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Introduction: The use of technetium 99m diethylenetriaminepentaacetic acid-galactosyl human serum albumin (99mTc-GSA) scintigraphy parameters, HH15 and LHL15, in assessing the future liver remnant function is not expedient because of their nonlinear behaviour against liver volume. Uptake rate constant for the binding of 99mTc-GSA to asialoglycoprotein receptors is probably more favourable, but the reported calculation methods are complex. We devised a simple method to calculate the uptake rate constant, KrGSA. Methods: Radioactivity counts for the entire liver and heart regions were extracted at 10, 20, and 30 min. Using whole liver and heart volumes measured from single-photon emission computed tomography images, free radioactivity corresponding to the liver blood pool was subtracted. The time activity curve was fitted to the equation L(t) = L(∞) × [1 − Exp (−kt)] using Microsoft Office Excel (add-in free programme Solver)®, where L(∞) is the count at plateau level and k denotes KrGSA. Results: KrGSA values accurately identified liver cirrhosis and were similar to the KICG. The areas under the curve for KrGSA and KICG in the receiver operating characteristic analysis were 0.808 and 0.795, respectively, and a good correlation was seen between KrGSA and KICG. Discussion/Conclusion: KrGSA can be utilized as an alternative to KICG in assessing the future liver remnant function.

A 40-year-old man suffered from short bowel syndrome. Since a large amount of intestinal output and watery diarrhea hampered his quality of life, we tried to control the intestinal output by reducing the secretion of gastric acid with lansoprazole. Because the small intestine was only 10 cm in length and effective absorption of oral lansoprazole was doubtful, we monitored his intragastric pH for 24 hours and confirmed that the holding time above pH 3.0 was 14.5 hours (60.4%). He spent his home life eating porridge during the day, and receiving total parenteral nutrition of 1,100 mL/day at night while taking lansoprazole as an oral tablet (30 mg) once a day.

To explore the underlying mechanism of rapid liver hypertrophy by liver partition in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), liver partition at different sites was investigated. Increased inflammatory cytokines owing to the liver partition have been reportedly responsible. If this were true, rapid liver hypertrophy should be achieved regardless of where the liver was split. A male Sprague-Dawley rat model was created, in which a liver split was placed inside the portal vein ligated lobe (PiLL), in addition to the ALPPS and portal vein ligation (PVL) models. Liver regeneration rate, inflammatory cytokine levels, activation status of the Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) pathway and expressions of regenerating islet-derived (Reg)3&alpha, and Reg3&beta, were investigated. The liver regeneration rate was significantly higher in the ALPPS group than in the PiLL group, whereas inflammatory cytokine levels were nearly equal. Additional volume increase in ALPPS group over PVL and PiLL groups was JAK2/STAT3-dependent. Reg3&alpha, expressions were observed only in the ALPPS group. An increase in inflammatory cytokines was not enough to describe the mechanism of rapid liver hypertrophy in ALPPS. Expressions of Reg3&alpha, could play an important role in conjunction with an activation of the JAK2/STAT3 pathway.

Purpose: The involvement of hepatic stellate cells (HSCs) with ischemia-reperfusion (I/R) injury in rat liver was examined using gliotoxin, which is known to induce HSC apoptosis. Methods: Male Sprague-Dawley rats were used. HSC was represented by a glial fibrillary acidic protein (GFAP)-positive cell. Liver ischemia was produced by cross-clamping the hepatoduodenal ligament. The degree of I/R injury was evaluated by a release of aminotransferases. Sinusoidal diameter and sinusoidal perfusion rates were examined using intravital fluorescence microscopy. Results: Gliotoxin significantly decreased the number of GFAP-positive cells 48 h after dosing (2.50 ± 0.19% [mean ± SD] in the nontreated group vs. 1.91 ± 0.46% in the gliotoxin-treated group). Liver damage was significantly suppressed by the pretreatment with gliotoxin. Sinusoidal diameters in zone 3 were wider in the gliotoxin group (10.25 ± 0.35 µm) than in the nontreated group (8.21 ± 0.50 µm). The sinusoidal perfusion rate was maintained as well in the gliotoxin group as in normal livers, even after I/R. Conclusions: Pretreatment with gliotoxin significantly reduced the number of HSCs in the liver and further suppressed liver injury following I/R. It is strongly suggested that HSCs play a functional role in exacerbating the degree of I/R injury of the liver.

In the portal vein resection of long distance, an interposition by autologous vein is mandatory. External iliac vein (EIV) has been used, but harvesting the EIV is associated with severe venous congestion of the affected lower extremity. We have reconstructed the EIV using a ringed expanded polytetrafluoroethylene (ePTFE) graft. Thirteen patients underwent this surgery. The right EIV was used for reconstructing the portal vein, and the retrieved portion of EIV was interposed by the ePTFE graft. We evaluated size and length of the graft, graft patency, girth of thigh, time for reconstruction of EIV, and graft infection. ePTFE grafts of 8 or 10 mm in diameter were used. The length of ePTFE graft used was 4.4 ± 0.5 cm. Graft patency was kept in 76.9% patients. Graft obstruction was encountered in three patients, and the girth of right thigh increased by about 10 cm. Time for reconstruction of EIV was 29.5 ± 6.8 min. Graft infection did not occur in any patients. Reconstruction of the EIV using a ringed ePTFE graft seems to be a feasible option for preventing the swelling of the affected lower extremity after procurement of EIV for repairing the portal vein.

Objective Visceral fat obesity is located upstream of metabolic syndrome and atherosclerotic diseases. Accumulating evidences indicate that several immunocytes including macrophages infiltrate into adipose tissue and induce chronic low-grade inflammation. We recently analyzed the association between visceral fat adiposity and the gene expression profile in peripheral blood cells in human subjects and demonstrated the close relationship of visceral fat adiposity and disturbance of circadian rhythm in peripheral blood cells. In a series of studies, we herein investigated the association of visceral fat adiposity and mRNA levels relating to inflammatory genes in peripheral blood cells. Approach and Results Microarray analysis was performed in peripheral blood cells from 28 obese subjects. Reverse transcription-polymerase chain reaction (RT-PCR) was conducted by using blood cells from 57 obese subjects. Obesity was defined as body mass index (BMI) greater than 25 kg/m2 according to the Japanese criteria. Gene expression profile analysis was carried out with Agilent whole human genome 4 × 44 K oligo-DNA microarray. Gene ontology (GO) analysis showed that 14 genes were significantly associated with visceral fat adiposity among 239 genes relating to inflammation. Among 14 genes, RT-PCR demonstrated that S100A8, S100A9, and S100A12 positively correlated with visceral fat adiposity in 57 subjects. Stepwise multiple regression analysis showed that S100A8 and S100A12 mRNA levels were closely associated with HOMA-IR and S100A9 mRNA was significantly related to adiponectin and CRP. Conclusions Peripheral blood mRNA levels of S100 family were closely associated with insulin resistance and inflammation.

In this study, to reduce leaky surface acoustic wave (LSAW) attenuation, a layered structure of air/bulk LiNbO3 (LN) layer/elastically softened LN substrate which can be fabricated by a reverse proton exchange (RPE) process was applied to 10° Y-X LN with a larger coupling factor. First, the LSAW attenuation on a structure of air/bulk LN/modified LN was calculated with all material constants of the buried proton exchange (PE) layer taken into consideration. It was found that a condition under which the attenuation decreases as compared with the bulk value exists for the free and metallized surfaces. Next, the LSAW propagation properties were measured using IDT pairs with a 3.6-μm wavelength on 10° Y-X LN with the RPE layer and the buried PE layer. The propagation loss PL for the metallized surface was decreased by carrying out the RPE process from 0.44 dB/λ of a virgin wafer to 0.01 dB/λ. The decrease in PL for the shorted grating was also observed. © 2012 Wiley Periodicals, Inc. Electron Comm Jpn, 95(3): 19–27, 2012; Published online in Wiley Online Library (wileyonlinelibrary.com). DOI 10.1002/ecj.10412

We investigated the relationship between intracoronary stenosis detected by multislice computed tomography and various clinical parameters in type 2 diabetic patients with hypertension treated with candesartan ( n =42). The results showed that carotid intima-media thickness, but not visceral fat area or adiponectin, correlated significantly with intracoronary stenosis ( p

A 74-year-old woman had an undifferentiated carcinoma with osteoclast-like giant cells (UCWOGC) in the body of the pancreas with massive portal vein tumor thrombus (PVTT). Because the PVTT progressed so rapidly into the right portal branch, the patient first underwent distal pancreatectomy and tumor thrombectomy to prevent life-threatening portal venous obstruction. Although a recurrent PVTT had developed early postoperatively, systemic gemcitabine treatment was so effective that it induced complete remission 5 months after the initiation of chemotherapy. The patient continued to be in complete response for 12 months, and has survived for 19 months since surgery.

AIM Visceral adiposity is linked with sleep-disordered breathing (SDB) (called Syndrome Z), and both correlate with coronary artery disease (CAD). The aim of the present study was to determine the significance of excess visceral fat, SDB and circulating levels of biomarkers in CAD in Japanese men. METHODS SDB, visceral fat area (VFA), and circulating levels of biomarkers were assessed in 60 Japanese male patients who underwent coronary angiography and overnight cardiorespiratory monitoring. RESULTS Age-adjusted logistic analysis showed a significant relationship between CAD and diabetes, hypertension, dyslipidemia, SDB (AHI ≥5 events/hour), visceral fat accumulation (VFA ≥100 cm(2)), the combination of visceral fat accumulation and hypertension or dyslipidemia, as well as the combination of visceral fat accumulation and SDB. Patients with VFA ≥100 cm(2) and SDB had significantly lower serum adiponectin levels and higher serum soluble CD40 ligand levels than those with VFA

Sleep-disordered breathing (SDB), especially sleep apnea-hypopnea syndrome, is often observed in patients with type 2 diabetes mellitus; but there are only a few studies on SDB in Japanese diabetic subjects. We investigated the prevalence of SDB in diabetic patients; associations between severity of sleep apnea (SA) and clinical factors, visceral fat, and adiponectin; and associations between type of SA and clinical factors. In the present study, 40 Japanese diabetic patients underwent overnight cardiorespiratory monitoring, and night and morning measurements of serum adiponectin concentrations. Sleep apnea was detected in Japanese diabetic patients at a high prevalence (77.5%). The following variables were associated with SDB: age, body mass index, estimated visceral fat area, and nocturnal reduction in serum adiponectin concentrations. The prevalence of central sleep apnea (CSA, >or=5/h) was 32.3% among diabetic SDB patients. Diabetic SDB patients with CSA had higher hemoglobin, increased intima-media thickness, and higher plasma brain natriuretic peptide levels than those without CSA (

We have demonstrated that adiponectin has anti-atherosclerotic properties. We also reported hypoadiponectinemia and nocturnal reduction in circulating adiponectin concentrations in patients of severe obstructive sleep apnea–hypopnea syndrome (OSAS). OSAS is often complicated with pulmonary hypertension. In this study, we investigated the effect of adiponectin on chronic hypoxia-induced pulmonary arterial remodeling in mice. Exposure of mice to 3-weeks sustained hypoxia (10% O2) resulted in significant accumulation of adiponectin in pulmonary arteries. The percentage media wall thickness (%MT), representing pulmonary arterial remodeling, under hypoxic condition, was greater in adiponectin-knockout mice than wild-type mice. Overexpression of adiponectin significantly decreased hypoxia-induced pulmonary arterial wall thickening and right ventricular hypertrophy. These findings demonstrate for the first time that overexpression of adiponectin suppresses the development of hypoxic-induced pulmonary remodeling, and that adiponectin may combat a new strategy for pulmonary vascular changes that underlie pulmonary hypertension in OSAS.

The propagation characteristics of a Love-type surface acoustic wave (SAW) on Y-cut X-propagating LiTaO3 with an amorphous tellurium dioxide (TeO2) thin film with a low phase velocity were investigated theoretically and experimentally, and an interdigital transducer (IDT) resonator using this structure was fabricated and evaluated. The K2 of the Love-type SAW on TeO2/Y–X LiTaO3 was calculated to be 6.6% at a transition thickness of 0.07λ. The insertion loss of a simple delay line was reduced by loading with TeO2 film because the bulk wave radiation in excitation and/or propagation of the LSAW was markedly suppressed. Beyond the experimental transition thickness of 0.12λ, the suppression of the bulk wave radiation was saturated. According to the propagation characteristics for IDT resonators fabricated using this structure, the admittance ratio increased and the minimum phase decreased until the TeO2 film thickness reached the experimental transition thickness. When the TeO2 film thickness was 0.12λ, such resonance properties as admittance ratio, minimum phase, and resonance quality factor of the Love-type SAW on TeO2/Al/Y–X LiTaO3 were almost equal to those for Au/Y–X LiTaO3 and were better than those for LSAW on Al/39° Y–X LiTaO3, except for the band-width ratio. Moreover, the TCD was initially decreased by loading with TeO2 film but then increased as film thickness increased.

Epitaxial (110)-oriented KNbO3 thin films were deposited on a (100) MgO substrate by RF-magnetron sputtering. To clarify the sputtering conditions necessary for obtaining a highly oriented KNbO3 thin film, the relationships among the degree of orientation, the composition ratio of K/Nb, and the lattice plane spacing were evaluated for KNbO3 thin films deposited using several types of target. In the deposition method using dual targets of KNbO3 and K2CO3, a higher orientation and a larger K/Nb ratio were incompatible. In single-target sputtering with a mixture target of KNbO3:K2CO3, as the substrate temperature decreased, although the K/Nb ratio increased and the (220)-plane spacing approached that of orthorhombic bulk KNbO3, the orientation deteriorated. Using a single K-rich target, K5NbOx, containing no CO2, a highly (110)-oriented KNbO3 thin film with a K/Nb ratio of 0.40 and a (220)-plane spacing near that of orthorhombic bulk KNbO3 was obtained by increasing the RF power applied to the O2-radical source. Moreover, the displacement current in the oriented KNbO3 thin film with a K/Nb ratio of 0.40 was observed when an electric field was applied to the interdigital transducer formed on the thin film. This indicates the existence of spontaneous polarization in the oriented KNbO3 thin film.

A Lamb wave exists in high-density states when its wavelength is comparable to substrate thickness. It propagates through the boundaries of the upper and lower surfaces in many modes. In this paper, proposes a hydrogen gas sensor fabricated using the good characteristics of a Lamb wave. The film thickness of a sensitive membrane and Lamb wave mode dependence are defined by theoretical analysis and experiment. A Y-cut, Z-direction propagation LiNbO3 substrate (91-µm-thick, double-sided polishing) was used as a piezoelectric substrate of a device. An interdigital transducer with a wavelength of 100 µm was installed on the surface of the device; a sensitive membrane was attached on to the rear face using an RF sputtering process. A palladium silver alloy was used as the sensitive membrane. The maximum frequency shift is 9.21 ppm at hydrogen concentration 9.1%.

Previous reports demonstrated that adiponectin has antiatherosclerotic properties. Obstructive sleep apnea-hypopnea syndrome (OSAHS) is reported to exacerbate atherosclerotic diseases. We investigated nocturnal alternation of serum adiponectin levels before sleep and after wake-up in OSAHS patients and the effect of sustained hypoxia on adiponectin in vivo and in vitro. We measured serum adiponectin concentrations in 75 OSAHS patients and 18 control subjects before sleep and after wake-up and examined the effect of one-night nasal continuous positive airway pressure (nCPAP) on adiponectin in 24 severe OSAHS patients. We investigated the effects of hypoxia on adiponectin in mice and cultured adipocytes with a sustained hypoxia model. Circulating adiponectin levels before sleep and after wake-up were lower in severe OSAHS patients than in control subjects [before sleep: 5.9 ± 2.9 vs. 8.8 ± 5.6 μg/ml ( P < 0.05); after wake-up: 5.2 ± 2.6 vs. 8.5 ± 5.5 μg/ml ( P < 0.01), respectively; means ± SD]. Serum adiponectin levels diminished significantly during sleep in severe OSAHS patients ( P < 0.0001), but one-night nCPAP improved the drop in serum adiponectin levels [−18.4 ± 13.4% vs. −10.4 ± 12.4% ( P < 0.05)]. In C57BL/6J mice and 3T3-L1 adipocytes, hypoxic exposure decreased adiponectin concentrations by inhibiting adiponectin regulatory mechanisms at secretion and transcriptional levels. The present study demonstrates nocturnal reduction in circulating adiponectin levels in severe OSAHS. Our experimental studies showed that hypoxic stress induced adiponectin dysregulation at transcriptional and posttranscriptional levels. Hypoxic stress is, at least partly, responsible for the reduction of serum adiponectin in severe OSAHS. Nocturnal reduction in adiponectin in severe OSAHS may be an important risk for cardiovascular events or other OSAHS-related diseases during sleep.

Objective— Obesity is recognized increasingly as a major risk factor for kidney disease. We reported previously that plasma adiponectin levels were decreased in obesity, and that adiponectin had defensive properties against type 2 diabetes and hypertension. In this study, we investigated the role of adiponectin for kidney disease in a subtotal nephrectomized mouse model. Methods and Results— Subtotal (5/6) nephrectomy was performed in adiponectin-knockout (APN-KO) and wild-type (WT) mice. The procedure resulted in significant accumulation of adiponectin in glomeruli and interstitium in the remnant kidney. Urinary albumin excretion, glomerular hypertrophy, and tubulointerstitial fibrosis were significantly worse in APN-KO mice compared with WT mice. Intraglomerular macrophage infiltration and mRNA levels of vascular cell adhesion molecule (VCAM)-1, MCP-1, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-β1, collagen type I/III, and NADPH oxidase components were significantly increased in KO mice compared with WT mice. Treatment of APN-KO mice with adenovirus-mediated adiponectin resulted in amelioration of albuminuria, glomerular hypertrophy, and tubulointerstitial fibrosis and reduced the elevated levels of VCAM-1, MCP-1, TNF-α, TGF-β1, collagen type I/III, and NADPH oxidase components mRNAs to the same levels as those in WT mice. Conclusions— Adiponectin accumulates to the injured kidney, and prevents glomerular and tubulointerstitial injury through modulating inflammation and oxidative stress.

We derived an exact frequency equation and examined the behaviors of the effective Q factor and effective resistance for the case in which coils are added to a dual-input twin-T quartz circuit whose null frequency can be changed by adjusting the applied voltage ratio. In the circuit construction, two sets of T-circuits are used in which a quartz resonator is placed in the shunt branch and the output of each circuit settles in one terminal. The changeable frequency range exceeds the limit determined by the electromechanical coupling factor of the piezoelectric resonator used without any decrease in the effective Q factor and any increase in the effective resistance, within the entire changeable-frequency range when the resonance frequency of a coil and a capacitor in the series branch of the twin-T circuit is set to almost the same value as the resonance frequency of the resonators used in the twin-T circuit. The derived null-frequency equation and effective Q factor agreed with the experimental results for AT-cut quartz resonators.

The reflection properties of a pure shear-horizontal (SH) surface acoustic wave (SAW) in a periodic gold (Au) grating on rotated Y-cut 90° X propagation langasite (LGS) with Euler angles of (0°,θ,90°) are investigated experimentally. The reflection coefficient was directly measured using an electrode consisting of two probe interdigital transducers and a shorted grating with 60 metal strips. When the Au film thickness was 0.015λ and the metallization ratio η was 0.43, the reflection coefficient was measured to be 0.73, which was larger than similarly measured values for Rayleigh waves on Al/ST-X quartz of 0.62 and Al/LGS(0°,140°,25°) of 0.41. By taking the measured propagation loss for SH SAW on Au/LGS(0°,0°,90°) into consideration, a reflection coefficient close to 1.0 was obtained. Furthermore, the equivalent-circuit parameters for SH SAW on Au/LGS(0°,0°,90°) were determined from the measured resonance characteristics of a normal IDT with 60 finger pairs; then the reflection coefficient was calculated using those parameters. The reflection coefficient predicted was 0.98 for the shorted grating with 60 metal strips on Au/LGS(0°,0°,90°), and agreed with the result obtained by direct measurement. The number of strips on Au/LGS(0°,0°,90°) required to obtain a reflection coefficient of 0.9 was predicted to be 20, which was one-fourth that in the case of Al/ST-X quartz.

Following the production of a uniaxially oriented Ta2O5 thin film on a single crystal substrate (X-cut LiTaO3) by RF sputtering, a Ta2O5 single-crystal film was created using linear rapid thermal annealing. Then the reflection high-energy electron diffraction (RHEED) pattern and X-ray diffraction pattern of the Ta2O5 single-crystal film were measured to examine its crystallization level. A refractive index tensor was obtained using the m-line technique and by measuring the Brewster angles of the film. Results showed clearly that the resultant single crystal film ws mostly composed of optically anisotropic crystals. In order to obtain the photo elastic constant of the thin film, we measured Raman–Nath diffracted light intensities for both Ta2O5 and Ta2O5/LiTaO3. From these results, the photo elastic constant of the thin film was about 6–10 times greater than that of LiTaO3.

For the frequency adjustment of a quartz crystal resonator, vacuum evaporation and ion beam etching are employed. However, with ion beam etching, a phenomenon occurs due to which the frequency further changes after the frequency adjustment and therefore high accuracy can not be obtained, which prevents the practical application. To address this issue, a theoretical analysis was conducted on the frequency change of the quartz crystal resonator caused by ion beam etching. The analysis determined the temperature distribution change of the quartz crystal resonator during ion beam irradiation by the finite difference method, and it was observed that this change of the radial direction of the disk crystal and the time constant of frequency change were equal. The temperature distribution change of the quartz crystal resonator during ion beam irradiation was calculated by the finite difference method. It was observed that the radial temperature distribution change and time constant of frequency change were equal. Subsequently, the heat stress distribution was calculated from the temperature distribution using a column coordinate model, and the change in resonance frequency was calculated by the perturbation method from the change in the elastic constant caused by this stress. In the analysis of AT-, BT-, and SC-cut resonators, both the calculated and experimental results were found to be in agreement. These results showed that thermal stress arose in the temperature distribution change caused during ion beam irradiation, and this thermal stress caused the frequency to change by changing the elastic constant.

We applied a plate mode wave (Lamb wave) to a high-frequency resonator. A Lamb wave in an acoustic bulk mode is excited faster than a surface acoustic wave in an extremely thin quartz substrate. The thickness of the substrate is comparable to the wavelength of the Lamb wave. This fact enables the fabrication of a high-frequency resonator that is operable at a high-frequency range, which cannot be achieved using a conventional quartz oscillator. In this manuscript, we present a discussion and comparison of an analytical procedure with experimental results.

A waveguide-type acoustooptic modulator (AOM) using coplanar AO coupling due to a surface acoustic wave (SAW), that is, Bragg diffraction, in a tapered crossed-channel proton-exchanged (PE) optical waveguide on a 128°-rotated Y-cut LiNbO3 substrate for an optical wavelength of 1.55 µm has been proposed. In this study, a monolithically integrated tandem waveguide-type AOM driven by SAW was designed and fabricated. The structure considered was a 2×4 optical switch, in which the input ports of two second 1×2 switches were connected to the two output ports of the first 2×2 switch on the same substrate. An interdigital transducer (IDT) with a period length of 32 µm and an overlap length of 2 mm was fabricated in the first and second stages of the AO interaction region. Diffraction efficiency was measured at a driving frequency of approximately 120 MHz. A diffraction efficiency of approximately 90% was obtained for each stage. When both stages were driven at the same frequency, a peak diffraction efficiency of 63% was obtained. Furthermore, the optical frequency shifts for the sum of two driving frequencies and the difference frequency ranging from DC to 5 MHz were observed.

A waveguide-type acoustooptic modulator (AOM) driven by a surface acoustic wave (SAW) in a tapered crossed-channel waveguide on a 128°-rotated Y-cut LiNbO3 substrate has been proposed for an optical wavelength of 1.55 µm. In this study, to improve the diffraction properties of the waveguide-type AOM, the dependences of the diffraction properties on the relative position of the SAW beam for the diffraction region were simulated using a beam-propagation method (BPM) and measured. By decreasing SAW beam width, although the input voltage needed to obtain the maximum diffraction efficiency increased, diffraction efficiency improved to 84% from the previous value of 65%. Furthermore, to obtain a lower driving voltage, the utilization of a unidirectional transducer was investigated for the AO interaction on a planar optical waveguide at an optical wavelength of 0.633 µm.

症例は, 75歳の女性で, 食後2～3時間後の嘔吐を主訴に受診した. 腹部単純X線写真では, 鏡面像は認めなかった. 絶飲食にて軽快したが, 食事再開にて再度嘔気・嘔吐出現した. 小腸造影にて, Treitz靱帯付近に小腸の集塊像と狭窄像および, 十二指腸の拡張を認めた. 腹部CT検査では, 十二指腸水平脚腹側に嚢状構造を認めた. 以上の所見より, 右傍十二指腸ヘルニアの診断にて, 開腹手術を施行した. 開腹所見では, 十二指腸空腸曲すぐ肛門側の空腸が約12cm嵌入していた. ヘルニア門は, 十二指腸上行部の右側頭側であり, 下腸間膜静脈の走行とは独立した位置関係であり, 下結腸間膜窩に発生した右傍十二指腸ヘルニアと診断した. 嵌入した腸管を還納後, ヘルニア門を閉鎖した. 術後経過良好で, 小腸造影で通過障害は認めなかった. 非常に稀な下結腸間膜窩に発生した右傍十二指腸ヘルニアの1例を経験したので報告する.

Obesity is associated with metabolic disorders, such as insulin resistance. Visfatin is an adipose-derived secretory factor to exert insulin-mimetic effects. Plasma visfatin levels and mRNA levels of visfatin in adipose tissues are increased in obesity. However, the mechanism that mediates induction of visfatin mRNA in adipose tissue of obesity remains unknown. Recent studies have reported that fat tissue is hypoxia in obesity. In this study, we investigated the effects of hypoxia on mRNA expression of visfatin in adipocytes. Hypoxia increased visfatin mRNA expression. Desferoxamine and Cobaltous chloride, two hypoxia mimetic compounds, also increased visfatin mRNA levels. Dimethyloxallyl glycine, a stabilizer of hypoxia-inducible factor 1alpha (HIF1alpha), mimicked the hypoxia-mediated upregulation of visfatin, and YC1, an inhibitor of HIF1 cancelled the hypoxia-induced upregulation of visfatin mRNA. We identified two functional hypoxia responsive elements (HRE) in mouse visfatin promoter. Hypoxic treatment and overexpression of HIF1alpha increased the promoter activity, and mutation of the HRE blunted hypoxia-induced activation of visfatin promoter. Our results suggest that visfatin mRNA expression is upregulated in the fat tissue of obesity through the activation of HIF1alpha pathway due to hypoxia.

In this study, we examined the temperature characteristics of a Lamb wave propagating on a thin quartz crystal substrate. Consequently, we found a new cut where frequency hardly changes with temperature. The steady frequency–temperature characteristics show a quadric curve and the third curve. The analytical results and experimental results for the temperature characteristics of a Lamb wave propagating on an AT cut quartz are compared and discussed in this study. The agreement between the theoretical and experimental results shows that the analytical results of this study were reliable.

Plate wave (Lamb wave) propagation in an extremely thin quartz substrate is analyzed. A cut angle is sought that exhibits an ultrastable temperature dependence of the frequency characteristics so that the frequency changes little with temperature. Highly stable temperature characteristics of the frequency indicating second- and third-order curves are obtained. Theoretical and experimental investigations of the temperature characteristics of the frequency of Lamb waves propagating in an AT-cut quartz substrate indicate excellent agreement between the two, confirming that the reliability of the results of the present analysis is high. © 2006 Wiley Periodicals, Inc. Electron Comm Jpn Pt 2, 89(8): 9–15, 2006; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/ecjb.20262

胃原発の小細胞癌は稀な腫瘍であり,一般型腺癌に比べ転移および浸潤傾向が強く予後不良である.今回われわれは胃原発小細胞癌と術前診断し,手術を施行した1例を経験したので報告する.症例は85歳の女性.平成17年2月,心窩部痛を主訴に受診,上部内視鏡検査で胃体上部に2型病変を認めた.同部位の生検および免疫組織学的検査で,胃原発の小細胞癌と術前診断し,平成17年3月手術を施行した.開腹所見は, T2, N0, H0, P0, M0, StageIBで,胃全摘・D2郭清を施行した.切除標本で病変は36×36mmの2型腫瘍で,割面では粘膜下腫瘍様に増殖していた.病理診断は, small cell car-cinoma, medullary type, INFβ, T2(MP), 1y2, v3, nl, PM(-), DM(-), Stage IIであった.免疫組織学的にCD56, NSE, synaptophysin, chromogranin Aが強陽性を示した.術後化学療法は年齢を考慮して施行しなかった.術後10カ月目に多発性肝転移再発が確認されたが,現在外来にて経過観察中である.

症例は54歳,男性.検診で異常を指摘され,胃内視鏡検査にて,胃体部後壁の胃癌(3型)と診断された.注腸検査で,右側結腸腸間膜側に多発連続性の腫瘍を認め,大腸内視鏡で同部位にたこいぼ状の腫瘍を認めた.生検組織は胃癌と同様で,胃癌,転移性大腸腫瘍と診断した.術中所見で,腹膜播種はなく,腹水細胞診は陰性だが,左胃動脈,大動脈周囲のリンパ節転移を認めた.悪性腫瘍によるネフローゼ症候群もあり,幽門側胃切除術,右結腸切除術を姑息的に施行した.病理組織検査で,大腸腫瘍(tub2)は,胃癌と同様で,リンパ管侵襲を強く認めた(ly3). 免疫染色結果から胃癌の大腸転移と診断した.術後5カ月で左鎖骨上リンパ節転移を認め, 9カ月後,大腸吻合部近傍に再発と思われる粘膜病変を認めた.術後,癌化学療法は無効で,リンパ行性に再燃し,第317病日に死亡した.

尿膜管遺残症に対して,最近では腹腔鏡下手術の報告も散見する.今回われわれは,吊り上げ法を用いた腹腔鏡下摘出術を経験したので報告する.症例は24歳男性.臍部痛を主訴に平成16年4月19日受診した.臍瘻孔造影・CT検査で臍から膀胱への約4 cmの瘻孔を認め,尿膜管臍瘻の診断で, 5月11日,腹腔鏡下摘出術を施行した.皮下鋼線を左下腹部に2カ所刺入し,吊り上げ法を施行した.右鎖骨中線上臍高部(5 mm, scope port),右上腹部・右下腹部(5 mm)の3孔式で行った.腹壁正中に大網の癒着を認め切離した.膀胱頂部近傍の正中臍靱帯を体外結紮切離した後,切離端を把持・牽引しながら尿膜管組織を臍直下まで超音波凝固切開装置を用いて切離した.臍瘻孔周囲を切開し,尿膜管を摘出した.摘出標本は8 cmで,組織学的にも尿膜管臍瘻の感染と診断した.手術時間は85分,出血はごく少量.術後経過良好で7日目に退院した.

The propagation characteristics of two modes of surface acoustic waves (SAWs) on ST quartz with a tantalum pentoxide (Ta2O5) thin film are investigated theoretically and experimentally. One is the pure shear-horizontal (SH)-type SAW and the other is the Love-wave-type SAW converted from the leaky SAW (LSAW). For these SAWs, stronger energy trapping effects on the surface can be expected by loading the substrate with the Ta2O5 thin film, because this film has a relatively high density. In fact, the film thickness of the Ta2O5 film required to obtain the minimum insertion loss and the maximum K2 for the SH-type SAW on ST-90°X quartz is around 0.01 λ, which is approximately one-fourth of that reported for silicon dioxide film. Furthermore, the attenuation of the LSAW on ST-33°X quartz was reduced by loading with the Ta2O5 film because the LSAW becomes the Love-wave-type SAW without attenuation.

An integrated acoustooptic frequency shifter in a crossed-channel waveguide is demonstrated at an optical wavelength of 1.55 ?m. A novel tapered device was designed to make the acoustooptic interaction region longer and thus the driving surface acoustic wave (SAW) power lower, and the device was fabricated by the proton-exchange method and post-annealing in a 128? rotated Y-cut LiNbO3 substrate. At SAW power of 1.4 W, a 40% diffraction efficiency and a bandwidth of 5 MHz centered at 196 MHz were obtained. The frequency shift of Bragg diffracted light was confirmed in an optical heterodyne experiment.

PROBLEM TO BE SOLVED: To provide a Lamb-wave type high-frequency resonator that has a high Q value, high phase velocity and superior frequency temperature characteristics. SOLUTION: The Lamb-wave type high-frequency resonator 10 has a liquid crystal substrate 20, an IDT electrode 30 constituted by interposing a first cross finger electrode 31 and a second cross finger electrode 32 into the main surface of the liquid crystal substrate 20 and reflectors 40, 50 arranged on both sides of the traveling direction of the Lamb wave of the IDT electrode 30. If the crossing width between the first cross finger electrode 31 and the second cross finger electrode 32 is W and the wavelength of the Lamb wave is λ, the crossing width W is set within a range, expressed by 21λ≤W≤54λ. In addition, the IDT electrode 30 is formed so that the segmentation angle of the liquid crystal substrate 20 and the propagating direction of the Lamb wave become (0, θ, 0) by Euler angle representation and within a range, in which the angle θ is expressed as being 35 degrees ≤θ≤47.2 degrees, normalized substrate thickness t/λ, expressed by a relation between the thickness t of the liquid crystal substrate 20 and the wavelength λ of the Lamb wave, set to be within a range of 0.176≤t/λ≤1.925. COPYRIGHT: (C)2008,JPO&INPIT

The Ta2O5 thin film is a novel piezoelectric thin film, and its application as a surface acoustic wave communication element is expected. Thus, we attempted to grow the single crystal thin film on an amorphous substrate. In this study, a uniaxial orientation film was established on both an amorphous substrate and a single crystal substrate using the RF sputtering method. A new heating method for fabricating a single crystal thin film was proposed, and the basic examination was carried out. As a result, a high-quality crystal thin film was obtained on both kinds of substrates.

Context Erlotinib is a selective epidermal growth factor receptor tyrosine kinase inhibitor used as a target therapy against non-small lung cancer and advanced pancreatic cancer. A regimen of erlotinib plus gemcitabine has been proven to prolong overall survival in the patient with advanced pancreatic cancer. In addition to common adverse effects, such as diarrhea, mucositis and skin rash (acne form eruptions), acute interstitial lung disease (ILD) has been reported as an infrequent but potentially fatal complication. We here report a case of a Japanese patient with erlotinib-induced ILD in whom high-dose corticosteroid therapy was successful. Case report A fifty-five-year-old male with cancer of the head of the pancreas with multiple liver metastases started treatment with gemcitabine plus erlotinib. On the 13th day of erlotinib treatment, he had high fever. Chest computed tomography (CT) scan showed a diffuse ground-glass like infiltration of both lungs. He was diagnosed with ILD, and high-dose corticosteroid therapy was started. Two weeks after the introduction of steroid therapy, the reticular shadow faded away on CT. He was successfully treated with corticosteroid for erlotinib-induced acute ILD although he died 6 months after the initiation of chemotherapy owing to disease progression. Conclusion we showed a case of a successfully treated Japanese patient of erlotinib-induced ILD. Because erlotinib-induced ILD would frequently occur in Japanese patients, closer attention to ILD should be paid for Japanese patients than in Western populations. If erlotinib-induced ILD occurs, a high-dose corticosteroid therapy would be a useful option of treatment. Image: Interstitial lung disease at chest CT., JOP. Journal of the Pancreas, Vol 15, No 6 (2014): November - p. 541-632

The bulk wave, which is radiated into the substrate from the leaky surface acoustic wave (LSAW), can be suppressed by loading the substrate with a thin film of dielectric such as tantalum pentoxide (Ta2O5) and silicon dioxide (SiO2). Rotated Y-cut X-propagating lithium niobate (LiNbO3) is used for the substrate. For a certain range of the rotation angle, the attenuation of the LSAW can be suppressed by choosing the appropriate material and thickness for the film. For the free surface of 64° Y−X LiNbO3 with Ta2O5 film, and the metallized surface of 41° Y−X LiNbO3 with SiO2 film, the measured propagation losses decreased approximately to one-fourth to half of that of the sample without the thin film. It is shown that, even if the propagation path is a free surface, the particle displacement distribution in the LSAW is concentrated near the substrate surface by the loading with the thin film, as for the metallized surface. This result suggests that the bulk wave radiation in the LSAW excitation can be suppre...

This paper shows that the bulk wave that is radiated to the inside of the substrate in the excitation and propagation of a leaky surface acoustic wave (LSAW) can be suppressed by forming a proton-exchanged layer on the surface of the substrate. It is theoretically shown that, even if the electrical condition of the propagation path is a free surface, the particle displacement distribution of the LSAW particle is concentrated at the substrate surface by proton exchange, as in the case of a metallized surface. This result suggests that the bulk wave radiation in LSAW excitation can be suppressed. The bulk wave radiation loss is examined by measuring the insertion loss between the input and the output IDT on the 41° Y-X LiNbO3 substrate, and it is shown that the bulk wave can be reduced to zero by proton exchange. It is shown experimentally that the leak loss in the propagation due to the bulk wave radiation can be reduced to approximately one-third by the proton exchange. © 1999 Scripta Technica, Electron Comm Jpn Pt 3, 83(1): 44–52, 2000

Elastic constants of unidirectional carbon fiber reinforced polymer (CFRP) laminates are determined by water immersion ultrasonic sing-around method. The unidirectional CFRP has hexagonal symmetry, and the five independent stiffness constants (C11, C12, C13, C33, C44) are derived from the two series of sing-around periods. In the one series, the fiber direction is set to be always perpendicular to the incidence-refraction plane. From the measurement result, C11, C12 and C66 are obtained explicitly. In the other series, the fiber direction is set to be contained in the incidence-refraction plane. From this result, C13, C33 and C44 are obtained by successive approximation using least square method.

A method of vibration analysis for an ultrasonic motor using asymmetric flexural vibrations and symmetric contour vibrations of a thick rectangular plate is given. An investigation of the symmetricity of the flexural vibrations using the Rayleigh quotient is used to derive an expression for the resonant frequency of the same flexural mode and the similarity ratio of the vibration plate thickness and contour dimensions. The possibility of estimating the resonant frequency of a rectangular plate of different dimensions is then confirmed experimentally. With the contour vibration mode with small displacements at the middle and large displacements at the ends, the middle side constrained is analyzed. The vibration plate was an SUS304 rectangular plate with a PZT plate attached; as in the case of the PZT rectangular plate, it is confirmed experimentally that shear stress can be neglected. When allowance is made for machined holes in the vibration plate (such as screw holes), a value close to the measurement value is still obtained.

Evidence suggests that visceral fat accumulation plays a central role in the development of metabolic syndrome. Excess visceral fat causes local chronic low-grade inflammation and dysregulation of adipocytokines, which contribute in the pathogenesis of the metabolic syndrome. These changes may affect the gene expression in peripheral blood cells. This study for the first time examined the association between visceral fat adiposity and gene expression profile in peripheral blood cells. The gene expression profile was analyzed in peripheral blood cells from 28 obese subjects by microarray analysis. Reverse transcription-polymerase chain reaction (RT-PCR) was performed using peripheral blood cells from 57 obese subjects. Obesity was defined as body mass index (BMI) greater than 25 kg/m(2) according to the Japanese criteria, and the estimated visceral fat area (eVFA) was measured by abdominal bioelectrical impedance. Analysis of gene expression profile was carried out with Agilent whole human genome 4 × 44 K oligo-DNA microarray. The expression of several genes related to circadian rhythm, inflammation, and oxidative stress correlated significantly with visceral fat accumulation. Period homolog 1 (PER1) mRNA level in blood cells correlated negatively with visceral fat adiposity. Stepwise multiple regression analysis identified eVFA as a significant determinant of PER1 expression. In conclusion, visceral fat adiposity correlated with the expression of genes related to circadian rhythm and inflammation in peripheral blood cells.

BACKGROUND Enhancement of liver regeneration is a matter of importance after partial liver transplantation including small-for-size grafting. Mitochondrial adenosine triphosphate (ATP)-sensitive K⁺ (mitoKATP) channel plays an important role in mitochondrial bioenergetics, which is a prerequisite for liver regeneration. However, the ATP-sensitive K⁺ (KATP) channel in hepatocytes is incompletely understood. We investigated the KATP channel in hepatocytes and examined the effects of diazoxide, a potent KATP channel opener, on liver regeneration using a rat model. METHODS Using rat primary hepatocytes, expression and localization of KATP channel subunits, Kir6.x and sulfonylurea receptor (SUR)x, were studied by polymerase chain reaction, Western blotting, and immunostaining. To investigate the role of KATP channel openers in liver regeneration, we allocated rats into four groups: control (vehicle) (n=24), diazoxide (n=24), vehicle plus channel blocker (n=6), and diazoxide plus channel blocker (n=6) groups. After 70% partial hepatectomy, hepatic tissue ATP levels, liver-to-body weight ratio, and proliferation rate of hepatocytes were examined. RESULTS KATP channel subunits, Kir6.1 and SUR1, were detected on hepatic mitochondria. During liver regeneration, liver-to-body weight ratio, proliferation rate of hepatocytes, and the hepatic ATP level were significantly higher in the diazoxide group than the control group at 2 days after partial hepatectomy. These effects of diazoxide were neutralized by a KATP channel blocker. CONCLUSIONS We demonstrated the existence of a mitoKATP channel in hepatocytes composed of Kir6.1 and SUR1. Diazoxide could enhance liver regeneration by keeping a higher ATP content of the liver tissue. These results suggest that diazoxide will sustain the mitochondrial energetics through the mitoKATP channel opening.

In a surface acoustic wave substrate with a “piezoelectric thin-film/substrate” configuration, the temperature coefficients of the acoustic constants of the Ta2O5 and ZnO thin films were determined by means of the least square method based on the experimental values of the temperature coefficients of the acoustic constants. Also, with regard to the two-layered model of a “piezoelectric thin-film/piezoelectric thin-film/substrate” configuration, the surface acoustic wave speed, electromechanical coupling coefficient and temperature characteristics were computed and the combinations of the film thicknesses were derived for a first-order zero-temperature coefficient. Further, it is recognized that the ZnO thin film and the Ta2O5 thin film have second-order delay time temperature dependences with opposite signs and then a method is proposed for controlling the first- and second-order temperature coefficients in a two-layered substrate. It is found experimentally and theoretically that there exists a highly stable substrate which exhibits a third-order characteristic at an appropriate film thickness.

Extended liver resection is currently the major curative therapy for primary and metastatic malignant liver tumors because of a lack of donors for liver transplantation. Although liver resection is now a safer procedure, fatal liver failure and dysfunction may still occur after massive liver resection and often lead to postoperative death. To prevent the fatal complications after liver resection, we have to understand the molecular mechanism underlying liver dysfunction and failure in remnant livers after massive liver resection. Failure of liver regeneration associated with liver ischemia is a major cause of fatal liver failure after massive liver resection.1-3 Many researchers and surgeons have sought effective strategy against ischemia-reperfusion (I/ R) liver injury.4-6 However, the underlying mechanism of liver regeneration failure after I/R injury is not yet fully understood. Therefore, the development of an effective strategy to minimize ischemia and postoperative liver failure is critical to establish safe and effective surgery for massive liver resection. Liver progenitor cells, a subpopulation of mesenchymal stem cells (MSCs), have been extensively studied because of their ability to differentiate into both hepatocytes and bile duct epithelial cells. In healthy livers, liver regeneration triggered by loss of liver mass as the result of surgical resection is mediated by the proliferation of mature hepatocytes and biliary epithelial cells. When proliferation of these cells is impaired by insults such as drugs, viral infection, and toxins, liver progenitor cells become active, resulting in insuring regeneration. In addition to transdifferentiation of liver progenitor cells, in recent studies that use injury models in other organs, authors have shown that MSCs have the potential to prevent cell death and stimulate endogenous regenerative abilities through differentiation-independent mechanisms.7-10 Liver progenitor cells could prevent liver failure via 2 distinct mechanisms: transdifferentiation and cytoprotection. It is possible that liver progenitor cells have dual functions to protect against ischemic liver injury as well as fatal liver failure after massive liver resection. We have recently reported the induction of liver epithelial cells (LECs) in the portal vein–occluded liver lobes. LECs were differentiated into hepatocytes and bile duct epithelial cells in culture. We also observed that transplanted LECs transdifferentiated into albumin producing cells in the liver,11 suggesting LECs as liver progenitor cells. The aim of the current study was to investigate the hepatoprotective roles of LECs against ischemia. To evaluate the cellular response of LECs under hypoxia, we assessed cell survival and intra-cellular ATP levels. The expression of hypoxiainducible factor-1 (HIF-1) target genes, pyruvate dehydrogenase kinase-1 (PDK-1), and stromal cell–derived factor-1 (SDF-1) were then assessed. Finally, we demonstrated the protection of hepatocytes from hypoxia by in vivo induction of LECs. Our results suggest that LECs have capacity to protect the liver from lethal insults by paracrine signaling of SDF-1 as well as differentiation into parenchymal cells.