Search

Novel pressure-free Cu nanoparticle joints for power electronic devices were fabricated, and their reliability was investigated. Si heater chips were bonded to Cu-65Mo baseplates without applied pressure in a N2 atmosphere. The increase in thermal resistance was found to be less than 30% after 1000 thermal cycles of −40/150 °C and −40/200 °C. Samples with Ag- or Cu-coated baseplates showed no deterioration following 3000 power cycles of 65/250 °C. In contrast, samples with baseplates coated with Au or Ni exhibited an increase in thermal resistance in power cycle tests of 65/200 °C and 65/250 °C.

リンパ節の転移程度と所属リンパ節の分類の妥当性にっき,TNM分類と大腸癌取扱い規約を比較検討した.対象は1974年から1988年までに癌研外科において根治手術が行われ,リンパ節転移陽性であった結腸癌162例である.TNM分類,大腸癌取扱い規約ともに,nlとn2,n3群との累積5年生存率(以下,累積5生率)の間には有意差があり,リンパ節の転移程度はいずれも予後を反映していた。また所属リンパ節の分類法は,転移個数を基にしたTNM分類より解剖学的な拡がりを基にした大腸癌取り扱い規約の方が,転移率の分布が妥当で(TNM:n1=14.4%,n2=2.5%,n3=7.9%,規約:n1=15.9%,n2=7.4%,n3=1.4%),累積5生率の開きも適当であった.(TNM:n1-86.0%,n2=68.8%,n3=64.7%,規約:n1=84.5%,n2=66.7%,n3;55.6%)

A randomized clinical trial of adjuvant chemotherapy has been evaluated for non-small cell lung cancer (NSCLC) patients, because the prognosis of early NSCLC does not enough after surgery (stage I: 70-80%, stage II: 50% in overall 5-years survival). Japanese guide line for lung cancer treatment (2005 edition) recommends adjuvant chemotherapy after complete resection for pathological stage IB, II and IIIA. Previous studies have suggested that uracil-tegafur has benefit for stage IB NSCLC patients, and platinum-based adjuvant chemotherapy has benefit for stage IB, II and IIIA NSCLC patients. In 2007 ASCO Annual Meeting, Harpole D talked about molecular prognostic profiles in early resected NSCLC. The goal of this study design is to validate a molecular-based tumor model that identifies those patients at low risk for cancer recurrence who will not benefit from adjuvant chemotherapy. The remaining patients will be randomly assigned to observation (the present standard of care) or adjuvant chemotherapy to determine the efficacy of adjuvant in this population. Biomarker for response of chemotherapy will be available to know who has benefit from adjuvant chemotherapy. When each patient has appropriate adjuvant chemotherapy, the prognosis is improved by that.

The integrated interleaving error correcting scheme allows the use of redundancies of different levels through all data blocks. That is, a redundancy of the error correcting capability of a (strong) code can be distributed over data blocks which are encoded with different redundancies. The high dimensional parity code is defined as a product code of simple parity check codes. Since the structure of the code is very simple, expect that the encoding procedure is also simple. Another advantage of the code is that the code can be viewed as a low density parity check code. Therefore the powerful decoding method, the sum-product algorithm can be applied in decoding. In this paper, the codes are used as constituent codes for the integrated interleaving error correcting scheme.

We adopt the simulated annealing method for dealing with raw material transportation ship operation scheduling. The scheduling algorithm should satisfy the proper stock for each raw material level by satisfying the restriction conditions of the transportation ship and the harbour equipment. The developed scheduling algorithm consists mainly of two parts: 1) the operation of the ship is simulated by decision variables, such as the order of the operation of ship and the type of raw material on-board, for calculating the amount of each raw material unloaded and the unloading time; and 2) the simulation calculates the change in the stock level of each raw material type based on the simulation result by which the first simulation is operated. The evaluation function, comprising the operating cost of the ship and the propriety of the stock level, can be calculated by using these two simulation results.

Background Evidence-based data regarding the role of chemotherapy in the management of gastrointestinal neuroendocrine tumors are scarce, mainly because the results of only small studies are available. Combination chemotherapy with regimens such as cisplatin–etoposide was reported to have activity against gastrointestinal neuroendocrine tumors. However, few studies have documented a good response of gastrointestinal neuroendocrine tumors to second-line chemotherapy. Patients and methods We studied three patients with unresectable gastrointestinal neuroendocrine tumors who received irinotecan or amrubicin after prior chemotherapy with platinum and etoposide. ResultsThe characteristics of the three patients are shown below. All were men, with a median age of 69 years (range, 62–70). The site of the primary tumor was the stomach in two patients and the esophagus in one. One patient with a gastric neuroendocrine tumor received irinotecan as second-line chemotherapy, and the other received amrubicin as second-line chemotherapy followed by irinotecan as third-line therapy. A partial response was obtained in one patient after two courses of irinotecan, and this patient is now receiving the fifth course of irinotecan. The patient with an esophageal neuroendocrine tumor received amrubicin as second-line chemotherapy, followed by irinotecan as third-line therapy. The second course of irinotecan is now being administered, and response will be evaluated after completion of the second course. Both patients who received amrubicin as second-line therapy had progressive disease after two courses of amrubicin. Conclusions We described our experience with a case of gastrointestinal neuroendocrine tumor that responded to irinotecan after prior chemotherapy. Irinotecan might be effective against gastrointestinal neuroendocrine tumor. However, further clinical studies are required to confirm currently available evidence.

Immunoassay is known as one of the most important analytical methods and widely used in clinical diagnoses and biochemical studies. The conventional immunoassay, however, requires a long assay time. We developed a bead-bed immunoassay system integrated on a microchip which successfully reduces the assay time from 2 days to 30 minutes using simple operations for assay (Sato et al, 2000 and 2001). Here, aiming at high throughput assay, an integrated immunoassay system using a multichannel microchip was developed for simultaneous analyses of multiple samples.

To prevent cerebral infarction during perioperative period, we have used an axillary artery for systemic perfusion and selective cerebral perfusion for aortic arch operation. Since 1996, 34 aortic arch operations were performed in our institution. Simultaneous 5 CABGs, 4 AVRs, 2 aortic root replacements and 1 MVR were performed. There were 2 hospital deaths (5.9%, sepsis and acute heart failure) and only 1 (2.9%) cerebral infarction. There were no deaths in patients over 75 years of age and in patients with extensive aneurysm which were replaced by 2-staged operation. Overall 3 years survival was 94.1% with no further death. We conclude that aortic arch operation through an axillary artery perfusion and with hypothermic selective cerebral perfusion can be performed with very low mortality and morbidity.

A retrospective follow-up study was conducted on patients with subacutely progressive interstitial pneumonia who underwent surgical biopsy. Pathologically, they were subclassified into subacute interstitial pneumonia (SIP) and SIP + F, which consisted of an SIP lesion and a focal usual interstitial pneumonia. The SIP group consisted of 35 cases and the SIP + F group, of 15 cases. The majority of patients in both groups were female and complained of dyspnea. Both groups showed increased neutrophil counts (8.8%, 6.3%), eosinophils (6%, 5.6%), and lymphocytes (43.1%, 42.3%) in bronchoalveolar lavage. Chest radiography generally demonstrated predominant lower lobe involvement together with shrinkage in both groups, and differentiation of the two was difficult before biopsy. All but one improved temporarily with steroid therapy, or spontaneously, in both groups. On further observation after temporary improvement, 27 cases (82%), did not show any worsening and 6 cases (18%) showed worsening (including death) in the SIP group, while 6 cases (43%) showed no worsening, though 8 cases (57%) worsened in the SIP + F group. Deaths in either group that were not related to the original diseases were excluded from the statistical analysis. We concluded that the presence of focal usual interstitial pneumonia in SIP lesions affects prognosis in patients with subacutely progressive interstitial pneumonia.

There is no consensus regarding the surgical approach to adenocarcinoma in Barrett's esophagus. From 1980 to 1988, 8 patients with adenocarcinoma in Barrett's esophagus were treated at the National Cancer Center Hospital. Seven patients underwent subtotal esophagectomy with extended lymph node dissection, and one transhiatal esophagogastrectomy with regional lymph node dissection. In 4 patients tumor invasion was limited within the submucosa and in 4 within the muscularis propria. Four of 8 patients had stage I disease. The 5-year survival rate for the 8 patients was 64.3%. Some reports have indicated that endoscopic survey for Barrett's esophagus is important for early diagnosis. We conclude that survival after esophagectomy for adenocarcinoma in Barrett's esophagus is dependent on the method of operation, and that patients with early lesions may expect significantly better survival after extended lymph node dissection.

A 42-years-old female was referred to the university hospital because of cystic lesions of the right superior mediastinum. Drainage tube was found at right supraclavicular fossa with prolonged lymphatic discharge. We diagnosed this case as a benign cystic lymphangiomas with CT scan and CT scan with cystography and chemical analysis of the contents of the cyst. Intralesional OK-432 therapy for cystic mediastinal lymphangioma was performed. OK-432 was administered through intralesionally placed drainage tube. Excellent result was obtained. A few weeks later, residual lymphatic discharge through drainage tube became stopped. No expansion of the mediastinal cyst was found after drainage tube removal. Intralesional OK-432 therapy for cystic mediastinal lymphangioma was very effective and useful, it should be recommended for the management of the first choice of therapeutic method for cystic mediastinal lymphangioma because of no neurological deficit after this treatment.

In spite of the conventional definition of early esophageal cancer which includes mucosal and submucosal cancers without lymph node metastasis, esophageal mucosal cancers are now considered as the early cancer in clinical field. The esophageal mucosal cancers are subclassified into m1 (intraepithelial cancer), m2(lamina propria mucosae) and m3(muscularis mucosae) in clinical view points. M1 and m2 esophageal cancers which had no lymph node metastasis could be treated completely by endoscopic mucosal resection. On the other hand, the patients with m3 cancer which showed lymph node metastasis in 10% of the cases should be treated by esophagectomy with lymph node dissection. For the diagnosis of the depth of carcinoma invasion, now, endoscopy with dye iodine stain and toluisine blue stain were most useful. Fundamentally, macroscopic appearance of lesions classified by Japanese Society for Esophageal Diseases are well related to the depth of invasion. Almost all mucosal cancers showed the superficial and flat type (0-IIc type). Subclassification of m1, m2 and m3 were easily differentiated by endoscopic observation of their characteristic appearances. In the evaluation of the methods of treatment for mucosal cancer, endoscopic mucosal resection and esopagostomy showed a complete resectability. While, the former was superior in the quality of life after treatment.

Pneumocystis carinii pneumonia is the most common respiratory infection in patients with the acquired immunodeficiency syndrome, and inhalation of pentamidine aerosol is currently used for secondary prophylaxis. A 16-year-old patient with hemophilia A and the acquired immunodeficiency syndrome had a spontaneous pneumothorax during inhalation of pentamidine aerosol for secondary prophylaxis of Pneumocystis carinii pneumonia. Tube thoracostomy and pleurodesis were done without success. Thoracotomy was done 27 days after admission. The patient tolerated the procedure well, and the postoperative course was uneventful. Grocott staining of tissue from the bronchopleural fistula revealed Pneumocystis carinii, which suggests that the pentamidine aerosol failed to control and active Pneumocystis infection in peripheral lung zones.

SRPX2 (Sushi repeat-containing protein, X-linked 2) has recently emerged as a multifunctional protein that is involved in seizure disorders, angiogenesis and cellular adhesion. Here, we analyzed this protein biochemically. SRPX2 protein was secreted with a highly post-translational modification. Chondroitinase ABC treatment completely decreased the molecular mass of purified SRPX2 protein to its predicted size, whereas heparitinase, keratanase and hyaluroinidase did not. Secreted SRPX2 protein was also detected using an anti-chondroitin sulfate antibody. These results indicate that SRPX2 is a novel chondroitin sulfate proteoglycan (CSPG). Furthermore, a binding assay revealed that hepatocyte growth factor dose-dependently binds to SRPX2 protein, and a ligand–glycosaminoglycans interaction was speculated to be likely in proteoglycans. Regarding its molecular architecture, SRPX2 has sushi repeat modules similar to four other CSPGs/lecticans; however, the molecular architecture of SRPX2 seems to be quite different from that of the lecticans. Taken together, we found that SRPX2 is a novel CSPG that is overexpressed in gastrointestinal cancer cells. Our findings provide key glycobiological insight into SRPX2 in cancer cells and demonstrate that SRPX2 is a new member of the cancer-related proteoglycan family.

Forty-two patients with non-Hodgkin's lymphoma were treated between October 1983 and December 1992 in the department of Otolaryngology, Kagawa Medical School Hospital. The twenty-six of these patients whose tumor originated in Waldeyer's ring and who were diagnosed as Stage I or II have been reviewed. In principle, method of treatment was a combination of chemotherapy and radiotherapy. Between 1983 to 1987, COP was primarily used (9 cases) as combination chemotherapy, and after 1988 CHOP was used (17 cases). VAMA was used to treat the poor response and recurring cases. The five-year estimated overall survival rates calculated by the Kaplan-Meier method were 33.3% and 94.1% in the COP and CHOP groups, respectively. We investigated age, stage, cell type and grade, as factors related to recovery, but except for cell type, there were no significant differences in overall survival. The most serious side effect was decreased leucocyte count, but we prescribed G-CSF and were able to continue treatment.

We report 4 patients, 1 female and 3 males aged 26-74 years, who underwent surgical treatment for renal malignant tumors with supradiaphragmatic extension into the vena cava. All of their tumor thrombi extended to the right atrium as confirmed by magnetic resonance imaging. The distinctive symptom was liver dysfunction caused by disturbance of the hepatic vein drainage in two patients. However, there was no common symptom in these 4 patients. Preoperative metastasis was found only in the female, whose metastasis was solitary in the lung and seemed to be able to be removed easily after radical nephrectomy. All of these 4 patients had radical nephrectomy and removal of the tumor thrombi with the use of cardiopulmonary bypass and temporary exsanguination. In 3 of these patients, the liver was mobilized to expose the retrohepatic vena cava by incision of the falciform, triangular and coronary ligaments. Two patients with vena caval wall invasion had vena cavectomy and an artificial vascular graft was then sutured to replace the caval wall in one of them. Preoperative liver dysfunction was gradually improved after operation and completely recovered about 1 week later. A postoperative complication, wound infection, occurred in only one patient. Pathological examination revealed renal cell carcinoma in 3 patients and nephroblastoma in the remaining one. In renal cell carcinoma, both patients without distant metastasis were alive about 15 months postoperatively. However, the one with lung metastasis died with newly appeared multiple metastases 9 months postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

A 62-year-old male patient consulted us because of gross hematuria and was diagnosed as having a bladder tumor. Total cystectomy was performed and a Koch pouch was utilized. Two years and nine months later, he died as a result of recurrence of bladder tumor and pathological autopsy was performed. A microscopic section of the reservoir mucosa showed a reduction in the number of crypts and an increase in the number of goblet cells. These morphological changes seemed to be caused by chronic exposure to urine, but have a favorable effect upon metabolic alterations following the utilization of the Kock pouch.

Using four different psychological tests, namely Spielberger's rating scale [The State-Trait Anxiety Inventory (STAI)], Self-Rating Depression Scale (SDS), Maudsley Personality Inventory (MPI) and Baum test, we investigated the perioperative psychological status of patients undergoing radical mastectomy for breast cancer and compared data with those of patients undergoing total hysterectomy for uterine myoma. Parameters reflecting the psychological status of hysterectomy patients disclosed lower postoperative anxiety, and slight nervousness and persistent depression perioperatively. In contrast, in patients with breast cancer, those with nervousness had persistent anxiety and depression, while those without nervousness showed the same persistent depression as in hysterectomy patients, as well as a high anxiety level postoperatively. Therefore, we speculate that the persistence of depressive mood during the perioperative period is a factor in the psychological disturbance of mastectomy patients with breast cancer, and moreover, they appear markedly apprehensive because of cancer. These results suggest that the persistence of anxiety and depressive mood associated with cancer is a prime factor in the etiology of postoperative psychological disturbance.

Ketone body (3-hydroxy butyric acid) present in the blood was successively examined during surgical operations to ascertain the condition of energy metabolism and its clinical significance. In 10 patients (R group) to whom only the lactated Ringer's solution was infused during the operation, values of 3-hydroxy butyric acid increased remarkably in the 30 minutes after the operation began. In 7 patients (GI group), to whom the lactated Ringer's solution in 5% of glucose was administered, the values also increased in the 30 minutes after the operation was started. However, after the administration of glucose the values decreased, and returned to the normal value with administration of insulin. Furthermore, blood sugar readings which were examined at the same time increased significantly immediately after the beginning of the operation in both groups. Insulin readings showed considerably low values during the operation in R group. The readings of free fatty acid tended to show high values in R group, while they tended to decrease after the dose of glucose in GI group. With regard to epinephrine and norepinephrine readings, both groups showed significantly high values 30 minutes after the start of operation.

In order to study the changes of the psychological status during perioperative period, we performed four different psychological tests, Spielberger's rating scale "The State-Trait Anxiety Inventory (STAI)", Self-rating Depression Scale (SDS), Maudsley Personality Inventory (MPI) and Baum test, in 63 patients who received simple total hysterectomy for myoma of uterus. The anxiety ratings showed a significant decrease postoperatively. On the contrary, the SDS index that expresses the level of depressive mood showed no significant change during perioperative period. Moreover the patients who had shown a tendency of nervousness in MPI kept the high level of the SDS index during perioperative period than the other patients who had not shown a tendency of nervousness in MPI. In Baum test, more than 75% of patients manifested psychologic fragility or lability. These results suggest that depressive mood affects strictly the psychological status in postoperative period more than anxiety. We presume that the depressive mood during perioperative period is responsible for the postoperative psychological disturbance.