Improvement of charge trapping characteristics of Al2O 3/Al-rich Al2O3/SiO2 stacked films by thermal annealing

Thin film Al2O3/Al-rich Al2O 3/SiO2 structures were fabricated on p-Si substrates. Radio-frequency magnetron co-sputtering was used to form Al-rich Al 2O3 thin film as the charge-trapping layer of nonvolatile Al2O3 memory. Capacitance-voltage measurements showed a large hysteresis due to charge trapping in the Al-rich Al2O 3 layer. The charge trap density was estimated to be 42.7 × 1018 cm- 3, which is the largest value ever reported for an Al-rich Al2O3 layer; it is six times larger than that of a conventional metal-nitride-oxide-silicon memory. Thermal annealing was found to reduce the leakage current of the Al2O3 blocking layer, thereby providing this structure with better data retention at room temperature than an as-deposited one. In addition, the annealed structure was found to exhibit good data retention even at 100 C. © 2013 Elsevier B.V. All rights reserved

Usefulness of right ventriculography compared with computed tomography for ruling out the possibility of lead perforation before lead extraction

Purpose High-risk patients can be identified by preprocedural computed tomography (CT) before lead extraction. However, CT evaluation may be difficult especially for lead tip identification due to artifacts in the leads. Selective right ventriculography (RVG) may enable preprocedural evaluation of lead perforation. We investigated the efficacy of RVG for identifying right ventricular (RV) lead perforation compared with CT in patients who underwent lead extraction. Methods Ninety-five consecutive patients who were examined by thin-section non-ECG-gated multi-detector CT and RVG before lead extraction were investigated retrospectively. Newly recognized pericardial effusion after lead extraction was used as a reference standard for lead perforation. We analyzed the prevalence of RV lead perforation diagnosed by each method. The difference in the detection rates of lead perforation by RVG and CT was evaluated. Results Of the 115 RV leads in the 95 patients, lead perforation was diagnosed for 35 leads using CT, but the leads for 29 (83%) of those 35 leads diagnosed as lead perforation by CT were shown to be within the right ventricle by RVG. Three patients with 5 leads could not be evaluated by CT due to motion artifacts. The diagnostic accuracies of RVG and CT were significantly different (p < 0.001). There was no complication of pericardial effusion caused by RV lead extraction. Conclusion RVG for identification of RV lead perforation leads to fewer false-positives compared to non-ECG-gated CT. However, even in cases in which lead perforation is diagnosed, most leads may be safely extracted by transvenous lead extraction

False-negative coagulation factor activity results due to the presence of antiphospholipid antibodies in a case of autoimmune hemolytic anemia

An 88-year-old female was admitted with autoimmune hemolytic anemia (AIHA). Coagulation test revealed severe prolongation of activated partial thromboplastin time (APTT). APTT cross-mixing test with patient plasma and normal plasma demonstrated an inhibitory pattern. Several intrinsic coagulation factor activities, particularly factor IX, showed remarkable decreases, and the inhibitor titers for coagulation factors VIII and IX were elevated. Although AIHA with existing antiphospholipid (aPL) antibodies was diagnosed initially, purpura developed on extremities intermittently during the clinical course. Considering the possibility of coexisting acquired hemophilia, APTT cross-mixing test with patient’s plasma and equal amount of the recombinant factor VIII product instead of normal plasma was performed. The APTT value on equal mixing samples with patient plasma and recombinant factor VIII product was decreased to within the normal range, and coagulation factor IX activity was restored. These results indicate that the recombinant factor VIII product had a neutralizing effect on aPL antibodies. We concluded that recombinant factor VIII product may lead to the repair of incorrect results from the APTT-dependent diagnostic system in the presence of aPL antibodies

microRNA デ カガク ホウシャセン リョウホウ ノ コウカ オ ヨソクスル

While global microRNA（miRNA）expression patterns of many embryologic, physiologic, and oncogenic processes have been described, description of the role of miRNAs for preoperative chemoradiotherapy（CRT）in rectal cancer is lacking. Our purpose of this study was to define the expression pattern of miRNAs for prediction of response to chemoradiotherapy in rectal cancer. Rectal cancer patients（n＝22）who underwent preoperative CRT（40Gy radiotherapy combined with S-1）were studied. S-1 is a novel oral fluoropyrimidine inhibitory for dihydropyrimidine dehydrogenase and has potent radiosensitizing property. RNA harvested from biopsy specimens of rectal cancer before preoperative CRT was hybridized to miRNA microarrays（８２１genes）. Response to CRT was determined by histopathologic examination（Japanese Society for Cancer of the Colon and Rectum）of surgically resected specimens and RECIST. Groups were classified as responders（ grade 2 or 3, CR or PR）or nonresponders（grade 0 or 1, SD or PD）, respectively. Response to CRT determined by histopathologic examination of surgically resected specimens and RECIST were as follows : responders（grade 2 or 3, n＝15）,（PR, n＝１４）, nonresponders（grade 0 or 1, n＝7）（, SD, n＝8）. Response rate was６８％（grade 2 or 3）and 63％（PR）. Two miRNAs（miR- 142, 223）with increased expression were identified that correctly differentiated responders from nonresponders of CRT by histopathologic examination. One overexpressed（miR-223）and 4 underexpressed miRNAs（miR-17, 20, 92, 106）differentiated responders from nonresponders of CRT by RECIST. Rectal cancer may have a distinct miRNA expression to predict pathological response to preoperative chemoradiotherapy

Yキャク フンゴウブ キョウサク オ ガッペイ シタ チョウ コウレイシャ イ ゼンテキ ノ イチレイ

An 88-year-old male patient was referred to our hospital after being diagnosed with gastric cancer during extensive investigations for anemia. The patient underwent total gastrectomy followed by Roux-en Y reconstruction. An esophagus jejunum anastomosis was performed using a Curbed-Shaft Detachable Head Circular Stapler （25 mm）（CDH25）. An anastomosis of the jejunum was performed approximately 40 cm distal to the esophagus jejunum anastomosis using a Straight Shaft Detachable Head Circular Stapler（21 mm）（SDH21）. A seromuscular suture was applied to each anastomotic site. The patient started oral intake on Day 8 after the operation, and was transferred to the urology department on Day 22 for the treatment of renal cancer. Approximately 2 weeks after the transfer, the patient developed fever above 38℃. CT revealed marked enlargement of the duodenum, suggesting stenosis at the Y anastomotic site. The stenosis was successfully treated by endoscopic balloon dilatation without performing. Here, we report a case with favorable outcome

ダイチョウ ゲンパツ アクセイ リンパシュ ノ 3レイ

Compared with carcinomas of the digestive organs, malignant lymphomas of the digestive organs are rare, especially those of the colon and rectum. Three patients with malignant lymphoma arising in the colon experienced at our hospital from １９９１ to ２０１０ are presented here. These ages ranged from ５９ to ７８. The male was two and the female was one. Two patients underwent ileocecal resection and one patient did extended right hemicolectomy, and two patients had partial resection of the ileum, because of tumor invaded. Histopathologically all three patients had non-Hodgkin’s lymphoma, B-cell type. According to LSG classification, all cases were of diffuse type, including two of large cell type, one of medium-sized cell type. As post operative adjuvant chemotherapy, CHOP and R-CHOP was given to two patients. IPI were H, HI, LI, respectively. As for prognosis, two patients died, and one patient is alive. Prognosis of malignant lymphoma of the colon is very poor, and combination of surgical operation and chemotherapy is very important for treatment

Intraperitoneal infusion of paclitaxel with S-1 for peritoneal metastasis of advanced gastric cancer : phase I study

Background : Intraperitoneal administration of taxanes revealed excellent anti-tumor effect for peritoneal metastasis of gastric cancer in some experimental models. The aim of this study is to determine maximum tolerated dose (MTD), dose limiting toxicity (DLT) and recommended dose (RD) of intraperitoneally infused paclitaxel (PTX) with S-1 as a phase I study. Patients and Methods : Eighteen patients with advanced gastric cancer in addition to confirmed peritoneal metastasis using laparoscopy were enrolled in this study. The regimen consists of oral administration of S-1 (Dose 80mg : BSA1.5 m2) for 14 days and intraperitoneal infusion of PTX (Dose escalation : level I : 40, II : 60, III : 80, level IV : 90, V : 100 mg/m2) at day1 and 14. PTX concentrations in serum and ascites were determined at 4, 8, 12, 24, 48 hours after the infusion, which was repeated twice every 4 weeks. Results : The number of patients were as follows : Level I : 3, Level II : 6, Level III : 3, Level IV : 3, Level V : 3. Grade 3 leukocytopenia was confirmed in 1 (Level II) and 2 (Level V). MTD is 90 mg/m2, RD is 80 mg/m2 and DLT is Grade 3 leukocytopenia. The average serum PTX concentrations remained in optimal range except for all 3 of level V patients. In all cohorts, the PTX concentrations in the ascites were approximately 1000 folds higher than those in serum for 48 hours after the infusion. Conclusions : MTD and RD were PTX 90 mg/m2, 80 mg/m2, respectively. These findings were supported by pharmocokinetics of PT

Alterations in 18F-FDG accumulation into neck-related muscles after neck dissection for patients with oral cancers

Background: 18 F-fluoro-2-deoxy-D-glucose ( 18 F-FDG) accumulations are commonly seen in the neck-related muscles of the surgical and non-surgical sides after surgery with neck dissection (ND) for oral cancers, which leads to radiologists having difficulty in diagnosing the lesions. To examine the alterations in 18 F-FDG accumulation in neck-related muscles of patients after ND for oral cancer. Material and Methods: 18 F-FDG accumulations on positron emission tomography (PET)-computed tomography (CT) in neck-related muscles were retrospectively analyzed after surgical dissection of cervical lymph nodes in oral cancers. Results: According to the extent of ND of cervical lymph nodes, the rate of patients with 18 F-FDG-PET-positive areas increased in the trapezius, sternocleidomastoid, and posterior neck muscles of the surgical and/or non-surgical sides. In addition, SUVmax of 18 F-FDG-PET-positive areas in the trapezius and sternocleidomastoid muscles were increased according to the extent of the ND. Conclusions: In evaluating 18 F-FDG accumulations after ND for oral cancers, we should pay attention to the 18 F-FDG distributions in neck-related muscles including the non-surgical side as false-positive finding

The safety and usefulness of the single incision, transabdominal pre-peritoneal (TAPP) laparoscopic technique for inguinal hernia

Background : The safety and usefulness of the SILS-TAPP (transabdominal preperitoneal) procedure remain unclear. The aim of this study was to clarify the safety and usefulness of the SILS-TAPP procedure compared with standard laparoscopic TAPP and TEPP (totally extra-peritoneal pre-peritoneal) procedures. Patients and methods : 85 patients underwent laparoscopic inguinal hernia repairs (TEPP, 30 patients ; TAPP, 20 patients ; SILS-TAPP, 35 patients) from 2007 to 2011. The operative outcomes of the three groups were compared. Results : There was no difference in the patients’ characteristics among the three groups. The TEPP Group had a longer operation time. One patient in the SILS-TAPP group had an intraoperative complication. One patient in the TAPP group had a postoperative complication, and one patient had ileus and one had an umbilical hernia in the SILS-TAPP group. The postoperative hospital stay was not significantly different among the three groups. There were no recurrences in the TEPP group, 1 case of recurrence (5.0%) in the TAPP group, and 1 case (2.9%) in the SILS-TAPP group. Conclusions : The present findings show that the SILS-TAPP repair is safe and feasible for the repair of adult inguinal hernia