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We have developed a new phoswich detector consisting of an NE213 liquid scintillator surrounded by an NE115 plastic scintillator to measure high energy neutron spectra accurately in a charged-particle mixed field. Differences in the decay time constants of light outputs from the two scintillators make it possible to separate charged-particle-induced and neutron-induced pulses. Experiments were carried out at the RIKEN and at the NIRS cyclotrons. This detector was found to be able to discriminate neutron and gamma-ray events from external-proton events. This detector will be useful to measure high energy neutrons in space.

Theory and experiment of the degradation of II-VI blue-green laser diodes using quantum-well (QW) structures are presented. We develop the fundamental equations for the operation current of laser diodes as a function of aging time under the constant optical power aging condition. We show experimental results for the increase of the operation current as a function of aging time and its dependence on the ambient temperature. We find that the increase of the threshold current and the operation current under constant optical output power aging condition is caused by the increase of the nonradiative recombination current due to the increase of the defect density. The generation of the defect density follows a kinetic mechanism caused by an electron-hole recombination enhancement. Thermal effects also accelerate the degradation of the laser diodes. Our theory agrees very well with the experiment.

A newly developed large two-pad journal bearing with cooling ditches and viscous pump for turbines of electric utilities was analyzed theoretically. The turbulent thermohydrodynamic lubrication analysis was done in connection with the flow analysis of oil circulating system through the cooling ditches and the viscous pump. The complicated simultaneous equations concerned with the oil flow in the bearing were solved and used to design a bearing of 535 mm diameter which will make its appearance in a near future. Full size bearing tests were carried out to check the bearing performance and viscous pump performance and to confirm the accuracy of the calculation method. Good agreement was obtained between the theoretical and experimental results.

We have investigated the mechanism of stimulated emission in ZnCdSeZnSSe quantum wells through measurements of the optical gain spectrum between 77 and 270 K. We also calculated the optical gain using a model which included many-body effects and found excellent agreement with our measurements. Our results are inconsistent with an excitonic gain mechanism and we conclude that the stimulated emission arises from an electron—hole plasma in our samples. However, we find that the electron-hole Coulomb interaction is still significant at room temperature in II–VI heterostructures.

BACKGROUND The number of long-term survivors after hematopoietic stem cell transplantation (HSCT) showed steady increase in the past two decades. Second malignancies after HSCT are a devastating late complication. We analyzed the incidence of, risk compared with that in the general population, and risk factors for secondary solid cancers. PATIENTS AND METHODS Patients were 17 545 adult recipients of a first allogeneic stem cell transplantation between 1990 and 2007 in Japan. Risks of developing secondary solid tumors were compared with general population by using standard incidence ratios (SIRs). RESULTS Two-hundred sixty-nine secondary solid cancers were identified. The cumulative incidence was 0.7% [95% confidence interval (CI), 0.6%-0.9%] at 5 years and 1.7% (95% CI, 1.4%-1.9%) at 10 years after transplant. The risk was significantly higher than that in the general population (SIR=1.8, 95% CI, 1.5-2.0). Risk was higher for oral cancer (SIR=15.7, 95% CI, 12.1-20.1), esophageal cancer (SIR=8.5, 95% CI, 6.1-11.5), colon cancer (SIR=1.9, 95% CI, 1.2-2.7), skin cancer (SIR=7.2, 95% CI, 3.9-12.4), and brain/nervous system cancer (SIR=4.1, 95% CI, 1.6-8.4). The risk of developing oral, esophageal, or skin cancer was higher at all times after 1-year post-transplant. Extensive-type chronic graft-versus-host disease (GVHD) was a significant risk factor for the development of all solid tumors (RR=1.8, P

The safety and efficacy of myeloablative therapy followed by autologous peripheral blood stem cell transplantation (ABSCT) for acute myelogenous leukemia (AML) were evaluated in 60 patients. Peripheral blood stem cells (PBSC) were collected during recovery after consolidation chemotherapy. High-dose chemotherapy consisting of busulfan (16 mg/kg), etoposide (40 mg/kg), and cytosine arabinoside (3 g/m2 x 4) (BEA regimen) was used for pretransplant conditioning in 13 patients. For the remaining 47 patients, granulocyte colony-stimulating factor (G-CSF) was administered concurrently with the BEA regimen during conditioning. Unpurged, cryopreserved PBSC containing a median number of 5.4 x 10(8) MNC/kg or 12 x 10(4) CFU-GM/kg were reinfused at transplantation. The median number of days to granulocytes exceeding 500/microl and last platelet transfusion were 15 (8-44) and 24 (0->180), respectively. The 3-year probabilities of disease-free survival (DFS) and relapse were 78.6 and 21.4% for patients transplanted in first remission, 29.6 and 64.4% for those in second or third remission, and 11.1 and 77.8% for those in relapse, respectively. There were no transplant-related deaths within 100 days of transplantation. Age, disease status at transplantation, and number of induction chemotherapies to first complete remission were risk factors affecting the outcome of ABSCT. These results of ABSCT for AML in first remission warrant a prospective study of ABSCT as post-remission therapy.

With the exception of carcinomas of the skin and lip, carcinoma of the bronchus is the most common carcinoma that afflicts recipients of solid organ grafts. Of 859 tumors occurring in 830 recipients of thoracic organs reported to the Cincinnati Tumor Transplant Registry, 242 were carcinomas and 68 of these were bronchogenic carcinomas, which therefore made up 8 % of the overall total. There are, however, relatively few reports of heart transplant patients with bronchogenic carcinoma in the literature. We present details of four patients who developed this malignancy out of a total of 196 patients who survived and have been followed up for more than 3 months at our center, an incidence of 2 %. The mean period from the time of transplant to diagnosis of malignancy was 58 months (range 11–82 months). The histology was squamous or anaplastic in three cases, and adenocarcinoma in one. Immunosuppressive therapy was reduced in all cases. Resection was carried out in two patients (both of whom died 6 and 11 months later, respectively), resection was combined with chemotherapy and radiation in one patient (alive 15 months later), and therapy consisting of radiation alone was given to one patient (died within 1 month). We conclude that bronchogenic carcinoma is relatively common in patients with heart transplants and that it has a poor prognosis.

YBa/sub 2/Cu/sub 3/O/sub 7-y/ (YBCO) thick films were prepared by liquid phase epitaxy on crystalline substrates. The microstructure of the films is dominated by the misfit of the constant between the YBCO and the substrate. Misfit dislocations are introduced to release the stress due to lattice misfit between the YBCO and the substrate. The residual stress caused other kinds of defects in the YBCO films. The defects introduced to the YBCO films behave as effective pinning centers to enhance the pinning force in the magnetic field.

C-axis oriented Nd/sub 1+x/Ba/sub 2-x/Cu/sub 3/O/sub y/ thick films were grown by the liquid phase epitaxy (LPE) technique onto MgO (100) single crystal substrates in Ar gas atmosphere containing 0.5 at.% O/sub 2/. The superconducting transition temperature T/sub c/ was very broad, when the film thickness was 10 /spl mu/m but became very sharp when it was increased to 100 /spl mu/m. The T/sub c/ value for the 100 /spl mu/m thick film could be increased up to 92 K by post-annealing at 300/spl deg/C for 336 hrs in O/sub 2/ atmosphere. Moreover, the peak effect, which is characterized by an increase in magnetisation with increasing magnetic field up to 15000 G at 50 K, was observed in the 100 /spl mu/m thick film. A substantial improvement in the superconducting properties when the film thickness is increased to 100 /spl mu/m, can be attributed to the stable persistence of the steady state growth mode instead of the transient mode responsible for the first 10 /spl mu/m thick deposition.

We present a kinetic model for the optical output degradation of light-emitting diodes based on the carrier-recombination enhanced defect motion. Our model leads to analytical solutions and universal curves for the optical output power and the defect density as a function of the normalized aging time with the initial quantum efficiency as the determining parameter. The theoretical results explain very well the time dependence of the II-VI light-emitting diodes under constant current aging condition. The faster aging rate with increasing bias current or temperature is also investigated both experimentally and theoretically, resulting in a very good agreement. Our model provides a quantitative description of the light-emitting diode aging characteristics for compound semiconductors in the presence of electron-hole recombination-enhanced defect generation.

We characterized the proliferative action of prostaglandins (PGs) in relation to their membrane receptors on rat hepatocytes in primary culture. PGs in the order 16,16-dimethyl PGE2 > PGE2 > PGF2alpha >> PGD2 augmented epidermal growth factor (EGF)/insulin-induced DNA synthesis, assessed by [(3)H]thymidine incorporation, in a concentration-dependent manner, whereas PGs alone did not stimulate basal DNA synthesis without EGF and insulin. The cells exhibited [(3)H]PGE2 binding sites that were displaced by unlabeled PGs in the order PGE1 = PGE2 > PGF2alpha > PGD2. PGE2 inhibited glucagon-stimulated adenosine 3',5'-cyclic monophosphate (cAMP) accumulation concentration dependently. The mean effective concentration for DNA synthesis, median inhibitory concentration for cAMP accumulation, and dissociation constant for [(3)H]PGE2 binding at 25 degrees C were almost identical (approximately 70 nM). Treatment of the cells with pertussis toxin (100 ng/ml), which ADP-ribosylated most of the 41-kDa substrate, abolished the proliferative effects of PGs. We detected the expression of mRNA of the EP3 subtype PGE2 receptor using reverse transcription-polymerase chain reaction. Moreover, an EP3 agonist, enprostil, but not the EP1 agonist 17-phenyl-trinor-PGE2 or the EP2/EP4 agonist 11-deoxy-PGE1, stimulated EGF/insulin-induced DNA synthesis. These results indicate that PGs act as comitogenic growth factors through the EP3 subtype PGE2 receptor coupled with G(i) protein in cultured rat hepatocytes.

A lifetime of over 100 h has been achieved at room temperature under CW conditions for a ZnCdSe/ZnSSe/ZnMgSSe separate-confinement heterostructure laser diode with a dark-spot density lower than 3 × 10 3 cm −2 . The density of pre-existing crystal defects such as stacking faults is reduced when there is a GaAs buffer layer on the GaAs substrate and Zn is irradiated before ZnSe growth. We have entered into a stage where the operation of II–VI laser diodes is limited by recombination enhanced defect reaction. Despite possible rapid degradation mechanisms, especially those related to II–VI materials' higher ionicity than that of III–V material's, II–VI laser diodes have shown a lifetime of more than 100 h for the first time.

Oxidation studies on intermetallic compounds carried out in Japan in the last ten years have been summarized and critically reviewed. The major effort was expended to improve the oxidation resistance of TiAl-base materials. The methods tried include alloying additions, surface treatments and combinations of the both. Alloying additions to TiAl were more closely reviewed here. An excellent oxidation resistance was obtained owing to the formation of Al2O3 scales by alloying additions of 0.2Zr, 0.2Hf or 500 ppm Cl, and by Nb-ion implantation. Preoxidation under reduced oxygen pressures also resulted in the formation of protective Al2O3 scales. Ceramic coatings and MCrAlY type coatings showed some improvement in the oxidation resistance. Studies on other aluminides of current interest arc relatively few. On the other hand, studies on suicides arc becoming more active than before, though still few in comparison with TiAl-base materials. In the concluding remarks directions for future studies are shown. Oxidation von intermetallischen Verbindungen – Japanische Aktivitaten Die in den letzten Jahren in Japan durchgefuhrten Oxidationsuntersuchungen an intermetallischen Verbindungen werden zusammengefast und kritisch bewertet. Die Hauptanstrengungen richteten sich auf die Verbesserung des Oxidationswiderstandes von Werkstoffen auf TiAl-Basis. Die versuchten Methoden beinhalten Legierungszugaben, Oberflachenbehandlungen und eine Kombination von beiden. Die Legierungszugaben zu TiAl werden hier naher betrachtet. Durch die Zugabe von 0.2Zr, 0.2Hf oder 500 ppm Cl und beim Nb-Ionen-Implantieren wird durch die Bildung von Al2O3-Zunder ein ausgezeichneter Oxidationswiderstand erreicht. Die Voroxidation unter reduziertem Sauerstoffdruck fuhrte ebenfalls zur Bildung eines schutzenden Al2O3-Zunders. Keramische Beschichtungen and Beschichtungen vom Typ MCrAlY zeigten einige Verbesserungen im Oxidationswiderstand. Untersuchungen an anderen Aluminiden mit aktuellem Interesse gibt es nur relativ wenig. Andererseits werden zunehmend Studien an Siliciden durchgefuhrt, wenn auch deren Anzahl noch gering ist verglichen mit Werkstoffen auf TiAl-Basis. In den Schlusfolgerungen werden Zielrichtungen fur zukunftige Untersuchungen aufgezeigt.

To elucidate the impact of pretransplant body mass index (BMI) on the clinical outcome, we performed a retrospective study with registry data including a total of 12 050 patients (age ⩾18 years) who received allogeneic hematopoietic SCT (HSCT) between 2000 and 2010. Patients were stratified as follows: BMI

Background Clostridium difficile is a major cause of nosocomial diarrhea. The incidence and prognosis of C. difficile-associated diarrhea (CDAD) has not yet been assessed in adult patients after unrelated cord blood transplantation (uCBT). Methods The medical records of 135 adult unrelated cord blood transplant recipients were reviewed retrospectively to investigate the clinical features of CDAD after uCBT. These data were compared to medical records of 39 unrelated bone marrow transplant recipients and 27 related peripheral blood stem cell transplant recipients as controls. Results A total of 17 recipients developed CDAD, with onset occurring at a median of 22 days (range, 0–56 days) after transplantation. Among the unrelated cord blood transplant recipients, 11 (9%) developed CDAD. These results were comparable with those of CDAD after unrelated bone marrow transplantation (uBMT) (2/39, 6%) and related peripheral blood stem cell transplantation (rPBSCT) (4/27, 16%) (P = 0.37). Fifteen of the infected recipients were successfully treated with oral metronidazole, vancomycin, or cessation of antibiotics. The remaining 2 recipients who developed CDAD after uCBT died of other causes. The development of CDAD did not negatively affect overall survival after uCBT. Conclusions These data indicate that the incidence and prognosis of CDAD after uCBT are comparable with those after uBMT and rPBSCT.

Background We aimed to clarify the impact of the donor source of allogeneic stem cell transplantation (allo-SCT) on Philadelphia chromosome-negative acute lymphoblastic leukemia [Ph(-) ALL] with focus on cord blood (CB). Patients and methods We retrospectively analyzed data of 1726 patients who underwent myeloablative allo-SCT for adult Ph(-) ALL. The sources of the allo-SCT were related donors (RD; N = 684), unrelated donors (URD; N = 809), and CB (N = 233). Results Overall survival (OS) in patients after CB allo-SCT in first complete remission (CR1) was comparable with that after RD or URD allo-SCT (RD: 65%, URD: 64% and CB: 57% at 4 years, P = 0.11). CB was not a significant risk factor for relapse or non-relapse mortality as well as for OS in multivariate analyses. Similarly, the donor source was not a significant risk factor for OS in subsequent CR or non-CR (RD: 47%, URD: 39% and CB: 48% in subsequent CR, P = 0.33; RD: 15%, URD: 21% and CB: 18% in non-CR, P = 0.20 at 4 years). Conclusion Allo-SCT using CB led to OS similar to those of RD or URD in any disease status. To avoid missing the appropriate timing, CB is a favorable alternative source for adult Ph(-) ALL patients without a suitable RD or URD.

Ag ions were implanted in LiNbO3 at energies of 25 keV and 3 MeV. Optical absorption spectra were measured in the visible range. A large absorption peak due to small colloidal Ag metal was observed at 460 and 510 nm for the as‐implanted sample at 3 MeV and 25 keV, respectively. Subsequently, the samples were heated in air up to 600 °C. The absorption peak moved toward longer wavelengths up to 560 nm when the sample was heated at high temperature. Small droplets of metallic Ag expelled from the implanted layer formed on the surface of the sample even when the samples were held at room temperature. The number and size of the droplets grew with time and their growth was accelerated when the samples were heated at high temperature.

The effects of a sonicated Porphyromonas gingivalis ATCC 33277 protein extract on the mitogenic and chemotactic responses of human periodontal ligament (PDL) cells to the recombinant human platelet-derived growth factor-BB homodimer (PDGF-BB) were examined in vitro. Proliferation of PDL cells was inhibited by P. gingivalis extract at concentrations higher than 10 micrograms/mL protein. At 100 micrograms/mL of P. gingivalis extract, cells did not proliferate. DNA synthesis in PDL cells, as revealed by [3H]-thymidine incorporation, was also inhibited by approximately 50% in the presence of 50 micrograms/mL P. gingivalis extract for 24 hours. In contrast, PDGF-BB at 1 ng/mL enhanced DNA synthesis in PDL cells, followed by maximum enhancement at concentrations higher than 10 ng/mL PDGF-BB. However, this mitogenic response to PDGF-BB was markedly reduced in the presence of 20 micrograms/mL of P. gingivalis extract and did not reach the maximum level even if PDGF-BB concentrations were increased to 250 ng/mL. PDL cells exhibited a chemotactic response to PDGF-BB at 1 ng/mL, which was also inhibited by pretreatment of the cells with P. gingivalis extract at 10 to 50 micrograms/mL. Scatchard analysis of a [125I]-PDGF binding assay demonstrated that PDL cells have both high and low PDGF binding affinity sites. Treatment of the cells with P. gingivalis extract decreased the number of PDGF-binding sites to approximately 35% of the control level, while it caused only a slight change in the affinities of both types of binding site. These results indicated that the P. gingivalis extract reduced mitogenic and chemotactic responses of human PDL cells, possibly through mechanisms involving a decrease in PDGF-binding capacity of these cells. Due to this inhibitory effect of P. gingivalis, the normal levels of PDGF in periodontal lesions may not be sufficient to promote periodontal regeneration through activation of PDL cell proliferation and migration. Therefore, the therapeutic use of PDGF-BB, as a supplement to pre-existing PDGF and as an adjunct, while also eliminating P. gingivalis from periodontal lesions, would help periodontal tissue regeneration.

This paper describes the performance characteristics of two types of journal bearings, tilting-pad and offset halves, operating under high-speed conditions where the journal peripheral speed is in excess of 100 m/s. Experimental investigations into bearing eccentricity, temperatures and dynamic coefficients were carried out with a specially designed test rig. These results are compared with theoretical data which are obtained from thermohydrodynamic lubrication theory. The agreement is satisfactory. However, further improvements are necessary to predict more accurate thermal performance of the unloaded pads.

c -axis oriented YBa 2 Cu 3 O 7 − y (Y123) thick films were grown on NdGaO 3 (110) single crystalline substrates by liquid phase epitaxy (LPE). The growth mode of the film changes from a multi-nucleation growth to a spiral-step growth. The growth of the initial stage occurs due to the local supersaturation at the growth interface by the temperature difference between the substrate and the surface of the melt and the later stage growth is driven by the supersaturation from the transport of the solute through convection of the melt. The change of growth mode is also described as the change from the transient mode LPE (TMLE) growth to the steady state growth.

A 52-year-old man underwent non-myeloablative stem cell transplantation from his HLA identical sister for the treatment of mantle cell lymphoma. On day 0, he developed a high-grade fever, watery diarrhea and vesicles scattered on the skin. Well experienced dermatologists diagnosed these lesions as VZV reactivation. High dose antiviral agents were ineffective, and Fusarium solani was cultured from his stool and sputum. Systemic fusariosis progressed rapidly and he died of multiorgan failure on day 18. It is sometimes difficult to differentiate between viral and fungal blisters based on macroscopic examinations. We recommend early histopathological examination of the skin, when HSCT recipients develop vesicles.

ZnSSe and ZnMgSSe epitaxial layers grown on (001)GaAs substrates are characterized by etching and transmission electron microscopy (TEM). It is found that etch pits etched by bromine-methanol correspond to stacking faults in ZnSSe. These stacking faults, whose Burgers vector is 1/3 〈111〉, are extrinsic. It is found that stacking faults lying on (11) and (111) cannot be revealed by this etchant in ZnSSe. TEM establishes that etch pits in ZnMgSSe etched by HCl correspond not only to stacking faults but also to threading dislocations. Furthermore, all stacking faults lying on the four equivalent {111} planes can be observed as etch pits in ZnMgSSe.

IntroductionThe sedation could consist in a therapeutic strategy in advanced cancer conditions.ObjectiveTo study the drugs administered to patients under Palliative Care Sedation (PCS) audits effects on vital signs.MethodsOur retrospective study included 101 oncological patients with mean age of 66.5 ± 13.4 years old and mean weight of 48.5 ± 3.36 kg, under PCS. The data were analysed applying the test of Wilcoxon.ResultsThe drugs administered to these patients under PCS were morphine 55 mg/kg/day associated to midazolam 52.5 mg/kg/day (Morph/Midazo) or the association of morphine 55 mg/kg/day, midazolam 52.5 mg/kg/day and neuroleptics such as chlorpromazine 54.5 mg/kg/day or haloperidol 13.25 mg/kg/day (Morph/Midazo/Neurol). The values of vital signs of these patients when the sedation was initiated were: systolic blood pressure 116.55 ± 16.98 mmHg, diastolic bloodpressure73.17 ± 10.55 mmHg, heart rate 83.41 ± 16.25bpm, respiratory rate 19.39 ± 3.97 rpm and body temperature 35.91 ± 0.57 °C. No significant differences between these groups were observed. Vital signs measures were collected 48 hours before the patient's death. Significant reduction in systolic blood pressure 77.5 mmHg, diastolic blood pressure 43.3 mmHg were observed in the group (Morph/Benzo/Neurol). The Wilcoxon test for independent samples to a significance level of 5% we obtain a P-value of 0.01. The sedation period was 2.56 ± 0.23 days.ConclusionNeuroleptic, a central nervous system (CNS) depressant drug, when associated to other two depressants (morphine/midazolam), conducted to the patient's vital signs reduction.Considering the short period of time between the beginning of sedation and the patients’ death; and that palliative sedation should not include the hastening of patients’ death, we suggest a better drug association criteria.Disclosure of interestThe authors have not supplied their declaration of competing interest.

致死量を超えるアルコール中毒例の臨床症状および生命を脅かす危険因子を明らかにするために,1983年1月1日から1994年3月31日までに岩手医科大学高次救急センターを受診し,来院時の血中アルコールが400mg/dl以上であった症例について,意識レベル,バイタルサイン,血液検査値,治療法,血中アルコール消失速度について検討した。性別は男性29例,女性4例で平均年齢は42.1±12.1歳であった。血中濃度が500mg/dl以上の9例はいずれも意識レベルがJapan coma scale(以下JCSと略す)100以上で,うち4例はJCS300であった。瞳孔径は,血中濃度が500mg/dl以上の9例のうち3例は散瞳,2例に瞳孔不同を認めた。対光反射は,血中濃度が500mg/dl以上の9例のうち2例は反射消失,4例に反射遅延を認めた。血中アルコール濃度が500mg/dl未満の症例は全例対光反射は迅速で,意識レベルは個人差が大きかった。収縮期血圧,平均心拍数,呼吸数で生命を脅かす徴候は認めなかった。20例に軽度の低体温,16例に低酸素血症,6例にPaCO2の蓄積を認めた。血中アルコール消失速度は-225mg/dl/hrであった。治療は輸液および呼吸管理のみで,全例軽快退院した。多量飲酒者の生命を脅かす徴候は呼吸不全と低体温が考えられたが,医療機関で適切な管理が行われれば生命を脅かすには至らないと思われた。

Three unusual injuries of the cervical spine in wearers of three-point seat belts are reported. In two cases, the presence of bruising under the chin indicated their involvement in the mechanism of the injury. In the remaining one case, a seat belt might have been related to the injury because there was no other complication. The pattern of spinal injury and neck bruising suggest that the responsible flexion force was enhanced in some way by seat belt fixation at the mid-cervical region. We suggest that neck bruising should arouse suspicion of cervical spinal trauma.

Although recent improvements have been indicated in the outcome after allogeneic hematopoietic cell transplantation (allo-HCT), little information is available on how changes in transplant modalities have affected the outcomes after allo-HCT in non-remission, based on patient age, donor source and disease type. We compared the incidence and causes of non-relapse mortality (NRM) after allo-HCT in non-remission among three consecutive four-year periods using a nationwide transplant outcome registry database. A total of 3308 patients with acute leukemia in non-remission were analyzed. The risk of NRM decreased over the three periods, and the hazard ratios (HRs) in 2001–2004 and 2005–2008 compared with 1997–2000 were 0.86 (95% CI, 0.70–1.06; P=0.16) and 0.65 (95% CI, 0.53–0.80; P

The outcomes for allogeneic hematopoietic cell transplantation (allo-HCT) are heavily influenced by non-relapse mortality (NRM). We retrospectively assessed the changes in the incidence and causes of NRM after allo-HCT over the past 12 years. NRM, relapse rate and OS were analyzed using the Japan transplant outcome database of 6501 adult patients with acute leukemia or myelodysplastic syndrome who received their first allo-HCT in remission from 1997 through 2008. In multivariate analysis in patients aged 16-49 years, the adjusted hazard ratios (HRs) for NRM for 2001-2004 and 2005-2008 were 0.78 (95% confidence interval, 0.65-0.93) and 0.64 (0.54-0.78), respectively, compared with 1997-2000. The HR for overall mortality in 2005-2008 was 0.81 (0.70-0.93) compared with 1997-2000. In patients aged 50-70 years, the HRs for NRM and overall mortality in 2005-2008 were 0.56 (0.46-0.68) and 0.66 (0.47-0.93), respectively, compared with those in 2001-2004. We found that causes of death that contributed to the changes in NRM varied among subgroups. In conclusion, our study indicated that the incidence of NRM after allo-HCT has significantly decreased over the past 12 years, which has led to an improvement of OS, and also showed reductions in NRM in subgroups consisting of older patients and those who received unrelated cord blood transplantation.

To estimate the impact of surgical site infection (SSI) on postoperative resource consumption for colon and rectal open and laparoscopic surgeries after accounting for infection depth and patient characteristics, and to compare these estimates among institutions.We collected administrative and SSI-related data from eight Japanese hospitals, and used generalized linear models to estimate excess postoperative length of stay (LOS) and charges attributable to SSI. Covariates included wound class, American Society of Anesthesiologists (ASA) score, operation time, emergency, colostomy, trauma, implant, and comorbidities.We examined 1,108 colon surgery (CS) and 477 rectal surgery (RS) patients. For open surgery, the postoperative LOS in non-SSI patients was 13.5 (CS) and 15.9 days (RS). Compared with non-SSI patients, the postoperative LOS increased by 4.5 (CS) and 2.8 days (RS) for superficial SSI, 6.8 (CS) and 8.5 days (RS) for deep SSI, and 7.8 and 9.5 days for space/organ SSI. For laparoscopic surgery, the postoperative LOS was 9.8 (CS) and 14.6 days (RS). SSI was significantly associated with increased postoperative LOS for superficial SSI [by 4.8 (CS) and 3.6 days (RS)], deep SSI [by 10.3 (CS) and 23.9 days (RS)], and space/organ SSI [by 8.9 days (RS)]. The postoperative LOS among hospitals was 3.8-10.4 days (CS) and 1.3-12.2 days (RS). Postoperative SSI-attributable charges ranged from $386 to $2,873, depending on organ, procedure, and infection depth.This study quantified the impact of SSIs on resource consumption and confirmed significant cost variations among hospitals. These variations could not be explained by patient characteristics or infection type.

We report on a pressure-induced evolution of exotic superconductivity and spin correlations in CeIr(In$_{1-x}$Cd$_{x}$)$_5$ by means of In-Nuclear-Quadrupole-Resonance (NQR) studies. Measurements of an NQR spectrum and nuclear-spin-lattice-relaxation rate $1/T_1$ have revealed that antiferromagnetism induced by the Cd-doping emerges locally around Cd dopants, but superconductivity is suddenly induced at $T_c$ = 0.7 and 0.9 K at 2.34 and 2.75 GPa, respectively. The unique superconducting characteristics with a large fraction of the residual density of state at the Fermi level that increases with $T_c$ differ from those for anisotropic superconductivity mediated by antiferromagnetic correlations. By incorporating the pressure dependence of the NQR frequency pointing to the valence change of Ce, we suggest that unconventional superconductivity in the CeIr(In$_{1-x}$Cd$_{x}$)$_5$ system may be mediated by valence fluctuations., Comment: Accepted for publication in Physical Review Letters

While we may realize commercialization of SOFC systems in the very near future, continuous challenges will be needed to develop advanced fuel cells with higher efficiency, higher durability, better flexibility, as well as lower production cost. For realizing next-generation SOFCs, we may apply a broad range of knowledge related to (1) electrolyte and (2) electrode materials for cell development as well as (3) explore alternative fuels. This entry gives an overview on possible alternative approaches for these three important aspects to realize advanced high-performance SOFCs in a future generation.

Congenital generalized lipodystrophy (CGL) is a rare disease, the main symptoms of which are a reduction of systemic subcutaneous fat, characteristic facial features, hypertrichosis, and insulin-resistant diabetes. We report herein the unusual case of a 25-year-old man with CGL in whom gas gangrene developed, an association which has never before been encountered.

Summary Regulation of spleen-colony formation, a clonal assay for haemopoietic stem cells, is very different in mice and rats. In the rat, there is an involution of the colony-forming ability of the spleen during infantile development, whereas in mice the ability is maintained throughout life. In our re-evaluation of endogenous spleen colony formation in rats after graded doses of total-body irradiation, colonies ceased to appear after 12 weeks of age. However, histological sections showed that there were tiny colonies growing in the spleen, even at 20 weeks. These microscopical colonies developed into visible colonies when the rats were given treatments that increased the haemopoietic requirement. Thus, the amount of 59 FeCl 3 , incorporated into the spleen increased to compensate for a decrease in uptake by the bone marrow. Rats in which bone-marrow activity was inhibited by 89 SrCl 2 , showed extensive colony formation in the spleen, even after 12 weeks of age, when the endogenous colonies were induced by a sublethal dose of radiation. About twice as much 59 Fe acetate activity was incorporated into the spleens of the experimental animals than in those of control rats. These findings imply that spleen-colony formation responds to the haemopoietic requirement of the spleen rather than that of the bone marrow. Furthermore, the requirement of the spleen seems to be much smaller in rats than in mice, because bone-marrow capacity for haemopoiesis is relatively larger in rats.

Ascending axonal volleys were analysed after epidural stimulation at multiple sites along the cervical cord to localise the site of the lesion precisely in cervical spondylotic myelopathy. The intraoperative recordings uncovered a single site of focal conduction block in 129 of 136 affected patients who underwent surgical intervention because of evidence of multilevel compression obtained by magnetic resonance imaging. Statistical analyses showed a shift of abnormalities from lower to upper cervical levels with advancing age (p0.0001). In particular, 92% of the oldest group (aged over 70 years) had localised dysfunction at C3-4 or C4-5, while 68% of patients aged under 60 years had lesions at C5-6 or C6-7.

Background Pneumonia caused by Stenotrophomonas maltophilia is rare, but can be lethal in severely immunocompromised patients. However, its clinical course remains unclear. Patients and methods Patients with pneumonia caused by S. maltophilia in Toranomon Hospital (890 beds, Tokyo, Japan) were reviewed retrospectively between April 2006 and March 2010. Results During the study period, 10 cases of S. maltophilia pneumonia were identified. Seven patients had acute myeloid leukemia, 2 had myelodysplastic syndrome, and 1 had malignant lymphoma. All patients developed symptoms after allogeneic hematopoietic stem cell transplantation (HSCT). Five patients received first cord blood transplantation (CBT), 4 patients received second CBT, and 1 patient received first peripheral blood stem cell transplantation (PBSCT). The overall incidence of S. maltophilia pneumonia among 508 patients who received HSCT during the period was 2.0%. The incidence was 0% (0/95) in patients after bone marrow transplantation, 0.8% (1/133) after PBSCT, and 3.2% (9/279) after CBT. Pneumonia developed a median of 13.5 days (range, 6–40) after transplantation. At onset, the median white blood cell count was 10/μL (range, 10–1900), and the median neutrophil count was 0/μL (range, 0–1720). In all patients, S. maltophilia bacteremia developed with bloody sputum or hemoptysis. The 28-day mortality rate was 100%; the median survival after onset of pneumonia was 2 days (range, 1–10). Conclusions Hemorrhagic S. maltophilia pneumonia rapidly progresses and is fatal in patients with hematologic malignancy. Attention should be particularly paid to the neutropenic phase early after HSCT or prolonged neutropenia due to engraftment failure. A prompt trimethoprim-sulfamethoxazole-based multidrug combination regimen should be considered to rescue suspected cases of S. maltophilia pneumonia in these severely immunosuppressed patients.

Abstract 4535 Incidence and clinical features of idiopathic pneumonia syndrome and diffuse alveolar hemorrhage after unrelated cord blood transplantation. Aya Nishida 1, Atsushi Wake 1, Hisashi Yamamoto 1, Kazuya Ishiwata 1, Nobuaki Nakano 1, Masanori Tsuji 1, Yuki-Asano Mori 1, Naoyuki Uchida 1, Koji Izutsu 1, Kazuhiro Masuoka 1, Akiko Yoneyama 3, Shigeyoshi Makino 4, Shuichi Taniguchi 1. 1 Department of Hematology, Toranomon Hospital, Tokyo, Japan; 2 Department of Pathology, Toranomon Hospital, Tokyo, Japan; 3 Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan; 4 Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan [Background] Idiopathic pneumonia syndrome (IPS) and diffuse alveolar hemorrhage (DAH) are non-infectious pulmonary complications of hematopoietic stem cell transplantation (HSCT) with unclear pathogenesis and treatment. [Objective and method] To investigate the incidence and clinical features of IPS/DAH after unrelated cord blood transplantation (uCBT), we retrospectively analyzed 370 patients underwent uCBT from January 2005 to June 2010 at Toranomon Hospital. Diagnosis of IPS/DAH was made by multilobar infiltrates on CXR or CT, clinical signs of pneumonia: cough, dyspnea, or rales, abnormal physiology: increased arterial-alveolar oxygen gradient, or the needfor supplemental oxygen support, and no evidence of respiratory tract infection. [Result:] Twenty five cases of IPS/DAH were identified, with incidence of 6.8%. The median-age was 59 years (range; 26–72). Nineteen patients underwent transplantation for leukemia, 4 for malignant lymphoma, and 2 for aplastic anemia. IPS/DAH was diagnosed at a median of 34 days (range; 8–93) after uCBT. All patients were administered mPSL therapy. Nine of 25 patients were administered etanercept combined with mPSL pulse therapy. Five of 9 had not responded, while 4 responders had worse their respiratory condition after discontinuation of etanercept therapy. Twenty four of 25 died of respiratory failure. [Conclusion] IPS/DAH after uCBT are fetal pulmonary complications. It is suggested that the incidence of IPS/DAH after uCBT appears similar to that observed after transplantation using other sources. But our results suggested that the existing treatment such as etanercept combined mPSL pulse have only limited efficacy as a therapy for IPS/DAH after uCBT. Further research is needed to characterize the condition of this syndrome and to investigate the optimal therapy and prophylaxis. Disclosures: No relevant conflicts of interest to declare.

Grid interconnection of distributed power generation (DG) such as photovoltaic (PV) power generation systems to distribution systems is important to prevent islanding operation of DG to keep the safety. However, since dead zones exist in the islanding detection devices, detection time may be delayed. In this paper, we try to evaluate possibility that power flow stays in the dead zones. And we propose an islanding prevention method by avoiding the dead zones using a static var compensator (SVC). (6 pages)

Excitation into the absorption band at 255 nm in Cu + -doped NaCl results in the recently found 420 nm emission band in addition to the characteristic 360 nm emission band due to the isolated Cu + ion. It has been shown from the isotopic substitution data and the lifetime measurements that the origin of the 420 nm emission band is attributed to the Cu + ion perturbed by the OH - ion in the crystal.

Distribution of mRNA expression of 1,25-dihydroxyvitamin D3 receptor (VDR) and 25-hydroxyvitamin D3-24-hydroxylase (24-OHase) along the microdissected rat nephron segments was examined by reverse transcription-polymerase chain reaction (RT-PCR) technique. VDR mRNA was abundantly expressed in cortical segments (glomeruli, proximal convoluted tubule, proximal straight tubule, cortical thick ascending limb, distal convoluted tubule and cortical collecting duct), and it was also detected in outer medullary segments (medullary thick ascending limb, outer medullary collecting duct). Messenger RNA of 24-OHase was abundant in proximal convoluted tubule, and it was also present in proximal straight tubule, but not in other segments. The results demonstrate that in contrast to the expression of 24-OHase mRNA which is limited to the segments where the activity of this enzyme has been demonstrated, the expression of VDR mRNA is ubiquitous along the nephron segments.

We developed a 5MV 30mA electron processing system to meet the increasing need for a high energy electron accelerator for applications such as sterilization of medical goods, bulk plastic material and/or animal feed. The developed is the world-record electron accelerator using Cockcroft-Walton D.C. circuit and is used not only for the electron irradiation but also for X-ray irradiation by using X-ray conversion target. We expect this machine to replace disinfecting chemicals such as ETO and radioactive Co-60 or Cs-137 which are presently used for sterilization or bulk material irradiation.

Emergency or urgent surgery for ventricular septal perforation (VSP) following acute myocardial infarction still carries a high operative mortality rate. Hypothermic fibrillatory arrest studies without aortic cross-clamping and using continuous pulsatile coronary flow were performed to improve this result. Of 19 patients suffering from VSP. 12 underwent hypothermic (mean(s.d.) blood temperature 23.5(1.7)°C) ventricular fibrillation with concomitant pulsatile systemic and continuous coronary perfusion (group 1), and seven underwent deep hypothermic cardioplegic ischaemic arrest with systemic pulsatile perfusion alone (group 2). The two groups were comparable in terms of age, sex. location of infarction, number of coronary arteries involved, interval between infarction and surgery, and preoperative maximum enzyme levels and haemodynamics. Pulsatile flow with a mean(s.d.) pulse pressure of 48(13)mmHg was produced by an intra-aortic balloon pumping device in both groups. Operative exposure In the two groups was comparable. In group 1. mean(s.d.) cardiac output in the early postoperative period (within 3 h of procedure) was significantly higher than in group 2 (4.2(0.9) versus 2.6(0.7)Imin−1 m−2, P

The flow factors for the average Reynolds equation introduced by Patir and Cheng (1978, 1979) are extended to be valid for thin film gas lubrication. The effects of molecular mean free-path on the roughness-induced flow factors are included on the assumption that the local compressibility is small. The derivation of flow factors is carried out by means of the perturbation approach developed by Tripp (1983). The results are expressed in terms of Knudsen number, Peklenik parameter and nondimensional film thickness defined as the ratio of average film thickness and standard deviation of composite roughness. Two-dimensional roughness effects on the load-carrying capacity of a gas lubricated finite slider are also investigated.

目的:353例のDOA症例(疾病群222例,外因群131例)を搬入時の心電図から心停止過程にあわせてN型(心停止直前の正常QRSのもの),I型(心室細動のもの),II型(wide QRSのもの),IIIa型(心静止のもの)およびIIIb型(死後変化を伴っているもの)の5型に分類し,各段階におけるDOAの蘇生率やその予後などについて検討してみた。結果:これらのDOAのうち疾病群と外因群のいずれでもIIIa型がもっとも多かった。それに対し,心拍が停止しつつあるN型からII型のDOAは少なかった。全DOA例の蘇生率は20%であったが,疾病群の各型の蘇生率ではN型とI型で50%以上と高くなっていた。一方,外因群ではN型で33%ともっとも高かった。それらの蘇生例の予後をみると,疾病群で蘇生率の高いN型がもっともよく,つぎにI型であったが,外因群では蘇生率の高いN型で予後が悪かった。発見から救急部に搬入までの全DOAの平均時間は32.3分であり,これらのDOA症例を5型に分類したときの疾病群ではII型で16.1分ともっとも短く,IIIa型で29.2分と有意に長かった。また,蘇生例や予後のよい症例で搬入時間が短い傾向が認められていた。外因群ではI型で26.5分ともっとも短かった。心停止はいずれの型でも就眠安静時と運動時に循環器系疾患の原因で発生した例が多く,外因群では交通事故の原因がもっとも多かった。結論:DOAを心電図から分類して解析すると,安静時と運動時に心疾患および交通事故で発生するIIIa型のDOAがもっとも多く,救命率向上にはIIIa型に対する対策が問題であるとされ,搬入までの時間を短縮するために,by-standerや救急隊のよりいっそうのCPR教育の充実と普及が望まれた。また,外因群ではとくに現場で輸液などの積極的な救急処置が必要と推察された。

We report the optical properties of the O-2 center in KCl-KBr mixed crystals. The O-2 ion has different molecular axes in its excited state along the 〈110〉 direction in KCl and along 〈111〉 in KBr. As a result of this, the former system shows double structure side bands and the latter shows single structure side band in their emission spectra. It is the motivation of the present work to investigate how the emission of the O-2 center behaves in a mixed KCl1-xBrx system. From lifetime measurements, we have determined an activation energy δE for the non-radiative process, a frequency factor v and the oscillator strength of the fluorescence ffluo for the O-2 center in the KCl1-xBrx system.

Organochlorine pesticides and polychlorinated biphenyls (PCBs) were determined in the blubber of six Guiana dolphins ( Sotalia guianensis ) from the coast of the state of Sao Paulo, Brazil. PCBs were at the highest levels on a lipid-weight basis (25.87 to 66.03μg g -1 ), followed by DDTs (16.91 to 55.91μg g -1 ), mirex (0.24 to 1.87μg g -1 ), chlordanes (0.11 to 0.49μg g -1 ), hexachlorobenzene (HCB) (0.07 to 0.17μg g -1 ), heptachlor epoxide (0.05 to 0.16μg g -1 ) and hexachlorociclohexane (HCHs) (0.03 to 0.21μg g -1 ). The presence of PCBs in Guiana dolphins suggests input from the Cubatao industrial complex – the largest in Brazil. The mean p,p’ -DDE/3DDT ratio was approximately 0.8 and is indicative of previous DDT application in the study area. The occurrence of HCB and HCHs can be attributed to industrial effluents and dumping on the borders of the Santos-Sao Vicente estuarine complex.