Experimental Study on Sleeve Anastomosis in Relation to Pulmonary Hemodynamics

The two different sleeve anastomosis procedures, which is composed of the right angle (S-group) and oblique anastomoses (O-group) against the tracheal axis were evaluated in relation to pulmonary oxygenation and circulation. In the S group, the deleterious results of pulmonary function such as a decrease in PaO2, an elevation of A-aDO2, a rise of pulmonary artery pressure and a reduction of cardiac output were obtained in addition to the results of an increased pulmonary extravascular water volume (PEWV) measurement and the structural exacerbation by histologic examination. In the operative procedure of oblique sleeve anastomosis is preferred over that of right angle one on the basis of a result regarding pulmonary circulation in this study. It, also, was certified that at least 7 mm orifice size in the anastomotic site is required for permitting a long term survival on dogs

Preparation of ZnO Films by Activated Reactive Evaporation Method

Zinc oxide films were prepared on silica glass substrates by the use of an r.f. activated reactive evaporation (ARE) method, and were examined by X-ray diffraction (XRD) and scanning electron micrograph (SEM). XRD measurements indicate that the films were c-axis oriented and that an r.f. plasma of Zn and O was necessary for the ZnO film deposition. Substrate temperature, oxygen gas pressure, evaporation rate, r.f. power and inlet position of oxygen gas effect the c-axis orientation, the growth rate and the microstructure of the films. Optimum conditions for a dense film with a fine texture of the surface and having good crystallinity were as follows: the substrate temperature;400℃, the evaporation rate;5.0(A)/s, the oxygen pressure;2.0x10(-4) Torr, the r.f. power;150 to 200W, and the oxygen gas inlet near the substrate. For the film prepared under the optimum conditions, the standard deviation　σ　of the rocking curve for the (002) diffraction was 1.9deg, smaller than that of the film prepared by using an r.f. sputtering method

Nickel-based phosphide superconductor with infinite-layer structure, BaNi2P2

Analogous to cuprate high-Tc superconductors, a NiP-based compound system has several crystals in which the Ni-P layers have different stacking structures. Herein, the properties of BaNi2P2 are reported. BaNi2P2 has an infinite-layer structure, and shows a superconducting transition at ~3 K. Moreover, it exhibits metallic conduction and Pauli paramagnetism in the temperature range of 4-300 K. Below 3 K, the resistivity sharply drops to zero, and the magnetic susceptibility becomes negative, while the volume fraction of the superconducting phase estimated from the diamagnetic susceptibility reaches ~100 vol.% at 1.9 K. These observations substantiate that BaNi2P2 is a bulk superconductor.Comment: 9 pages, 4 figures, Solid State Communications, in press. Received 4 March 2008. Accepted 2 May 2008. Available online 14 May 200

Severe Case of Peripheral Leukocytosis Initially Diagnosed as Myelodysplastic Syndrome/Myeloproliferative Neoplasm, Unclassifiable, but Possibly Prefibrotic Primary Myelofibrosis

Leukocytosis is occasionally seen in patients with presumptive but undiagnosed myeloproliferative disorders (MPD). A 74-year-old woman was admitted to our hospital for tarry stools, anemia, and marked peripheral leukocytosis of 1.4×105/μL. Gastroenteroscopy revealed an acute gastric and duodenal mucosal lesion that was treated successfully via endoscopic hemoclipping. Bone marrow aspiration revealed marked megakaryocyte proliferation with atypia of naked nuclei and marrow hypercellularity (90% cellularity). A fluorescence in situ hybridization test could not detect the BCR-ABL fusion gene. Bone marrow aspiration later revealed further abnormalities of megakaryocytes. The patient died from cerebral bleeding. The present case fulfilled 2 of the 3 major criteria of primary myelofibrosis according to the World Health Organization 2008 classification:namely, megakaryocytic hyperplasia with hypercellular marrow and granulocytic hyperplasia. However, the megakaryocytic abnormality was not strictly compatible with the criteria. Instead, we considered prefibrotic primary myelofibrosis as a possibility, although myelodysplastic syndrome/myeloproliferative neoplasm, unclassifiable (MDS/MPN-U) was technically the correct diagnosis. The present case shows that MPN diagnosis remains difficult and suggests that other cases of peripheral leukocytosis with diagnosed MDS/MPN-U might include similar findings

Conflict Estimation of Abstract Plans for Multi-Agent Systems

ABSTRACT In hierarchical planning, selecting a plan at an abstract level affects planning performance because an abstract plan restricts the scope of primitive plans. However, if all primitive plans under the selected abstract plan have difficult-to-resolve conflicts with the plans of other agents, the final plan after conflict resolution will be inefficient or of low quality. In this paper, we propose a conflict estimation method to generate quality plans efficiently for multi-agent systems by appropriately selecting abstract plans in hierarchical planning. This method enables agents to learn which abstract plans are less likely to cause conflicts or which conflicts will be easy to resolve

Purpose, use, and preparation of clinical practice guidelines for the management of biliary tract and ampullary carcinomas

Apart from periampullary carcinoma, the prognosis of biliary tract carcinomas, including hilar cholangiocarcinoma, extrahepatic biliary tract carcinoma, and gallbladder carcinoma, remains poor. Sophisticated diagnostic skills and treatment methods and their application are naturally required to achieve better treatment results for biliary tract carcinomas. However, it is not too much to say that, due to the paucity of high-level evidence for the management of these carcinomas, medical care by healthcare providers in clinics and at medical institutes throughout the world is currently delivered without common consensus and common standards. The clinical practice guidelines for the management of biliary carcinoma outlined here were produced with the aim that they could be used by physicians involved in the care of biliary tract carcinomas, as indicators that could help them provide their patients with the most appropriate care possible at this time. Also, the guidelines were prepared to provide measures that could assure patients with biliary tract carcinomas of safe medical care. The present guidelines are characterized by their clarification of clinical questions assumed to be often shared by healthcare professionals. For clarity, we divided the contents of the guidelines into eight areas. In each area, clinical questions are presented, together with recommendations of clinical actions in response to the question. As mentioned already, there is a paucity of high-level evidence in this area; therefore, the recommendations are classified into grades, of which there are five: A, strongly recommend performing the clinical action; B, recommend performing the clinical action; C1, the clinical action may be useful, although there is a lack of high-level scientific evidence; C2, clinical action not definitively recommended ecause of insufficient scientific evidence; D, recommend not performing the clinical action. The grading of the recommendations is based on the determination of the level of evidence in references on which the recommendation is based