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A 52-year-old woman was diagnosed as having anti-centromere antibody (ACA)-positive primary Sjögren syndrome (pSS). Eight years later, she visited our hospital because she had developed dyspnoea. She was diagnosed as having pulmonary arterial hypertension (PAH) with pulmonary veno-occlusive disease on the basis of the results of right heart catheterisation, a severe decrease in diffusing capacity of the lung for carbon monoxide (D

A 78-year-old man who had worked in the building industry visited our hospital because of groundglass opacity with smoothly thickened, intralobular interstitial lines and interlobular septal lines on chest high-resolution computed tomography (HRCT). HRCT image also showed a focal area of reticulation and pleural thickening. Lung specimens obtained by surgical lung biopsy showed accumulations of intra-alveolar periodic acid-Schiffpositive materials, usual interstitial pneumonia (UIP)-like subpleural lung fibrosis and asbestos bodies (1 body/cm2 in high-power field, ×400). Serum granulocyte-macrophage colony stimulating factor autoantibody was positive. The patient was diagnosed as having autoimmune pulmonary alveolar proteinosis (PAP) and needed differential diagnosis from secondary PAP caused from pulmonary asbestosis and UIP. Careful observation of the manifestations of pulmonary asbestosis and the progression of fibrosis using HRCT will be necessary in this patient.

Anti-melanoma differentiation-associated gene 5 antibody (anti-MDA5-Ab) is associated with fatal rapidly progressive interstitial lung disease (RP-ILD) in patients with dermatomyositis (DM). We attempted to clarify whether anti-MDA5-Ab is associated with long-term outcomes in patients with DM-ILD.Thirty-six patients with DM-ILD were retrospectively analyzed for their serum anti-MDA5-Ab by using an enzyme-linked immunosorbent assay. We analyzed the association between clinical parameters, including the serum levels of anti-MDA5-Ab and ferritin.Fourteen patients (39%) were positive for anti-MDA5-Ab. The serum levels of anti-MDA5-Ab and ferritin in 7 patients with acute death were higher than those in the surviving patients. An "unclassifiable pattern" on chest computed tomography and the development of RP-ILD were also prognostic markers. The serum levels of anti-MDA5-Ab and ferritin (cut-off levels, 100 IU/mL and 899 ng/mL, respectively) were markers predictive of acute death, showing good sensitivity (86% and 83%) and specificity (97% and 100%). All 7 patients with acute death developed RP-ILD and were positive for anti-MDA5-Ab, including 6 patients with a high titer (≥100 IU/mL), whereas only 2 patients (29%) developed RP-ILD among the 7 survivors with a low titer of anti-MDA5-Ab (100 IU/mL). In contrast, a low positive titer of anti-MDA5-Ab was not associated with changes in pulmonary function for 2 years.Although a high serum titer of anti-MDA5-Ab (≥100 IU/mL) is associated with acute death via the development of RP-ILD, outcomes in the chronic phase for patients with a low titer of anti-MDA5-Ab (100 IU/mL) were similar to those of patients without anti-MDA5-Ab.

We describe a case of a woman who presented with a persistent cough, general fatigue, and a fever. Interstitial lung disease was rapidly progressive and resistant to high-dose steroid therapy. She tested positive for the presence of anti-melanoma differentiation-associated gene 5 (MDA-5) antibody, although she had no skin manifestations of dermatomyositis. She was eventually diagnosed with unclassifiable idiopathic interstitial pneumonia and was successfully treated with intensive immunosuppressive therapy including intravenous cyclophosphamide. To our knowledge, this is the first report of anti-MDA-5 antibody in a patient with idiopathic interstitial pneumonia.

A 40-year-old female dental technician visited our hospital for the investigation of a chest X-ray abnormality. Chest computed tomography demonstrated centrilobular nodules and lung volume reduction, and her serum KL-6 level was elevated. A histological analysis of the specimens obtained on a surgical lung biopsy showed peribronchiolar fibrosis with pigmented macrophages and cholesterol clefts. An energy-dispersive X-ray analysis showed that these lung tissues contained some metals, including indium. The serum indium level was also elevated. We diagnosed this patient with pneumoconiosis caused by exposure to sandblasting certain dental metals. This is the first reported case of pneumoconiosis in a dental technician associated with exposure to indium.

The main target of anti-inflammatory drug therapies for coronavirus disease 2019 (COVID-19) is reducing the risk of acute respiratory distress syndrome (ARDS), an important risk factor for acute death. In the RECOVERY trial, 6 mg/day of dexamethasone for up to 10 days improved 28-day mortality compared with those who received usual care alone. Here, we present three COVID-19 cases who improved after treatment with methylprednisolone (MPSL) and/or following prednisolone (PSL) for acute progression of respiratory failure. Three male COVID-19 patients, aged 56, 84, and 49 years old, developed acute respiratory failure after admission. MPSL therapy (500 mg/day for 3 days) was started for these patients at 4, 4, and, 2 days after admission, respectively, when oxygen administration was required. Following this therapy, two of the three present cases received 30 or 40 mg/day of PSL for an additional 6 and 8 days, respectively. The remaining case discontinued corticosteroid after MPSL therapy. All three cases survived, had fever reduction at 6, 2, and 1 days after start of MPSL therapy, could discontinue oxygen therapy at 6, 6, and 11 days after start of MPSL therapy, and showed negative results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction at 8, 6, and 22 days after start of MPSL therapy, respectively. No serious side effects due to drug discontinuation of treatment for COVID-19 were observed. MPSL is a candidate drug for corticosteroid therapy for COVID-19. Corticosteroid therapy should be started in the early stage of respiratory failure. Optimal drug selection, timing of intervention, dose, and duration of corticosteroid therapy for COVID-19 should be analyzed in the further studies. © Journal of Xiangya Medicine. All rights reserved.

The essential features and scale of sensor data was discussed to monitor the tool anomaly in the machining process from the pattern variation of large scale sensor data such as vibration and effective power. The cycle data, the time series sensor data collected with an acceleration or power sensor in one periodical machining of the given groove shape, had been measured periodically. In this study, the graphic pattern formed by overwriting the time series cycle data on a specific coordinate system was treated as the “big sensor data”. The big data from the effective power sensor can stably respond to the cutting power changes and showed a strong possibility as a detecting device for tool anomaly such as abrasive wear and chipping. While the big data from the acceleration sensor only responded to a big event like the chattering vibration. The number of cycle data needed to generate the big sensor data also affected on the detection sensitivity for tool anomaly. It had been required a family of time series sensor data enough to represent the cutting power change as a visual graphic pattern.

A damage-free cutting method called the constant- load feeding method is proposed as a high-precision machining method in carbon-fiber-reinforced plastic (CFRP) cutting. The constant-load feeding method can minimize cutting defects such as burrs and scuffing during diamond-saw cutting. In addition, there was no apparent cutting damage to the cutting surface from drilling with a high-speed steel twist drill. The cutting resistance was kept at a constant value during the entire process. The constant-load feeding can self-regulate the optimal tool feed rate to realize damage-free machining of CFRP composites without any feedback control systems based on the cutting-force.

An innovative cutting method, constant load feeding method, is proposed as a high precision secondary working tool in CFRP cutting. The constant load feeding can restrain the occurrence of cutting defects such as burr and scuffing in a diamond saw cutting. The combining of constant load feeding with point contact eliminated most of the cutting defects even in the CFRP cutting with a low rigidity cutting tool like the diamond saw blade. In addition, there was no apparent cutting damage on the cutting surface obtained from the drilling with constant load feeding. These facts indicate that the self-generated feed rate in the constant load feeding would be the optimal feed rate to realize a defect-free drilling of CFRP composites.

It is well known that a series of cracks running perpendicular to the cutting edge are sometimes formed on the rake face of brittle cutting tools during intermittent cutting. The cutting tool is exposed to elevated temperatures during the periods of cutting and is cooled quickly during noncutting times. It has been suggested that repeated thermal shocks to the tool during intermittent cutting generate thermal fatigue and result in the observed thermal cracks. Recently, a high speed machining technique has attracted attention. The tool temperature during the period of cutting corresponds to the cutting speed. In addition, the cooling and lubricating conditions affect the tool temperature during noncutting times. The thermal shock applied to the tool increases with increasing cutting speed and cooling conditions. Therefore, to achieve high-speed cutting, the evaluation of the thermal shock and thermal crack resistance of the cutting tool is important. In this study, as a basis for improving the thermal shock resistance of brittle cutting tools during high-speed intermittent cutting from the viewpoint of cutting conditions, we focused on the cooling conditions of the cutting operation. An experimental study was conducted to examine the effects of noncutting time on thermal crack initiation. Thermal crack initiation was found to be restrained by reducing the noncutting time. In the turning experiments, when the noncutting time was less than 10 ms, thermal crack initiation was remarkably decreased even for a cutting speed of 500 m/min. In the milling operation, the number of cutting cycles before thermal crack initiation decreased with increasing cutting speed under conditions where the cutting speed was less than 500 m/min. However, when the cutting speed was greater than 600 m/min, thermal crack initiation was restrained. We applied the minimal quantity lubrication (MQL) coolant supply to the intermittent cutting operation. The experimental results showed that the MQL diminished tool wear compared with that under the dry cutting condition and inhibited thermal crack initiation compared with that under the wet cutting condition.

Angulated screw channel system abutments (ASCs) have recently been introduced to address the problem with visible screw access that may compromise esthetics. ASCs allow the screw access to be modified up to 25 degrees relative to the implant axis. However, a widened channel, which may cause thinning of the facial ceramic, is needed at the implant screw head to allow for proper engagement of the screwdriver. This technical report introduces a custom titanium insert design, the Satoshi Sakamoto (SS) abutment. The SS abutment consists of a custom titanium metal insert and zirconia coping in which the access hole is located in an esthetic position with an ASC system. The SS abutment results in a crown with more normal crown dimensions that also provides more space for the soft tissues. This SS abutment design allows clinicians to obtain screw-retained restorations with optimal esthetics and mechanical strength.

We propose a supervisory technique to monitor the material removal state and tool wear condition as well as the estimation method for overall power consumed in the machining from the effective spindle power change. The effective power (VAcosφ) was the optimal motor related parameter to represent the motor load. The cutting condition can be related with the effective power change by using the averaged effective power for 0.2 seconds. The mean effective power is in proportion to the material removal rate. In addition, the averaged effective power can monitor continuously the tool wear condition and tool breakage. There was a series of cutting conditions where the specific effective power becomes minimum in the grooving operation. Under the cutting conditions with the minimum specific effective power, the cutting would have been conducting at the least cutting resistance and less overall power consumed. These facts indicates that we can determine the cutting conditions, where the cutting resistance and overall power consumed are getting minimum at the same time, by measuring the effective spindle power change during the operation.

We propose a dynamic observation concept to pretend aged degradation of water-soluble coolant. The first-hand observation of coolants by a CCD microscope is extremely useful for monitoring the drastic appearance change. The appearance changes of coolant also could be monitored by combining the reflectance changes from the Red, Green and Blue LED lights. The physical process of absorbing light is occurred only at the specific wavelength in the water-soluble coolants. The absorbance at the specific wavelength would become a reliable indicator to predict the controlled condition of water-soluble coolant. Setting up these sensing systems to the machine tools make it possible to observe the coolant dynamically and on real time.

The quality of machining and assembling parts significantly depends on the skills of the technician. To achieve high-precision machining, a skilled technician carefully considers various factors and applies suitable machining methods and conditions. Therefore, to correctly evaluate the machining cost-precision tradeoffs of their designs, mechanical engineers should have intimate knowledge of machining methods and techniques. Mechanical engineers should know how machining technicians analyze blueprints and compile machining procedures. In Japan, many skilled technicians have been retiring in recent years—known as the “Year 2007 Problem”—and the shortage of technicians and downfall in the education of practical engineers have become a serious issue. In this study, to develop effective educational methods for apprentice or low-skilled technicians and engineers, we experimentally investigated the decision-making processes of highly skilled turning technicians before and during machining. We found that highly skilled technicians focus on the function and tolerance of the parts, whereas apprentice technicians tend to focus on the ease of machining.

To reduce the management cost and environmental load of water-soluble coolant, authors have been studying on a metabolic system for water-soluble coolant. More than 90% of waste water-soluble coolant is composed of water phase. If the oily additives and contaminants can be isolated from the waste coolant, the amount of waste coolant decreases remarkably because the recycled water can be reutilized as a diluent of renewal coolant. Authors has been developed some types of water recovery methods for the metabolic system. To complete the metabolic system for water-soluble coolant, the coolant diluted with recovered water should have the same machining performance and long-term stability as those of coolant diluted with tap water. In this report, we examined the machining performance and ability change of water-soluble coolant diluted with recycled water under operations encountered in machine tool.

In late years, multi-wire saw has been used for the slicing of a silicon ingot for solar batteries, and multi-wire sawing is going to become the mainstream of precision slicing method for hard and brittle materials. However, in slicing by multi-wire saw, the technique for appropriately evaluating the severity of the slicing state or the slicing conditions has not been established yet. Therefore, there are a lot of parts where it relies on expert's experience rule as for the decision of the slicing conditions. In this study, an evaluation functions to evaluate severity of a slicing state or slicing conditions are derived. An analytical technique for modeling the machining process used by other abrasive machining to derive the evaluation functions is applied for multi-wire sawing. And evaluation function “mean depth of cut”, “normalized depth of cut” and “specific slicing energy” are derived. In this paper, slicing experiments are done under various slicing conditions, and it is examined about utility of the derived evaluation functions. As a result of investigation, utility of the derived evaluation functions were confirmed.

The micro-Raman spectra of a double-layer light-emitting diode fabricated with poly(3,4-ethylenedioxythiophene)-poly(4-styrenesulfonate) (PEDOT–PSS) as a hole-injection layer and poly(2,7-(9,9-dioctylfluorene)- alt -benzothiadiazole) (F8BT) blended with poly(9,9-dioctylfluorene) (PF8) as an emissive layer have been measured with excitation at 633 nm. After the operation of the device, the intensities of the bands due to PEDOT have increased. These increases in Raman intensity have been attributed to the reduction (dedoping) of PEDOT chains during operation on the basis of the results of electrochemical oxidation and reduction of a PEDOT–PSS film. The reduction of PEDOT chains is most likely one of the intrinsic factors of the degradation of polymer light-emitting diodes.

In order to achieve a high efficiency and accuracy in slicing of hard and brittle materials, a work rotating type multi-wire sawing method has been devised. Work rotating type multi-wire sawing is one of the most effective slicing methods for hard and brittle materials. However, this method has to fix a workpiece at the end of the slicing process. When a diameter of workpiece is large, this fixation becomes difficult. The main purpose of this study is to propose a newly developed bundled workpieces method. By this method, several workpieces are bundled up around a core material and fixation of workpiece becomes needless. This new method is expected to prevent the sliced wafers from scattering and to enable complete slicing. The work material used in this study is borosilicate glass. The main results obtained are as follows. (1) Work rotating type multi-wire sawing using the bundled workpieces method makes it possible to prevent the wafers from breaking off before the completion of slicing, and to prevent them from scattering. (2) Work rotating type multi-wire sawing using coated bundled workpieces makes it possible to stabilize the slicing performance. (3) Work rotating type multi-wire sawing using this method improves the slicing rate. (4) Slicing precision of the normal work rotating type multi-wire sawing and bundled workpieces method is the same grade.

This paper presents the results of a series of experiments performed to examine the validity of a theoretical model for evaluation of cutting forces and machining error in ball end milling of curved surfaces. The experiments are carried out at various cutting conditions, for both contouring and ramping of convex and concave surfaces. A high precision machining center is used in the cutting tests. In contouring, the machining error is measured with an electric micrometer, while in ramping it is measured on a 3-coordinate measuring machine. The results show that in contouring, the cutting force component that influences the machining error decreases with an increase in milling position angle, while in ramping, the two force components that influence the machining error are hardly affected by the milling position angle. Moreover, in contouring, high machining accuracy is achieved in “Up cross-feed, Up cut” and “Down cross-feed, Down cut” modes, while in ramping, high machining accuracy is achieved in “Left cross-feed, Downward cut” and “Right cross-feed, Upward cut” modes. The theoretical and experimental results show reasonably good agreement.

Thinning of silicon wafers and reduction of kerf loss can minimize the manufacturing costs of semiconductor products. Currently, the volume of kerf loss is about the same as the volume of the wafer itself. Therefore, we study slicing techniques for silicon wafers that result in reduced kerf loss by using an ultrafine wire tool and fine abrasive grains. As a first step, grooving characteristics using an ultrafine tungsten wire tool and fine abrasive grains are investigated in this paper. A borosilicate glass is used as the work material. The main conclusions are as follows: Precision machining using ultrafine wire tool is possible and the kerf loss decreases because the groove width decreases. However, a larger diameter of the wire tool results in a deeper groove. A faster relative speed produces a shorter wire tool lifetime, but a deeper groove. To supply enough abrasive grains to the machined portion, it is necessary to use abrasive grains having a suitable particle size for the specific diameter of the ultrafine wire tool.

This paper presents a theoretical model by which cutting forces and machining error in ball end milling of curved surfaces can be predicted. The actual trochoidal paths of the cutting edges are considered in the evaluation of the chip geometry. The cutting forces are evaluated based on the theory of oblique cutting. The machining errors resulting from force induced tool deflections are calculated at various parts of the machined surface. The influences of various cutting conditions, cutting styles and cutting modes on cutting forces and machining error are investigated. The results of this study show that in contouring, the cutting force component which influences the machining error decreases with increase in milling position angle; while in ramping, the two force components which influence machining error are hardly affected by the milling position angle. It is further seen that in contouring, down cross-feed yields higher accuracy than up cross-feed, while in ramping, right cross-feed yields higher accuracy than left cross-feed. The machining error generally decreases with increase in milling position angle.

We have previously reported that dexamethasone increased follicle-stimulating hormone (FSH) secretion via suppression of inhibin in immature female rats. In the present study, we investigated the effects of dexamethasone or triamcinolone on follicular development and ovarian functions (estradiol and inhibin secretion) in equine chorionic gonadotropin (eCG)-primed immature female rats. Dexamethasone significantly increased the number of ovulated oocytes in immature female rats treated with 5 i.u. eCG. Serum concentration of FSH in eCG-treated female rats was increased by administration of dexamethasone or triamcinolone, showing the peak value at 9 h after its administration, although the levels of inhibin markedly decreased at that time. Serum concentrations of inhibin and estradiol in eCG-treated female rats increased at 24 h after administration of dexamethasone or triamcinolone. These results demonstrate that dexamethasone or triamcinolone increases FSH secretion, and the excess amount of FSH strongly stimulates follicular development cooperating with exogenous eCG.

Fuzzy control is applied to the superfinishing in order to optimize the cutting ability of the stone. The finishing performance of vitrified bonded WA stone is regarded as the fuzzy goal. At the beginning of cutting, the stone is in the stage of cutting to get high stock removal rate. But the cutting ability is decreasing as the finishing proceeds and is lost at the end of finishing, resulting in getting the smooth surface. A cutting resistance is used to monitor the cutting condition of stone. The cutting ability of stone is controlled by both the stone pressure and the amount of electricity for electrolytic in-process dressing. A water-solution type coolant and metal bonded diamond stone are used. The main results obtained are as follows. Fuzzy control makes it possible to give the optimized cutting ability to the diamond stone. In the first case, it is possible to get the large stock removal following the smooth surface in a limited time. In second case, it is possible to minimize the finishing time in which the finishing performance intended in stock removal and surface roughness is obtained. In third case, it is possible to keep the cutting ability of stone constant for a long time.

This paper describes a numerical and experimental analysis on the variation of the magnetic sensitivity of the active surface region of AlGaAs∕InGaAs two dimensional electron gas Hall effect biosensors with location and number of superparamagnetic beads. Experiments were conducted using linear arrays of devices consisting of ten sensors each with an area of 5×5μm2. The edges and corners of the Hall sensors were most sensitive and exhibited a linear response. These results are important for commercialization of high sensitivity Hall effect biosensors with a wide dynamic range.