Evaluation and Optimization of System Performance using HFO-mix Refrigerants for VRF and Mini-split Air-Conditioner

Global demand for air conditioning is expected to increase continuously. In order to minimize the impact on the climate as a total amount of CO2 equivalent, it is essential to continue to search for better refrigerants. On the other hand, product size and cost are important factors in providing value to users. This time, while using the experiment result of the mini-split type air-conditioner reported in the past, in addition, we conducted a new experiment on multi-type VRF air-conditioner. Then, the difference in COP performance between R-410A and alternative candidate refrigerants was evaluated. In addition, we studied the product design using R-452 B, R-454 B by simulation and compare the size when the performance is made identical by changing the system specifications with alternative refrigerant candidates. As a result, common results were obtained in both systems. It was found that R-452B and R-454B have better performance than R-410A. On the other hand, it was found that these refrigerants need to increase both the indoor heat exchanger and the outdoor heat exchanger to 120% in order to obtain the same performance as R-32

Thrombocytopenia in pegylated interferon and ribavirin combination therapy for chronic hepatitis C

BACKGROUND: This study aimed to examine the therapeutic effect and prognostic indicators of pegylated interferon (PEG-IFN) and ribavirin (RBV) combination therapy in thrombocytopenic patients with chronic hepatitis C, hepatitis C virus (HCV)-related cirrhosis, and those who underwent splenectomy or partial splenic embolization (PSE). METHODS: Of 326 patients with HCV-related chronic liver disease (252 with genotype 1b and 74 with genotype 2a/2b) treated with PEG-IFN/RBV, 90 were diagnosed with cirrhosis. RESULTS: Regardless of the degree of thrombocytopenia, the administration rate was significantly higher in the splenectomy/PSE group compared to the cirrhosis group. However, in patients with genotype 1b, the sustained virological response (SVR) rate was significantly lower in the cirrhosis and the splenectomy/PSE groups compared to the chronic hepatitis group. No cirrhotic patients with platelets less than 80,000 achieved an SVR. Patients with genotype 2a/2b were more likely to achieve an SVR than genotype 1b. Prognostic factors for SVR in patients with genotype 1b included the absence of esophageal and gastric varices, high serum ALT, low AST/ALT ratio, and the major homo type of the IL28B gene. Splenectomy- or PSE-facilitated induction of IFN in patients with genotype 2a/2b was more likely to achieve an SVR by an IFN dose maintenance regimen. Patients with genotype 1b have a low SVR regardless of splenectomy/PSE. In particular, patients with a hetero/minor type of IL28B did not have an SVR. CONCLUSIONS: Splenectomy/PSE for IFN therapy should be performed in patients expected to achieve a treatment response, considering their genotype and IL28B

The Usefulness of "Hybrid Unit" Goal-based Learning on Physical Education: Focusing on the practice of tag rugby, handball, and basketball in junior high schools

The purpose of this study was to address a motor learning program consisting of "hybrid units" and to clarify the usefulness of the learning sequence and arrangement by analyzing the common movement patterns among various athletic activities . Then, we conducted empirical lessons of two units: tag rugby-handball and handball-basketball. Results showed that " forming a line in a defense and "passing effectively in an attack" are common ways of moving. In addition, it was found that both defensive and offensive movements became progressively more complex and could be studied in a developmental sequence

Safety and Utility of Endoscopic Removal of Common Bile Duct Stones in the Elderly

We investigated the safety and utility of endoscopic removal of common　bile duct stones (CBDS) in the elderly. In all, 253 patients with CBDS who　underwent endoscopic retrograde cholangiopancreatography (ERCP) between January　2007 and December 2011 at Showa University Hospital were evaluated retorspectively. The median age of the patients was 75 years ; thus, we divided patients　into two groups, those aged ≥ 75 years (Group A ; n ＝ 134) and those aged ＜75 years (Group B ; n ＝ 119). Patients in Group A had significantly higher rates　of endoscopic sphincterotomy in palliative ERCP (24.8% vs. 10.7%; p ＝ 0.008) and　palliative removal of CBDS (34.8% vs. 20.9%; p ＝ 0.015) than patients in Group　B. However, the median dose of flunitrazepam was significantly lower for patients　in Group A than Group B (1 vs. 1.4 mg, respectively ; p ＜ 0.001). The rate of use　of pentazocine (18.5% vs. 54.7%; p ＜ 0.001) and scopolamine butylbromide (6.2%　vs. 23.9%; p ＜ 0.01) was significantly lower in Group A patients, whereas the use　of glucagon was significantly higher in this group (43.8 vs. 15.4%; p ＜ 0.001).　There were no significant differences in the rate of successful endoscopic removal　of CBDS, treatment time, complications, and the recurrence of CBDS between the　two groups. Endoscopic removal of CBDS in the elderly is a safe procedure with　good outcomes if the appropriate treatment is selected

Usefulness of Continuous Regional Arterial Infusion with Doripenem and Protease Inhibitors for Severe Acute Pancreatitis

Doripenem (DRPM) is a relatively new drug belonging to the carbapenem antibiotic group. We hypothesized that the pharmacological characteristics of DRPM could make it useful in the treatment of severe acute pancreatitis (SAP). We investigated the usefulness of continuous regional arterial infusion (CRAI) with DRPM and protease inhibitors for SAP. Two hundred and forty-two patients with SAP were admitted to Showa University Hospital between November 2002 and June 2013. Of these, 53 patients were treated with CRAI with carbapenem antibiotics and nafamostat mesilate (NM), a serine protease inhibitor, via the celiac and superior mesenteric arteries. Clinical outcomes were evaluated retrospectively in 34 patients treated with DRPM and 19 patients undergoing non-DRPM therapy (meropenem n=11, imipenem n=6; biapenem n=2). The median time to commencement of oral intake was significantly shorter in the DRPM than non-DRPM group (9 vs 14 hospital days, respectively; P<0.01). In addition, the rate of walled-off necrosis in the DRPM group tended to be lower than in the non-DRPM group (37.5 vs 64.7%, respectively, P=0.069). The results of the present study suggest that CRAI with DRPM and NM for SAP could have equivalent therapeutic effects to CRAI with other carbapenem antibiotics and NM

The Usefulness of "Hybrid Unit" Goal-based Learning on Physical Education: Focusing on the practice of tag rugby, handball, and basketball in junior high schools

The purpose of this study was to address a motor learning program consisting of "hybrid units" and to clarify the usefulness of the learning sequence and arrangement by analyzing the common movement patterns among various athletic activities . Then, we conducted empirical lessons of two units: tag rugby-handball and handball-basketball. Results showed that "forming a line in a defense" and "passing effectively in an attack" are common ways of moving. In addition, it was found that both defensive and offensive movements became progressively more complex and could be studied in a developmental sequence

Gastrointestinal Stromal Tumor of the Stomach with Narrow Stalk-Like Based, Uneven Protruding Appearance Presenting with Severe Acute Anemia despite Small Size

We report the case of a 56-year-old woman who had a gastrointestinal stromal tumor (GIST) of the stomach. She was admitted to our hospital for epigastric pain, nausea, and severe acute anemia (hemoglobin level 4.3 g/dl). Esophagogastroduodenoscopy revealed a narrow stalk-like based, hemorrhagic and uneven protruding lesion in the lesser curvature of the gastric upper corpus. Although the tumor was less than 2 cm in diameter and was probably a benign GIST according to histology, laparoscopy-assisted local resection was needed because the patient had continuous severe anemia and epigastric pain. Histological assessment showed that the elongated spindle-like tumor cells originated from the intrinsic muscle layer, and was shown with growth to the mucosal side, cropping out to the surface in most areas of the protruding lesion. Only a small part of the tumor was within nontumoral gastric mucosa. Most of the tumor cells demonstrated immunoreactivity for KIT and CD34 in the cytoplasm but not for αSMA, S100, and desmin. Mitotic activity (0/50 high power field) and the labeling index for MIB-1 (about 1%) were low. The GIST of the stomach described in this report was a rare case with a narrow stalk-like based, uneven protruding mass presenting with severe acute anemia despite small size

A Genetic Variant of the CD14 C-159T in Patients with Functional Dyspepsia (FD) in Japanese Subjects

Inflammatory changes in the gastric mucosa are commonly observed in Japanese patients with functional dyspepsia (FD). However, detailed data regarding the relationship between the genetic regulatory factors of inflammation and FD are not available. CD14 is an important mediator of the inflammatory response in the first line of host defense by recognition of Lipopolysaccharide (LPS). We aimed to investigate the association between CD14 promoter C-159T polymorphism and FD in a Japanese population. 108 patients with FD and 99 non-dyspeptic subjects enrolled in this study. Dyspeptic symptoms were divided according to Rome III criteria. CD14 gene C-159T polymorphism was determined by polymerase chain reaction-restriction fragment length polymorphism. In the non-dyspeptics, the CD14 genotype distribution was 28CC (28.3%), 51CT (51.5%), 21TT (21.2%). Meanwhile, the CD14 genotype distribution in FD was 31CC (28.4%), 56CT (51.4%), 22TT (20.2%). The genotype distribution was not significantly different. There was no significant difference between two groups in the genotype distribution. We did not found any association between CD14 genotypes and dyspeptic patients in different gender and Helicobacter pylori infection status. No significant association was also found between CD14 polymorphism and any of different subtypes of FD according to Rome III while there was a weak correlation between TT genotype and PDS in male subjects (TT vs others, OR = 3.18, 95% CI = 0.98−10.26, p = 0.06). In conclusion, our results suggest that CD14 polymorphism is unlikely to associate with susceptibility of dyspeptic symptoms. The role of inflammation related-gene polymorphisms to the development of dyspepsia needs to further evaluation

Correlation between magnifying narrow band imaging and histopathology in gastric protruding/or polypoid lesions: a pilot feasibility trial

<p>Abstract</p> <p>Background</p> <p>Several study showed usefulness of microscopic capillaries, seen by magnifying narrow band imaging (NBI) endoscopy for predicting histopathology among superficial depressed or flat elevated gastric neoplasia (GN). Here we assessed the diagnostic efficacy of magnifying NBI for predicting histopathology among gastric protruding/or polypoid lesions.</p> <p>Methods</p> <p>Using endoscopic pictures of magnifying NBI from 95 protruding/or polypoid lesions (19 fundic gland polyps: FGP, 47 hyperplastic polyps: HP, and 29 GN), fine mucosal patterns were classified into four categories: small round, prolonged, villous or ridge, and unclear patterns, and micro vascular patterns were classified into five categories: honey comb, dense vascular, fine net work, core vascular, and unclear patterns.</p> <p>Results</p> <p>Most suggestive micro vascular patterns for predicting FGP, and HP were honeycomb (sensitivity 94.7%, specificity 97.4%), and dense vascular patterns (sensitivity 93.6%, specificity 91.6%), respectively. Fine net work, core vascular, and unclear patterns presented higher specificity (97%, 100%, and 100%) for predicting GN, and diagnostic efficacy of combined of those patterns was favorable (sensitivity 86.2%, specificity 97.0%).</p> <p>Conclusion</p> <p>Micro vascular patterns by using magnifying NBI provides meaningful information for predicting the histopathology of gastric protruding/or polypoid lesions.</p