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It has been established that the initiation of paroxysmal atrial fibrillation (AF) is frequently associated with ectopic beats inside the thoracic veins, including the pulmonary veins, superior vena cava, coronary sinus, and/or vein of Marshall. However, similar arrhythmogenic ectopic discharge or premature atrial contractions (PACs) originating from the inferior vena cava (IVC) have been rarely described. We present the case of a 51-year-old man with paroxysmal AF undergoing electrophysiological study. Twelve-lead electrocardiography demonstrated PACs with negative P waves in the inferior leads. Ectopic beats originating from the ostium of the IVC, which were likely to initiate AF, were observed. Furthermore, the origin of the PAC was visualized using an electroanatomical local activation timing (LAT) map and located close to the fibrotic tissue of the vasculature. Radiofrequency catheter ablation was performed at the earliest activation site, and ectopic beats were not observed after the procedure. This is the first report to demonstrate a LAT contact map of ectopic discharge arising from the IVC. If PACs with negative P waves in the inferior leads are found in a patient with AF, the IVC should be investigated for possible focal ectopic discharges. LEARNING OBJECTIVE: Non-pulmonary vein foci play a significant role in the pathogenesis of atrial fibrillation (AF). However, inferior vena cava (IVC) triggers that initiate AF have rarely been described. Premature atrial contractions with negative P waves in the inferior leads may be associated with ectopic discharges originating from the IVC, which contribute to the initiation of AF.

Early-onset developmental and epileptic encephalopathy (DEE) is a group of devastating disorders that appear during the neonatal and infantile periods. Despite great progress in the discovery of genes leading to early-onset DEE, many cases with unexplained etiology remain. Furthermore, to date, the association of copy number variations (CNVs) with early-onset DEE has seldom been addressed. Here, we investigated the contribution of CNVs to epilepsy in a cohort of Japanese children with a variety of early-onset DEEs. Single nucleotide polymorphism (SNP) array analysis was performed for 83 cases that were previously negative for pathogenic single nucleotide variants (SNVs) in 109 genes known or suspected to cause epileptic seizures. Rare CNVs were detected in a total of 12 cases (14.4%), of which three cases (3.6%) involved clearly pathogenic CNVs and nine cases (10.8%) were CNVs of uncertain significance. The three pathogenic CNVs included two de novo heterozygous deletions involving known epileptic encephalopathy genes, such as GABRG2 and PCDH19, and one maternally inherited duplication encompassing MECP2. Our findings indicate rare CNVs are also relevant for the diagnosis of early-onset DEEs, highlighting the importance of not relying only on the investigation of SNVs/small indels at the risk of missing large deletions and duplications.

Graphene oxide, an oxidized derivative of graphene, has many intriguing properties, such as amphiphilicity, negative charge, and easy mass production. However, due to the electronic insulation, graphene oxide cannot be directly used as a conductive agent for lithium batteries before reduction. Here we have demonstrated the enhanced rate and cycle capability of LiMn0.7Fe0.3PO4 with in situ electrochemically reduced graphene oxide by starting from discharge to 1.5 V vs. Li+/Li. For example, LiMn0.7Fe0.3PO4 with 2 wt% electrochemically reduced graphene oxide can obtain a high discharge capacity of ∼83 mAh g−1 at 30C and capacity retention of ∼90% at 1C after 200 cycles, much higher performance than that without graphene oxide (∼10 mAh g−1 and ∼56%, respectively). Moreover, the cathode with in situ electrochemically reduced graphene oxide also shows better performances than that with the externally reduced graphene oxide. The boosted performance is attributed to the effective conductive network formed by the well-dispersed graphene oxide.

Obstructive sleep apnea (OSA) is associated with the occurrence of various kinds of bradyarrhythmia and tachyarrhythmia. The activation of the autonomic nerve system is an important causative factor of the pathogenesis of the arrhythmia in OSA patients. Previous studies have shown that the R-R interval is an effective parameter for evaluating autonomic nerve activities. However, whether or not OSA can induce variations in the R-R interval and whether or not continuous positive airway pressure (CPAP) therapy can improve these variations in OSA patients are unclear. The present study explored whether or not CPAP therapy could improve the regularity of the R-R interval.

Resting end-tidal CO2 levels obtained from capnography are associated with the severity of heart failure (HF). It has not been fully investigated whether other respiratory parameters acquired from detailed capnography waveform analyses could evaluate the recovery process in HF patients. In this case, the analysis of nasal capnography waveforms (diurnal five minutes recording) was performed to monitor and analyze end-tidal CO2 (ETCO2) values, inspiratory/expiratory ratio and respiratory intervals. We observed that these three parameters increased concurrently with decreasing plasma BNP levels during the recovery stage of HF. The kurtosis of frequency distributions of capnography waveforms became larger as HF improved. Proper utilization of these analyses could evaluate HF severity during the recovery process in patients with HF.

Background The purpose of this study is to investigate if a laryngeal mask could improve respiratory condition during radiofrequency catheter ablation (RFCA). Methods Twenty-four consecutive patients who underwent RFCA for atrial fibrillation were divided into two groups (Facemask group; n = 10, Laryngeal mask group; n = 14). All patients were completely sedated under intravenous anesthesia and fitted with artificial respirators during the RFCA. The capnography waveforms and their differential coefficients were analyzed to evaluate the changes of end-tidal CO2 (ETCO2) values, respiratory intervals, expiratory durations, and inspiratory durations. Results During the RFCA, ETCO2 values of the laryngeal mask group were higher than those of the facemask group (36.0 vs. 29.2 mmHg, p = 0.005). The respiratory interval was significantly longer in the laryngeal mask group than those in the facemask group (4.28 s vs.5.25 s, p 2 was significantly higher when using a laryngeal mask than when using a facemask. The inspiratory-expiratory ratio of the laryngeal mask group was significantly larger than that of the facemask group (1.59 vs. 1.27, p 2 value is the most influential parameter on the fluoroscopic duration during the RFCA procedure (β = − 0.477, p = 0.029). Conclusions The use of a laryngeal mask could stabilize respiration during intravenous anesthesia, which could improve the efficiency of RFCA.

Sleep-disordered breathing (SDB) is one of the most common complications among heart failure (HF) patients. Changes of respiratory patterns during the various stages in patients with HF have not been fully investigated. In this case, the algorism using thoracic impedance sensor and minute ventilation (sleep apnea monitoring [SAM] algorithm) with implanted pacemaker (REPLY 200 SR or DR, Sorin CRM SAS, Clamart, France) was used to monitor respiration. Impedance data from the implanted pacemaker can be converted into respiratory data, which can be used to calculate the respiratory disturbance index (RDI) per unit of time. Using this algorithm, we observed a sudden appearance of abnormal breathing at the onset of HF, followed by gradual improvement of respiratory patterns during the recovery stage. The results from respiratory monitoring using the SAM algorithm were strongly correlated with those from the positive airway pressure device. This case report could imply that proper utilization of this sensor could facilitate the early detection and therapeutic control of HF. Keywords: Heart failure, Pacemaker, Respiratory monitoring

The ambient temperature application of PEO-based polymer electrolytes has been restrained by their poor ionic conductivity. Herein, we report a super-concentrated polymer in “solvated ionic liquid” which is composed of polyethylene oxide (PEO), LiN(SO2CF3)2 (LiTFSI), and solvent with low viscosity. It is found that the maximum coordination during Li, polymer, and the solvent can be formed by the molar ratio of PEO/Li = 1:1 with 25 wt% of solvent, left no free solvent exits in the mixture. The electrochemical performance of the designed electrolyte was evaluated by using a LiFePO4/Li cell. Comparing to the conventional carbonate liquid electrolyte, the designed electrolyte achieves comparable rate performance (155.4 and 157.8 mAh g−1 discharge at 1 C for the designed and carbonate electrolyte, respectively) and higher cycle performance (capacity retention of 95.5% and 75.5% after 100 cycles for the designed and carbonate electrolyte, respectively). It has been further proven that incombustibility can be obtained by only adding ~15 wt% fire-retardant. We believe that the developed electrolyte is promising and practical for being applied in the polymer lithium-ion battery.

The requirements for volume and weight performance are becoming more and more urgent for the application of lithium-ion batteries in consumer electronics and electric vehicles. Herein, we demonstrate a facial and cost-effective synthesis approach of lithium-ion conducting glass ceramic (LICGC)/reduced graphene oxide (rGO) composite, in which the LICGC particles anchor on the rGO sheets densely and homogenously, forming a sandwich-like structure. The unique feature offers ultrafast Li-ion and electron pathways through the LICGC network and rGO sheets, resulting in the enhancement of the rate and cycle performances for the electrodes. For example, the results show that for LiFePO4 cathode with the polymer electrolyte, the addition of 10 wt% of LICGC/rGO composite achieved the higher rate capability (~122 mAh g−1, discharge at 3 C) and cyclability (~98.2% after 180 cycles at 1 C), compared to add LICGC only (~115 mAh g−1 and ~93.4%, respectively).

A high-capacity thick cathode has been studied as one of ways to improve the energy density of lithium secondary batteries. In this study, the LiFePO 4 cathode with a capacity per unit area of 8.4 m Ah cm −2 corresponding to four times the capacity of conventional cathodes has been developed using a three-dimensional porous aluminum current collector called “FUSPOROUS”. This unique current collector enables the smooth transfer of electrons and Li + -ions through the thick cathode, resulting in a good rate capability (discharge capacity ratio of 1.0 C/0.2 C = 0.980) and a high charge-discharge cycle performance (80% of the initial capacity at 2000th cycle) even though the electrode thickness is 400 μm. To take practical advantage of the developed thick cathode, conceptual designs for a 10-Ah class cell were also carried out using graphite and lithium-metal anodes.

Li metal battery with garnet-type Li7La3Zr2O12 (LLZ) as a solid electrolyte has attracted attentions as a promising candidate for high-energy batteries. However, the interfacial resistance between LLZ and Li is huge due to a point-point contact, leading to poor battery performances such as rate capability and cycleability. Here, we have studied the hybrid-electrolyte structure using the liquid electrolyte interlayer containing LiBH4 between LLZ and Li at high operating temperature of 120 °C. This hybrid-electrolyte structure offers high current density usage and a long-term cycleability. The Li|LLZ|Li symmetric cell shows high critical current density of 13 mA cm−2 and a long term cycle. The liquid electrolyte interlayer containing LiBH4 provides an improved coulombic efficiency of Li striping/plating due to an excellent reductive stability. Our findings suggest that the interfacial conditions on LLZ|Li could be effectively improved by using the modified liquid electrolyte interlayer.

Li metal battery with garnet-type Li7La3Zr2O12 (LLZ) as a solid electrolyte has attracted attentions as a promising candidate for high-energy batteries. However, the interfacial resistance between LLZ and Li is huge due to a point-point contact, leading to poor battery performances such as rate capability and cycleability. Here, we have studied the hybrid-electrolyte structure using the liquid electrolyte interlayer containing LiBH4 between LLZ and Li at high operating temperature of 120 °C. This hybrid-electrolyte structure offers high current density usage and a long-term cycleability. The Li|LLZ|Li symmetric cell shows high critical current density of 13 mA cm-2 and a long term cycle. The liquid electrolyte interlayer containing LiBH4 provides an improved coulombic efficiency of Li striping / plating due to an excellent reductive stability. Our findings suggest that the interfacial conditions on LLZ|Li could be effectively improved by using the modified liquid electrolyte interlayer.

Graphene has attracted considerable attention as the conductive agent for lithium batteries by providing a superior interfacial contact. However, the wrapping of active materials by the large area of graphene sheets may hinder the transportation of Li+ between active particles and electrolyte, especially at a high charge/discharge rates. Herein, holey graphene oxide (h-GO), which is made by a green wet ball-milling of GO in one step without using any catalysts or chemicals, is combined with carbon nanotubes (CNTs) and LiMn0.7Fe0.3PO4 (LMFP) to make a composite cathode for lithium batteries. Results show that after the electrochemical reduction, the LMFP cathode with h-GO/CNT shows remarkedly improved electrochemical performances due to the facilitated Li+ transport pathway, compared to that with conventional GO/CNT. For example, LMFP/h-GO/CNT composite cathode can achieve a discharge capacity of 112 mAh g−1 when discharged at 20 C, while LMFP electrode with conventional GO/CNT only shows a discharge capacity of 35 mAh g−1. This study provides a new approach for fabricating holey graphene and can open up new possibilities for applications on power sources.

This paper describes on-orbit operations of a power system for Japan’s Venus explorer Akatsuki. It was launched on May 20, 2010, and approached Venus on December 7, 2010, but orbit insertion failed because of a propulsion system malfunction. After the failure, the spacecraft stayed on an orbit nearer to the sun than Venus for 5 years before successfully entering an orbit around Venus in 2015. Telemetry data that show radiation degradation of the solar arrays, and here analytical results by the relative damage coefficients method are presented. The capacity loss of the batteries was successfully suppressed by lowering the state of charge and temperature. We plan to extend the mission period from 4.5 years to longer than 9 years to obtain more fruitful scientific results.

Introduction Olivine-type LiMnPO4 which is a cathode material for lithium ion batteries exhibits a higher operating potential (4.1 V vs. Li+/Li) than LiFePO4 thus has gathered more attention in recent years. However, due to the low electron conductivity of LiMnPO4 and the Jahn-Teller effect of Mn3+, it is difficult to achieve satisfied cycle performance. Fe doping of 10-30 mol% is promising as a solution to this problem [1]. Graphene is a single atomic monolayer of graphite and has been found a variety of applications in energy conversion and storage devices, due to the excellent properties such as high carrier mobility (~10,000 cm2 V−1 s−1 at room temperature), structural flexibility, chemical and thermal stability, mechanical strength and ultrahigh theoretical specific surface area (2630 m2g−1) [2]. Previous studies have reported the improved performance of LiMPO4 (M = Fe, Mn and Co by combining with graphene. In particular, it is attractive that the active material is supported on both sides of graphene to form a sandwich structure. One is that active material particles can be highly loaded and interconnected by the highly conductive matrix formed by graphene. The other one is that the sandwich structure can be beneficial for suppressing the graphene restacking and active material particles agglomeration. It is reported that such a graphene-metal oxide nanoparticle composite material can greatly improve the performances of the anode. However, there is still lack of a facial way to obtain ideally sandwich-structured composite material for cathode [3]. We will introduce a facial and high efficient way to synthesize carbon-coated LiMn0.7Fe0.3PO4 (LMFP)/reduced graphene oxide (rGO) sandwich-structured composite for high power lithium ion batteries [4]. Results and discussion The synthesis of sheet-like carbon-coated LMFP/rGO composite material is shown in Fig. 1. First, 0.3 g of LMFP powder (without carbon coating, average particle size 200 nm), 3 mL of oxidized graphite suspension and 0.04 g of sucrose are dispersed in 100 mL of water. Thereafter, by ultrasonic treatment for 2.5 hours, the oxidized graphite gradually peels off to form graphene oxide, and at the same time, the LMFP nanoparticles are supported on the surface of the GO by interaction with the GO functional group. The dissolved sucrose is coated with GO and LMFP particles to form a polymeric coating. After lyophilization, carbon coated LMFP/rGO composite material (LMFP/rGO@C) having a sandwich structure was obtained by heat treatment at 700 degrees under a reducing atmosphere. LMFP/rGO@C, acetylene black and binder were mixed at a mass ratio of 8:1:1 and coated onto Al foil to obtain a cathode electrode. Electrochemical characteristics were evaluated by preparing a 2032 type coin cell using Li foil as the counter electrode. The electrolyte was 1 mol dm-3 LiPF6/EC-DEC (1: 2). SEM image of the synthesized LMFP/rGO@C composite material is shown in Fig. 2. It is clearly observed that all the LMFP particles are uniformly dispersed on the rGO surface at high density (50 to 100 particles mm-2), forming a sandwich structure. The total content of rGO and carbon coating is estimated to be about 7 wt% from TG. Figure 3 shows the discharge rate performance of LMFP/rGO@C and carbon coated only LMFP (LMFP@C). It was confirmed that the discharge capacity of LMFP/rGO@C is greatly improved compared with LMFP@C. This should be due to the formation of a good three-dimensional conductive network by graphene. Acknowledgement We thank Taiheiyo Cement Co., Ltd for the providing of LiMn0.7Fe0.3PO4 powders and NIMS for the TEM measurement. Reference 1) Gong, et.al., Energy Environ. Sci. 4, 3223 (2011). 2) S. Han, et.al., Small. 9 1173–1187 (2013). 3) Z.-S. Wu, et.al. Nano Energy. 1 (2012). 4) D. Ding, et.al., submitted. Figure 1

Lithium metal is considered as the ultimate anode material for rechargeable batteries because it has the highest theoretical specific capacity (3,860 mAh g−1) and the lowest electrochemical potential (−3.04 V versus standard hydrogen electrode) of all possible candidates. However, dendritic Li growth and low Li Coulombic efficiency (CE) during Li plating/stripping hinder the practical applications of rechargeable lithium-metal batteries. In recent years, highly stable Li plating/stripping cycling has been achieved in the concentrated electrolytes of lithium bis(fluorosulfonyl) imide (LiFSI) in various solvents.1 , 2 Among the reported electrolytes, sulfolane (SL) is a promising solvent for high energy lithium metal batteries, since it has high anodic stability and low flammability. The concentrated electrolyte composed of LiFSI and SL shows high CE of ca. 98% and stable cycling of Li metal anode, however, the effect of LiFSI concentration on the long-term cyclability is unclear. Concentrated LiFSI/SL electrolytes have high viscosity and thus poor wettability toward conventional polyolefin separators, preventing stable Li plating/stripping cycling. We have previously reported that three dimensionally ordered macroporous polyimide (3DOM PI) membrane has high electrolyte wettability owing to its high porosity of ca. 70% and the relatively polar constituent of imide structure.3 Furthermore, uniform distribution of pores in a hexagonal close-packed arrangement of 3DOM PI membrane provides even current distribution during Li plating/stripping processes, preventing the dendritic Li growth. Therefore, 3DOM PI separator is expected to stabilize Li plating–stripping cycling. Here we studied the effect of LiFSI concentration in SL-based electrolyte on long-term Li plating/stripping behavior by using 3DOM PI separator. 3DOM PI separator exhibits good wettability toward concentrated LiFSI/SL electrolyte and highly stable Li plating/stripping than surfactant-coated polypropylene separator, enabling the evaluation of the long-term cyclability. Higher concentrated LiFSI/SL electrolyte realizes superior cyclability with low overpotential and high CEs during cycling. The ratio of F and N is higher, while that of C is much lower in the SEI on the Li metal cycled in the higher concentrated electrolyte. These results suggest that the FSI-derived SEI in the highly concentrated electrolyte suppresses decomposition of SL and subsequent increase in interfacial resistance, leading to long-term stable Li plating–stripping cycling. Acknowledgement This work is supported by The Furukawa Battery Co., Ltd. and 3DOM Inc. References X. Fan, L. Chen, X. Ji, T. Deng, S. Hou, J. Chen, J. Zheng, F. Wang, J. Jiang, K. Xu and C. Wang, Chem, 4, 174 (2018). X. Ren, S. Chen, H. Lee, D. Mei, M. H. Engelhard, S. D. Burton, W. Zhao, J. Zheng, Q. Li, M. S. Ding, M. Schroeder, J. Alvarado, K. Xu, Y. S. Meng, J. Liu, J.-G. Zhang and W. Xu, Chem, 4, 1877 (2018). Y. Maeyoshi, S. Miyamoto, H. Munakata and K. Kanamuraamura, J. Power Sources, 350, 103 (2017).

The phytohormone abscisic acid (ABA) is known to be a negative regulator of legume root nodule formation. By screening Lotus japonicus seedlings for survival on an agar medium containing 70 μM ABA, we obtained mutants that not only showed increased root nodule number, but also enhanced nitrogen fixation. The mutant was designated enf1 (enhanced nitrogen fixation 1) and was confirmed to be monogenic and incompletely dominant. In long-term growth experiments with M. loti, although some yield parameters were the same for both enf1 and wild-type plants, both the dry weight and N content of 100 seeds and entire enf1 plants were significantly larger compared than those traits in wild-type seeds and plants. The augmentation of the weight and N content of the enf1 plants most likely reflects the increased N supplied by the additional enf1 nodules and the concomitant increase in N fixation activity. We determined that the endogenous ABA concentration and the sensitivity to ABA of enf1 were lower than that of wild-type seedlings. When wild-type plants were treated with abamine, a specific inhibitor of 9-cis-epoxycarotenoid dioxygenase (NCED), which results in reduced ABA content, the N fixation activity of abamine-treated plants was elevated to the same levels as enf1. We also determined that production of nitric oxide (NO) in enf1 nodules was decreased. We conclude that endogenous ABA concentration not only regulates nodulation, but also nitrogen fixation activity by decreasing NO production in nodules.

The phytohormone abscisic acid (ABA) is known to be a negative regulator of legume root nodule formation. By screening Lotus japonicus seedlings for survival on an agar medium containing 70 microM ABA, we obtained mutants that not only showed increased root nodule number but also enhanced nitrogen fixation. The mutant was designated enhanced nitrogen fixation1 (enf1) and was confirmed to be monogenic and incompletely dominant. The low sensitivity to ABA phenotype was thought to result from either a decrease in the concentration of the plant's endogenous ABA or from a disruption in ABA signaling. We determined that the endogenous ABA concentration of enf1 was lower than that of wild-type seedlings, and furthermore, when wild-type plants were treated with abamine, a specific inhibitor of 9-cis-epoxycarotenoid dioxygenase, which results in reduced ABA content, the nitrogen fixation activity of abamine-treated plants was elevated to the same levels as enf1. We also determined that production of nitric oxide in enf1 nodules was decreased. We conclude that endogenous ABA concentration not only regulates nodulation but also nitrogen fixation activity by decreasing nitric oxide production in nodules.

Background: Recent studies suggest that treatment of heart failure (HF) could improve cardiac function and sleep apnea syndrome (SAS), but it is unknown how cardiac surgery may affect SAS in HF patients. Relationships between HF with valvular heart diseases and 2 types of SAS (obstructive sleep apnea (OSA) and central sleep apnea (CSA)) were examined. The effects of valve repair surgery on OSA and CSA was also investigated. Methods and Results: Polysomnography, echocardiography and right cardiac catheterization were used to study 150 severe HF patients with mitral valvular and/or aortic valvular diseases. Significant associations between SAS and age, gender, body mass index, or hypertension were observed. The value of the CSA-apnea index (AI) was significantly correlated with pulmonary capillary wedge pressure (PCWP) and mean pulmonary artery pressure (PAP). These associations were not identified for OSA-AI. Valve repair surgery was used to treat 74 patients with severe SAS. The treatment led to a significant improvement in PCWP and mean PAP, and CSA-AI, but not in OSA-AI. Conclusions: These findings suggest close associations between CSA and cardiac function in HF patients with valvular heart diseases. Furthermore, improvement of cardiac function with valvular surgery reduces the severity of CSA in HF patients with valvular heart diseases. (Circ J 2009; 73: 2148-2153)

Background Percutaneous coronary interventions involving small coronary vessels represent a true challenge because of the increased risk of restenosis and adverse outcomes. We evaluated the 2-year clinical outcomes between single everolimus-eluting stents (EES) and paclitaxel-eluting stents (PES) in small coronary artery disease. Methods From the data of SACRA (SmAll CoronaRy Artery treated by TAXUS Liberte) and PLUM (PROMUS/Xience V Everolimus-ELUting Coronary Stent for sMall coronary artery disease) registries, 245 patients with 258 lesions and 264 patients with 279 lesions, respectively, were enrolled in this study. Results The 2-year clinical driven target lesion revascularization (4.5% vs. 10.6%, p = 0.01) and target vessel revascularization (8.0% vs. 13.9%, p = 0.03) rates were significantly lower in the EES group compared with the PES group. Major adverse cardiac events in the EES group tended to be lower than those in the PES group (8.7% vs. 14.3%, p = 0.05). On the other hand, all new lesions for remote target vessel revascularization were observed at the proximal site of target lesions in both groups and those rates were not different between the two groups (3.4% vs. 3.3%, p > 0.99). Conclusion EES showed better clinical results at 2-year follow-up compared with PES in small coronary artery diseases, however, new lesions at the proximal remote site of the target lesion remain problematic.

Primary linitis plastica type of the colon ic cancer is uncommon. Only one hundred-odd cases have been reported in Japan since Watanabe and Yamamoto first reported in 1976. This type of cancer represents under one per cent of total colorectal cancers. This paper describes a recent case of primary diffuse infiltrative carcinoma of the rectum with a review of the literature. A 68-year-old woman was admitted to the hospital because of 2-month lasting melena and anal pain. On admission, the patient showed elevated levels of tumor markers. From barium enema and MRI findings, a diagnosis of the disease infiltrating into the uterus and vagina was made. Posterior pelvic excentration was carried out, resulteing in non-curative resection (S3, Ai Si, N4, Pl, and Stage IV). Postoperative course was uneventful and symptoms such as anal pain disappeared, however, since 2 months after the operation, lumbago, abdominal pain, and ascites occurred. Serum tumor markers also elevated remarkably. The patient died of cancer with peritonitis carcinomatosa and cahexia 6 months after the operation.

The mitochondrial DNA was isolated from Aspergillus niger WU-2223L, a citric acid-production strain, and characterized by restriction-endonuclease mapping. Cloned fragments which covered the total range of the mitochondrial DNA were assembled and utilized to construct the restriction-endonuclease map for nine restriction enzymes. This map showed that the mitochondrial DNA was a circular molecule of 32.6 kb.

Objective The prevalence of complex sleep apnea syndrome (CompSAS) among Asian patients with obstructive sleep apnea syndrome (OSAS) has not yet been reported. Distinguishing CompSAS from pure OSAS is difficult using only diagnostic polysomnography (PSG). We examined the prevalence of CompSAS in Japanese patients with OSAS and the possibility to distinguish CompSAS from pure OSAS by analyzing the severity of respiratory events based on either sleep body position or sleep stage using a diagnostic PSG. Patients and Methods A retrospective chart review of 297 consecutive Japanese patients who were 15 years of age or older with a primary diagnosis of OSAS who were referred for CPAP titration (AHI. 20 events/hr). Results Seventeen patients (5.7%) out of the 297 patients who had an obstructive apnea hypopnea index (AHI) of 20 or higher showed adverse increases in central apnea index (CAI) by the treatment with CPAP whereas obstructive apnea index (OAI) and mixed apnea index (MAI) were significantly decreased. In the results, the AHI on the PSG for CPAP titration reached only approximately half of the values on the diagnostic PSG. In these CompSAS patients, both the total CAI and the CAI in the supine position during NREM sleep on the diagnostic PSG were significantly higher than those in the OSAS group. The sleep body position did not so strongly affect the AHI, OAI and MAI in the CompSAS group. Multiple, stepwise, and logistic regression analyses revealed that the CAI in the supine position during NREM (p=0.026) was a significant variable to distinguish CompSAS from OSAS statistically although the variables were within the normal range. Conclusion The prevalence of CompSAS in Japanese OSAS patients may be lower when compared with Caucasian patients. The increase of CAI in the supine position during NREM sleep on diagnostic PSG may be a characteristic feature in CompSAS., Article, INTERNAL MEDICINE. 48(6):427-432 (2009)

OBJECTIVES: The purpose of this study was to determine the relationship between Sleep-disordered breathing (SDB) and cardiovascular disorders in a large Japanese population, and to assess the efficacy of continuous positive airway pressure (CPAP) in the treatment of SDB-associated arrhythmias. BACKGROUND: SDB is associated with cardiovascular disorders, such as hypertension, ischemic heart disease, and arrhythmias, and CPAP is one of the effective treatments for SDB; however, this relationship and the efficacy of CPAP treatment in a large population of Japanese patients remain undefined. METHODS AND RESULTS: The study population comprised 1413 Japanese subjects (mean age: 56.6 years old, 1123 men and 290 women) who were divided into 2 groups: SDB group ( n = 1064, apnea-hypopnea index (AHI)≥20)and control group ( n = 349, AHI < 20) by polysomnography (PSG) analysis. In baseline characteristics, age (58.3±14.7vs.50.0±18.4, p p p p p =0.015), or hyperlipidemia (15.6%vs.9.3%, p =0.018) were significantly associated with SDB. PSG revealed predominant occurrence of paroxysmal atrial fibrillation (PAF: 108/1064 vs. 3/349, p=0.005), premature ventricular complex (PVC: 359/1064vs.17/349, p=0.0012) and pause (sinus arrest ≥2 sec: 172/859vs.6/349, p=0.002) in SDB group. In the SDB group, 291 patients underwent CPAP titration and were then re-evaluated. CPAP therapy significantly reduced the occurrences of PAF (59/291vs.2/291, p=0.005), sinus bradycardia (18/291vs.0/291, p=0.002), and sinus pause (26/291 vs. 4/291, p=0.016). CONCLUSIONS: The results of this study provide a significant relationship between SDB and several cardiac disorders, and efficacy of CPAP in preventing SDB-associated arrhythmias in a large population of Japanese patients. Effect of CPAP on the arryhthmic events in patients with SAS during PSG recording

As one of the methods to improve the energy density of lithium secondary battery, the use of high capacity anode and cathode materials has been focused. Although metals and alloys are mentioned as anode material candidates with high capacity, on the other hand, the candidates for high capacity cathode are insufficient currently. Therefore, a large amount of active material has to be accumulated and compressed to the cathode to achieve high energy density in consideration of the capacity balance with anode (Fig. 1). However, good performance cannot be obtained in the conventional thick coating electrode with a large amount of active material. The thick coating electrode has many problems. The ohmic resistance increases as the distance between a current collector and active material is made longer. In addition, many cracks, dropouts, and exfoliations are caused by volume changes of the coated layer during charge and discharge. In this study, the high capacity thick cathode has been realized by using a porous aluminum as a current collector as a practical method to improve the energy density of lithium secondary battery (Fig. 2). The combination of the thick cathode with a very high capacity per unit area and a high capacity anode can omit the amount of supporting materials such as a separator in batteries, resulting in the high energy density. The various thick cathodes were prepared using lithium iron phosphate, lithium cobalt oxide, and lithium nickel-cobalt-manganese oxide, respectively, and their electrochemical characteristics were evaluated by half-cell test. Though the cathodes had about several times larger capacity than conventional coating cathodes, they exhibited excellent rate performance. For example, the cell comprised of the thick cathode using lithium iron phosphate with a porous aluminum and two pieces of graphite anodes showed approximately 4-5 times capacity of the cell using conventional coating electrode at the same effective electrode area, and no large difference was observed for a in the polarization of charge-discharge at 1.0CA (Fig. 3). In a cycle-life test, the cell exhibited an excellent charge-discharge cycle performance, and retained approximately 80% of initial capacity even at 2,000th cycle (Fig.4). Such excellent performance is expected to be due to the easy electrolyte permeation from one side to the other side of the thick cathode, which is achieved by a porous aluminum current collector in addition to three-dimensional current collection. Of course, the lithium-ion diffusion in the cathode is expected to be insufficient for charge and discharge reactions when the cathode and C rate become thicker and larger, respectively. Thus, further optimization is needed for the cathode as well as for the electrolyte solution and separator to improve the ion supply in the cell. Such battery design will be also mentioned in this study. Figure 1

Background: The purpose of this study was to determine the relationship between sleep apnea syndrome (SAS) and cardiovascular disorders, and to assess the efficacy of continuous positive airway pressure (CPAP) in SAS-associated arrhythmias. SAS is associated with cardiovascular disorders, such as hypertension, ischemic heart disease, and arrhythmias. CPAP is one of the effective treatments for SAS; however, this relationship and efficacy remain undefined. Methods and Results: The study population comprised 1413 Japanese subjects (mean age: 56.6 years old, 1123 men and 290 women) who were divided into two groups: SAS group (n=1064, apnea-hypopnea index (AHI)≥20) and control group (n=349, AHI