Physical and chemical aspects at the interface and in the bulk of CuInSe2-based thin-film photovoltaics.

Chalcopyrite CuInSe2 (CISe)-based thin-film photovoltaic solar cells have been attracting attention since the 1970s. The technologies of CISe-based thin-film growth and device fabrication processes have already been put into practical applications and today commercial products are available. Nevertheless, there are numerous poorly understood areas in the physical and chemical aspects of the underlying materials science and interfacial and bulk defect physics in CISe-based thin-films and devices for further developments. In this paper, current issues in physical and chemical studies of CISe-based materials and devices are reviewed. Correlations between Cu-deficient phases and the effects of alkali-metals, applications to lightweight and flexible solar minimodules, single-crystalline epitaxial Cu(In,Ga)Se2 films and devices, differences between Cu(In,Ga)Se2 and Ag(In,Ga)Se2 materials, wide-gap CuGaSe2 films and devices, all-dry processed CISe-based solar cells with high photovoltaic efficiencies, and also fundamental studies on open circuit voltage loss analysis and the energy band structure at the interface are among the main areas of discussion in this review.

Cerebrospinal fluid leak presented with the C1-C2 sign caused by spinal canal stenosis: a case report.

BACKGROUND: Intracranial hypotension is a disorder characterized by low cerebrospinal fluid (CSF) pressure typically caused by loss of CSF. Although some mechanisms account for the CSF leakage have been elucidated, spinal canal stenosis has never been reported as a pathological cause of intracranial hypotension. C1-C2 sign is a characteristic imaging feature, which indicates CSF collection between the spinous processes of C1 and C2, occasionally observed on magnetic resonance imaging (MRI) in patients with intracranial hypotension. CASE PRESENTATION: A 58-year-old man was presented to our institute with complaints of posterior cervical pain persisting for 3 months, along with numbness and muscle weakness of extremities. A fat suppression T2-weighted image of MRI illustrated fluid collection in the retrospinal region at C1-C2 level, and an 111In-DTPA cisternoscintigram clearly revealed the presence of CSF leakage into the same region. The MRI also showed stenosis in spinal canal at C3/4 level, and a computed tomography (CT) myelogram suggested a blockage at the same level. We gave a diagnosis as intracranial hypotension due to the CSF leakage, which might be caused by the spinal canal stenosis at C3/4 level. Despite 72 h of conservative therapy, a brain CT showed the development of bilateral subdural hematomas. We, therefore, performed burr-hole drainage of the subdural hematoma, blood-patch therapy at C1/2 level, and laminoplasty at C3-4 at the same time. Improvement of symptoms and imaging features which suggested the CSF leak and subdural hematoma were obtained post-operatively. CONCLUSION: The present case suggested the mechanism where the CSF leakage was revealed as fluid collection in the retrospinal region at C1-C2 level. Increased intradural pressure due to the spinal canal stenosis resulted in dural tear. CSF leaked into the epidural space and subsequently to the retrospinal region at C1-C2 level, due to the presence of spinal canal stenosis caudally as well as the vulnerability of the tissue structure in the retrospinal region at C1-C2 level. Thus, our theory supports the mechanisms of previously reported CSF dynamics associated to C1-C2 sign, and also, we suggest spinal canal stenosis as a novel etiology of intracranial hypotension.

Case report of two pregnancies and deliveries by a woman with Buerger disease.

Buerger disease is a chronic inflammatory disease that involves blood clot formation in the medium and small arteries, resulting in thrombophlebitis. It is usually observed in middle-aged men who smoke and is very rare in young women. Previous reports have indicated that Buerger disease worsens during pregnancy due to hypercoagulability associated with pregnancy, and newborns' birth weights were often lower than normal. This report describes a young woman with Buerger disease who experienced two pregnancies and deliveries. During the 1st pregnancy, d-dimer and soluble fibrin levels slightly increased, but no treatment was needed. However, during the 2nd pregnancy, d-dimer and soluble fibrin levels abruptly increased at 20 weeks of pregnancy, and heparin was administered subcutaneously. Four days after heparin administration, d-dimer and soluble fibrin levels decreased to normal pregnancy levels. d-dimer and soluble fibrin measurements were useful for evaluating the coagulation tendencies of this pregnant woman with Buerger disease.

Muscle-selective disinhibition of corticomotor representations using a motor imagery-based brain-computer interface.

Bridging between brain activity and machine control, brain-computer interface (BCI) can be employed to activate distributed neural circuits implicated in a specific aspect of motor control. Using a motor imagery-based BCI paradigm, we previously found a disinhibition within the primary motor cortex contralateral to the imagined movement, as evidenced by event-related desynchronization (ERD) of oscillatory cortical activity. Yet it is unclear whether this BCI approach does selectively facilitate corticomotor representations targeted by the imagery. To address this question, we used brain state-dependent transcranial magnetic stimulation while participants performed kinesthetic motor imagery of wrist movements with their right hand and received online visual feedback of the ERD. Single and paired-pulse magnetic stimulation were given to the left primary motor cortex at a low or high level of ERD to assess intracortical excitability. While intracortical facilitation showed no modulation by ERD, short-latency intracortical inhibition was reduced the higher the ERD. Intracortical disinhibition was only found in the agonist muscle targeted by motor imagery at high ERD level, but not in the antagonist muscle. Single pulse motor-evoked potential was also increased the higher the ERD. However, at high ERD level, this facilitatory effect on overall corticospinal excitability was not selective to the agonist muscle. Analogous results were found in two independent experiments, in which participants either performed kinesthetic motor imagery of wrist extension or flexion. Our results showed that motor imagery-based BCI can selectively disinhibit the corticomotor output to the agonist muscle, enabling effector-specific training in patients with motor paralysis.

Effectiveness of Corticosteroid Monotherapy for Dyspnea Relief in Patients with Terminal Cancer.

Dyspnea is a common symptom in patients with cancer, particularly those with late-stage terminal disease. It markedly affects terminal cancer patients, reducing their quality of life. Reduced quality of life also affects survival; therefore, dyspnea is a prognostic factor. However, the role of corticosteroids, which often are used to alleviate dyspnea, has not been sufficiently validated. In this study, we retrospectively investigated whether corticosteroid monotherapy was effective for dyspnea palliation. The effectiveness rate of corticosteroid therapy was 45% in nine male and two female study subjects (mean age: 74.5 years; range: 64-86 years). No significant differences were found between responders and nonresponders in the first-day corticosteroid doses (25.5 ± 10.86 vs. 36.1 ± 16.39 mg, P = .29) or doses administered on 2 days (47.7 ± 25.99 vs. 72.2 ± 32.78 mg, P = .25). The mean ± standard error assessment score changed significantly from 2.7 ± 0.14 at the beginning of corticosteroid administration to 1.5 ± 0.37 at the time of maximum effect (P = .028); however, the decrease to 2.1 ± 0.25 at the final administration was not significant (P = .068). This indicates that corticosteroid therapy relieved dyspnea and could provide an early-stage treatment option.

Range of Effective Corticosteroid Doses for Alleviating Dyspnea in Terminal Cancer Patients: A Retrospective Review.

This study aimed to determine the range of mean cumulative corticosteroid doses that could effectively palliate dyspnea in opioid-treated patients with terminal cancer and to investigate the demographic or biochemical factors predictive of corticosteroid responsiveness. To this end, responders and nonresponders were compared with regard to corticosteroid dose and whether they had initiated opioid use before or concomitantly with corticosteroid use. A logistic regression analysis was conducted to assess the impacts of demographic and biochemical factors on corticosteroid effectiveness. The final sample comprised 20 patients who satisfied the selection criteria. The responders accounted for 70% of the total sample (n = 14) and experienced the strongest effect with regard to dyspnea palliation at a mean cumulative dose equivalent to 64.4 mg prednisolone. However, no factors predictive of response were identified. In summary, this retrospective study identified effective corticosteroid doses for dyspnea alleviation in terminal cancer patients. Although our study sample was limited in size, the results support further prospective research.

Combined Effect of Opioids and Corticosteroids for Alleviating Dyspnea in Terminal Cancer Patients: A Retrospective Review.

Dyspnea is a prognostic factor that affects the quality of life of terminal cancer patients, and many reports have described opioid treatment for dyspnea alleviation. Here, we retrospectively evaluated differences in the effects of various opioids administered concomitantly with corticosteroids on dyspnea in 20 terminal-stage cancer patients (13 men, 7 women; mean age [range]: 71 [49-94] years) who received opioids concomitantly with corticosteroids. Effectiveness was assessed throughout administration using the Support Team Assessment Schedule, Japanese version (STAS-J), particularly the subscale indicating how strongly a patient is affected by symptoms. The effectiveness of combined opioid and corticosteroid therapy against dyspnea and the opioid dose comprised the primary and secondary foci, respectively. Among concomitantly treated patients, STAS-J scores at initiation (mean ± SD: 3.1 ± 0.24) and lowest recorded STAS-J scores (1.4 ± 0.22) differed significantly (P = .0034) among those receiving morphine, but not among those receiving oxycodone (P = .068) or fentanyl (P = .18). Concomitant opioid and corticosteroid treatment was associated with a ≥2-point STAS-J score improvement in 14/20 patients (effectiveness: 70%). The opioid dose did not significantly affect dyspnea alleviation. We conclude that concomitant opioid and corticosteroid treatment can effectively alleviate dyspnea in terminal cancer patients.

[Prevention of spinal hypotension associated with cesarean section by aortocaval compression--left 15 degree table tilt vs. uterine displacement by hand].

Women undergoing elective cesarean delivery were randomly assigned to receive a spinal anesthesia in either the semi-lateral (group SL) position or the supine position with uterine displacement (group UD). After spinal injection, group SL patients were turned to a 15 degrees left lateral supine position, and group UD patients had uterine displacement by hand. Ephedrine 4 mg i.v. was administered in case of nausea/vomiting and/or hypotension, defined as a systolic blood pressure below 100 mmHg. Arm systolic arterial pressure and leg systolic arterial pressure were similar in both groups, but the lowest leg systolic arterial pressure until delivery was significantly lower in the UD group (P < 0.05). Mean ephedrine requirement was significantly less in the SL group (P < 0.05). Apgar scores did not differ, but umbilical artery pH values were significantly higher in patients of the group SL (P < 0.01).

[Investigating the incidence of injection-site reactions associated with administration of oxaliplatin into a peripheral vein and management local adverse reactions].

In Aichi Cancer Center Hospital, we investigated the incidence of injection-site reactions associated with the administration of Oxaliplatin into a peripheral vein. We evaluated the frequency and severity of symptoms, and studied ways to manage its adverse reactions from September 2009 through March 2010. Oxaliplatin was injected into a peripheral vein in more than 90% of patients, suggesting that there would be a high risk of injection-site reactions. About 60% of patients had a numeric rating score of 5 or higher in this study, and more than 60% of injection-site reactions were improved by warming the injection site. Our results suggest that warming the injection site is one effective way to manage local adverse reactions when Oxaliplatin is administered into a peripheral vein.

[Incidence of infusion reactions induced by cetuximab chemotherapy].

We retrospectively investigated the incidence of infusion reactions following cetuximab chemotherapy in 93 patients with colorectal cancer. Patients received chemotherapy treatment from September 2008 to February 2010 at Aichi Cancer Center Hospital. The initial cetuximab dose was 400 mg/m(2), followed weekly by an additional 250 mg/m(2), and biweekly by 500 mg/m(2). Infusion reactions were observed in 12 patients (13%), with grade 1 reactions in 6 patients and grade 2 reactions in 6 patients. Eleven of the 12 patients (92%) experienced infusion reactions during the first treatment. Typical grade 1 adverse events were fever and chills, nausea, vomiting and pruritus. Non-steroidal anti-inflammatory drugs were given for fever and chills. Grade 2 adverse events included dyspnea and wheezing, eruption, facial flushing and convulsions. Steroids were given for these symptoms. Infusion reactions were observed in 3 of the 12 patients (25%) <15 min after intravenous injection, 16-60 min after injection in 3 more patients (25%), and 61-120 min after injection in the remaining 6 patients (50%).

Photocatalytic reduction of nitrobenzenes to aminobenzenes in aqueous suspensions of titanium(IV) oxide in the presence of hole scavengers under deaerated and aerated conditions.

Photocatalytic reduction of nitrobenzenes to corresponding aminobenzenes in aqueous suspensions of titanium(IV) oxide (TiO(2)) containing hole scavengers under various conditions was examined. In photocatalytic reduction of m-nitrobenzenesulfonic acid (m-NBS) in the presence of formic acid (FA) under deaerated conditions, m-aminobenzenesulfonic acid (m-ABS) was produced almost quantitatively in acidic suspensions and high efficiency (>99%) in FA utilization as a hole scavenger was achieved. No re-oxidation of m-ABS occurred in acidic conditions both in the presence and absence of FA. The high yield of m-ABS was explained by strong ability of FA as a hole scavenger and possible repulsion of the reduced functional group (ammonium group, -NH(3)(+)) from the protonated, i.e., positively charged TiO(2) surface in acidic suspensions avoiding re-oxidation of m-ABS. Using TiO(2) samples of various physical properties, which had been synthesized by a solvothermal method and post-calcination at various temperatures, effects of physical properties of the TiO(2) samples on m-ABS yield were also investigated. A linear correlation between the amount of m-NBS adsorbed and the m-ABS yield was observed, suggesting that ability of TiO(2) for m-NBS adsorption is one of the key factors for effective photocatalytic reduction of m-NBS to m-ABS. This photocatalytic system can be applied for reduction of aminonitrobenzenes to corresponding diaminobenzenes (DAB) in the presence of oxalic acid as a hole scavenger. High yields of m-ABS and DAB were achieved even when the reactions were performed in the presence of oxygen.

[Anesthetic management for electroconvulsive therapy using rocuronium bromide and sugammadex sodium in a patient with suspected malignant syndrome].

A 62-year-old woman was treated for schizophrenia for 40 years. When the symptoms had deteriorated and new medications had to be added, CPK rose and she malignant syndrome was suspected. The electroconvulsive therapy (ECT) was proposed because of no improvement of the symptoms. We employed rocuronium bromide instead of suxamethonium considering malignant syndrome. The maintenance of anesthesia was necessary, because the duration of rocuronium bromide is longer than that of suxamethonium chloride. Anesthesia was induced and maintained using target controlled infusion (TCI) of propofol. After ECT was performed, sugammadex sodium 4 mg . kg-1 was administered at 2 post-tetanic counts (PTC) and the patient could come out the operating room safely and speedy. ECT using rocuronium bromide and sugammadex sodium can be performed safely and speedily, when suxamethonium chloride cannot be used.

Simultaneous laparoscopic treatment for rectosigmoid and ileal endometriosis.

Endometriosis is common in women of childbearing age, while severe intestinal endometriosis requiring bowel resection is relatively rare. Intestinal endometriosis has recently been managed laparoscopically. We report the case of a 38-year-old patient with rectosigmoid and ileal endometriosis who was successfully treated by laparoscopic bowel resections. The patient had first presented at age 34 years with a chief complaint of rectal bleeding and lower abdominal pain related to the menstrual cycle. She underwent laparoscopic surgery and was diagnosed with severe endometriosis involving the rectosigmoid colon. Although an additional laparoscopic surgery had been planned, she did not return to the hospital. When she was 38 years old, she presented again with the same symptoms. Magnetic resonance imaging revealed a low intensity mass between the uterus and the rectosigmoid colon. A barium enema showed a stenotic site in the rectosigmoid colon. After hormone therapy, she underwent laparoscopic surgery. The anterior wall of the rectosigmoid colon adhered firmly to the corpus of the uterus, and another stenotic site was identified at the terminal ileum. The rectosigmoid colon and ileum were partially resected under laparoscopy. The postoperative course was uneventful and she was freed of symptoms. Laparoscopic treatment for patients with severe endometriosis of the bowel has becomes feasible and safe.

[Medulla and upper cervical cord compression by bilateral vertebral artery presented with myelopathy and drop attack: case report].

A 51-year-old man had suffered from attacks of quadri-paresis and unconsciousness for previous three years prior to presentation. Prior to admission, he had been received anticonvulsants, but his symptoms showed no improvement. Neurological examination revealed hyper-reflexia of his left lower extremity and moderate decrease of sense of pain, temperature, and tactile sensation in his left extremities and trunk, while vibratory sensation was normal. Magnetic resonance(MR) imaging revealed a flow-void area in the craniocervical junction and marked narrowing of the medulla oblongata and upper cervical cord by compression of the vertebral arteries(VA). CT myelography also showed the compression and narrowing of the spinal cord. Vertebral angiography demonstrated symmetrical running course of the arteries, which curved medially at the level of craniocervical junction. Suboccipital craniectomy and C1 and upper half of C2 laminectomies were performed. After dural opening, the ventrolateral aspects of the lower medulla oblongata and the upper cervical cord were found to be compressed by the VA. The arteries were retracted dorsolaterally by GORE-TEX tapes so as to decompress the medulla oblongata and cervical cord, and the tapes were anchored to the residual part of C1 posterior arch. Postoperative MR imaging and CT myelography showed complete decompression, and the patient was relieved of his previous neurological symptoms.