogenesis. Previous studies demonstrated that a mechanical force, cyclic strain, increases MT1-MMP expression by displacing Sp1 with increased Egr-1 expression and binding to the promoter site. However, the effect of shear stress (SS) on MT1-MMP expression is poorly understood. Although Egr-1 mRNA transcription and protein was induced (7.6-fold) in response to SS (n = 5, 0-8 h, p < 0.05), SS decreased MT1-MMP mRNA transcription and protein levels in a time-dependent fashion (10, 50, and 90% reduction at 1, 4, and 8 h, respectively; n = 5, p < 0.05). Egr-1 protein was increased after SS and cyclic strain, but Sp1 was serine-phosphorylated only after SS. SS increased Sp1 DNA binding (3.8-, 5.8-, and 2.4-fold increase at 1, 4, and 8 h, respectively; n = 5, p < 0.05) that was inhibitable by calf intestinal phosphatase. Thus, SS inhibits MT1-MMP expression despite Egr-1 up-regulation by inducing the serine phosphorylation of Sp1, which in turn increases its binding affinity for its site on the MT1-MMP promoter, reducing the ability of Egr-1 to displace it. These data illustrate the complex control of microvascular endothelial cell MT1-MMP expression in response to distinct environmental stimuli (cyclic strain versus shear stress), consisting of both the modulation of specific transcription factor expression (Egr-1) as well as transcription factor post-translational modification (serine phosphorylation of Sp1).

In the previous papers[4, 5, 6]S. Yamaguchi and T. Adati have established the differential geometric properties of holomorphically subprojective Kählerian manifolds. By the way, in[7]S. Yamaguchi has introduced the notion of Kählerian torse-forming vector fields. The principal purpose of this paper is to investigate the necessary and sufficient conditions in order that a Kählerian manifold is the holomorphically subprojective Kählerian manifold of the first kind, corresponding to T. Adati's conditions of a subprojective Riemannian manifold with respect to torse-forming vector fields.

A Kaehler manifold with the axiom of anti-invariant 2-spheres is a complex space form.

In two previous papers [9, 10] the present authors have established the differential geometric properties of holomorphically subprojective Kählerian manifolds. The purpose of this paper is to seek the necessary and sufficient conditions in order that a Kählerian manifold be the holomorphically subprojective Kählerian manifold of the first kind, corresponding to P. Rachevsky's conditions of a subprojective Riemannian manifold.

We prove the corresponding theorem for a -totally real minimal surface to Yau's theorem for a totally real minimal surface of a Kähler surface with constant holomorphic sectional curvature.

The metric compound structure of rank r is an obstructed structure of an induced structure on a real submanifold in an almost Hermitian manifold. In this paper we deal with a submanifold with metric compound structure of rank 2 in a Kaehlerian manifold and we classify it under some suitable conditions. Namely it is a standard sphere or neither Einstein nor conformally flat.

We deal with a horizontal conformal Killing tensor of degree p in a Sasakian space. After some preparations we prove that a horizontal conformal Killing tensor of odd degree is necessarily Killing. Moreover, we consider horizontal conformal Killing tensor of even degree. The form of the associated tensor is determined completely and a decomposition theorem is proved. Then we give the examples of a conformal Killing tensor of even degree and a special Killing tensor of odd degree with constant l.

Realistic performance predictions are required for efficient operation strategy of air conditioners. In this study, the application of a cost effective and non-intrusive black box model utilizing artificial neural networks (ANN) to predict the cooling capacity of air conditioning systems is investigated, while considering the effect of fouling and leakage that may occur after prolonged operation. The effect of various leakage and fouling combinations on the output cooling capacity were numerically simulated. The training data set is first generated for a system that is ideally operating without any fouling or leakage. The developed ANN model is tested to predict cooling capacity in “faulty” systems. The results indicated that, as long as leakage and fouling are limited below 10% and 4% respectively, the ANN model trained by the data generated with the ideal system, can predict cooling capacity with a relative averaged cooling capacity difference (ΔQ-e,rel) of approximately 13%. Moreover, the inclusion of data with different leakage and fouling combinations in the training set enables accurate predictions of the cooling capacity of the air conditioning system during the entire timespan of its operation. It suggests that cooling capacity under the fouling and leakage phenomena can be predicted using limited input information.

Objective: The aim was to examine the effects of lysophosphatidylcholine (LPC), an amphiphilic lipid metabolite in ischemic myocardium, on intracellular pH (pHi) regulatory systems in guinea pig papillary muscles. Methods: In CO2/HCO3−-buffered Tyrode solution, pHi, intracellular Na+ activity (aNai) and membrane potential of isolated guinea pig papillary muscles were measured using ion-selective microelectrode and conventional microelectrode. Standard ammonium prepulsing with 20 mM NH4Cl was used to produce an intracellular acid load, and effects of LPC on the pHi recovery from acidosis were evaluated in the absence and presence of a transport inhibitor. Results: LPC acidified the resting pHi by 0.03±0.01 pH units (n = 15, P<0.01) concomitantly with a slight decrease in resting membrane potential and an increase in aNai in quiescent preparations. The pHi recovery rate from an intracellular acid load was decreased to 83±4% of the control value by 30 μM LPC (n = 8, P<0.05) but not by 30 μM phosphatidylcholine (PC). In the presence of 10 μM 5-(N,N–hexamethylene) amiloride (HMA), a Na+–H+ exchange inhibitor, LPC still slowed pHi recovery from an intracellular acid load to 77±4% of the control (n = 5, P<0.05). However, LPC failed to alter the pHi recovery rate in the presence of 4,4′-diisothiocyanatostilbene–2,2′-disulfonic acid (DIDS, 0.5 mM), a Na+-HCO3− symport inhibitor. Conclusion: LPC impairs Na+–HCO3− symport but not Na+–H+ exchange, and LPC may potentiate its arrhythmogenic action by intensifying the intracellular acidosis in ischemic myocardium.

Let M be a compact Sasakian space admitting a conformal Killing p-form u. Then, we show that the associated form ϑ of a conformal Killing form u is a special Killing form with constant 1. Moreover we prove the decomposition theorem of u and seek the condition for M to be a unit sphere.