Load distribution and forearm muscle activity during cylinder grip at various grip strength values.

This study aimed to investigate load distribution and forearm muscle activity from strong to weak grip strength, using a cylindrical device (Grip Sensor). We invited 15 students and measured the pressure distribution and forearm muscle activity during grip tasks at 25%, 50%, 75%, and 100% maximum voluntary force (MVF). Pressure data from the Grip Sensor were assigned to seven anatomical regions; the sum of the data from the seven regions (Total force) and proportionate load distribution for each grip task were calculated. Electromyography recorded activity in the extensor carpi radialis longus (ECRL), flexor carpi radialis (FCR), extensor carpi ulnaris (ECU) and flexor carpi ulnaris (FCU) muscles. Forearm muscle activity increased significantly with grip strength (p < 0.05). The load proportion corresponding to the thumb did not significantly change with increasing strength. On the other hand, the fingertip ratio significantly decreased, and the palm ratio significantly increased with increasing strength (p < 0.05). The Grip Sensor showed a shift in the load distribution in the hand from fingertips to palm as grip strength increased. This result indicates that more detailed evaluations of hand function may be possible.

Sequentially addressable dielectrophoretic array for high-throughput sorting of large-volume biological compartments.

Droplet microfluidics has become a powerful tool in precision medicine, green biotechnology, and cell therapy for single-cell analysis and selection by virtue of its ability to effectively confine cells. However, there remains a fundamental trade-off between droplet volume and sorting throughput, limiting the advantages of droplet microfluidics to small droplets (<10 pl) that are incompatible with long-term maintenance and growth of most cells. We present a sequentially addressable dielectrophoretic array (SADA) sorter to overcome this problem. The SADA sorter uses an on-chip array of electrodes activated and deactivated in a sequence synchronized to the speed and position of a passing target droplet to deliver an accumulated dielectrophoretic force and gently pull it in the direction of sorting in a high-speed flow. We use it to demonstrate large-droplet sorting with ~20-fold higher throughputs than conventional techniques and apply it to long-term single-cell analysis of Saccharomyces cerevisiae based on their growth rate.

Enhancement of denitrification in a down-flow hanging sponge reactor by effluent recirculation.

A down-flow hanging sponge reactor, constructed by connecting three identical units in series, was applied to the treatment of artificial wastewater containing phenol and ammonia under high salinity conditions (10.9 g-Cl(-)/L). The theoretical hydraulic retention time (HRT) of each unit was 4 h (total HRT = 12 h). To enhance denitrification by effluent recirculation, the effluent recirculation ratio was increased in increments ranging from 0.0 to 2.0. The concentration of total ammonia nitrogen (TAN), NO2-N, and NO3-N in the final effluent as a proportion of the TAN in the influent was determined to calculate the unrecovered, or denitrification, proportion. The denitrification proportion of the reactor was equivalent to 19.1 ± 14.1% with no effluent recirculation; however, this was increased to 58.6 ± 6.2% when the effluent recirculation ratio was increased to 1.5. Further increasing the effluent recirculation ratio to 2.0 resulted in a decrease in the denitrification proportion to 50.9 ± 9.3%. Activity assays of nitrification and denitrification, as well as 16S rRNA gene sequence analysis, revealed that denitrification occurred primarily in the upper sections of the reactor, while nitrification increased in the lower sections of the reactor. Gene sequence analysis revealed that denitrification by Azoarcus-like species using phenol as an electron donor was dominant.

Preoperative routine evaluation of bilateral adrenal glands by endoscopic ultrasound and fine-needle aspiration in patients with potentially resectable lung cancer.

BACKGROUND AND STUDY AIMS: The aim of the current study was to assess the detection rate of the right adrenal gland and the diagnostic ability of endoscopic ultrasound (EUS) and fine-needle aspiration (FNA) for the diagnosis of adrenal metastasis in potentially resectable lung cancer. PATIENTS AND METHODS: This retrospective cohort study included a consecutive series of 150 patients undergoing EUS/EUS - FNA for staging of lung cancer. The detection rate of the right adrenal gland by EUS and the diagnostic accuracies of computed tomography (CT), positron emission tomography-CT (PET-CT), and EUS/EUS - FNA for the diagnosis of adrenal metastasis were evaluated. RESULTS: The right adrenal gland was visualized by EUS in 131 patients (87.3 %); the left adrenal gland was visualized in all patients. Findings suggestive of metastasis in either one of the adrenal glands or in both were observed in 6 patients (4.0 %) by CT, in 5 patients (3.3 %) by PET-CT, and in 11 patients (7.3 %) by EUS. EUS - FNA was performed simultaneously in the 11 patients, and in 4 patients the diagnosis of metastasis was established. The accuracy for the diagnosis of adrenal metastasis was 100 % for EUS/EUS - FNA, 96.0 % for CT, and 97.0 % for PET-CT (P = 0.1146). CONCLUSIONS: As well as the left adrenal gland, the right adrenal gland was also usually visible by EUS. EUS/EUS - FNA provided an accurate diagnosis of adrenal metastasis, although the prevalence of adrenal metastasis was relatively low in these patients with potentially resectable lung cancer.

Boron toxicity in rice (Oryza sativa L.). I. Quantitative trait locus (QTL) analysis of tolerance to boron toxicity.

Boron toxicity tolerance of rice plants was studied. Modern japonica subspecies such as Koshihikari, Nipponbare, and Sasanishiki were tolerant, whereas indica subspecies such as Kasalath and IR36 were intolerant to excessive application of boron (B), even though their shoot B contents under B toxicity were not significantly different. Recombinant inbred lines (RILs) of japonica Nekken-1 and indica IR36 were used for quantitative trait locus (QTL) analysis to identify the gene responsible for B toxicity tolerance. A major QTL that could explain 45% of the phenotypic variation was detected in chromosome 4. The QTL was confirmed using a population derived from a recombinant inbred line which is heterogenic at the QTL region. The QTL was also confirmed in other chromosome segment substitution lines (CSSLs).

Combining UASB and the "fourth generation" down-flow hanging sponge reactor for municipal wastewater treatment.

A "fourth generation" down-flow hanging sponge (DHS) Reactor has been developed and proposed as an improved variant of post-treatment system for UASB treating domestic wastewater. This paper evaluates the potential of the proposed combination of UASB and DHS as a sewage treatment system, especially for developing countries. A pilot-scale UASB (1.15 m3) and DHS (0.38 m3; volume of sponge) was installed in a municipal sewage treatment site and constantly monitored for 2 years. UASB was operated at an HRT of 6 h corresponding to an organic load of 2.15 kg-COD/m3 per day. Subsequently, the organic load in DHS was 2.35 kg-COD/m3 per day, operated at an HRT of 2 h. Organic removal by the whole system was satisfactory, accomplishing 96% of unfiltered BOD removal and 91% of unfiltered COD removal. However, nitrification decreased from 56% during the startup period to 28% afterwards. Investigation on DHS sludge was made by quantifying it and evaluating oxygen uptake rates with various substrates. Average concentration of trapped biomass was 26 g-VSS/L of sponge volume, increasing the SRT of the system to 100-125 d. Removal of coliforms obtained was 3-4 log10 with the final count of 10(3) to 10(4) MPN/100 ml in DHS effluent.

Treatment of wastewater containing a large amount of suspended solids by a novel multi-staged UASB reactor.

Treatment of artificial wastewater containing a large amount of suspended solids comprised of soybean processing waste and pig fodder was studied using a novel multi-staged upflow anaerobic sludge blanket reactor. The reactor consisted of three compartments, each containing a gas solid separator. The wastewater had chemical oxygen demand of approximately 21600 mg l(-1), suspended solids of 12800 mg l(-1), and an ammonia concentration of 945 mg l(-1). A continuous experiment without effluent circulation showed that the multi-staged reactor was not that effective for the treatment of wastewater containing a large amount of suspended solids. However, operation of the reactor with circulation of effluent enabled the reactor to achieve organic removal of 85% and approximately 70% methane conversion at loading rates of between 4.0 to 5.4 kg-chemical oxygen demand per cubic meter per day, meaning that the reactor was more effective when effluent was circulated. Morphological investigation revealed that the crude fiber in the sludge was partially degraded and that it had many small depressions on its surface. Evolved biogas may have become caught in these depressions of the fibers and caused washout of the sludge.

A low-cost municipal sewage treatment system with a combination of UASB and the "fourth-generation" downflow hanging sponge reactors.

This paper presents an evaluation of the process performance of a pilot-scale "fourth generation" downflow hanging sponge (DHS) post-treatment system combined with a UASB pretreatment unit treating municipal wastewater. After the successful operation of the second- and third-generation DHS reactors, the fourth-generation DHS reactor was developed to overcome a few shortcomings of its predecessors. This reactor was designed to further enhance the treatment efficiency and simplify the construction process in real scale, especially for the application in developing countries. Configuration of the reactor was modified to enhance the dissolution of air into the wastewater and to avert the possible clogging of the reactor especially during sudden washout from the UASB reactor. The whole system was operated at a total hydraulic retention time (HRT) of 8 h (UASB: 6 h and DHS: 2 h) for a period of over 600 days. The combined system was able to remove 96% of unfiltered BOD with only 9 mg/L remaining in the final effluent. Likewise, F. coli were removed by 3.45 log with the final count of 10(3) to 10(4) MPN/100 ml. Nutrient removal by the system was also satisfactory.

Tetralogy of fallot with anomalous origin of the right pulmonary artery from the ascending aorta and hypoplastic left pulmonary artery.

A case of tetralogy of Fallot associated with anomalous origin of the right pulmonary artery from the ascending aorta and hypoplastic left pulmonary artery was successfully repaired. Following the simultaneous procedure with banding of the right pulmonary artery and replacement of modified Blalock-Taussig shunt to the left pulmonary artery at 34 days of age, the intracardiac repair was performed successfully at 1 year and 10 months of age. The patient was well 6 months postoperatively, without unilateral pulmonary hypertension.

Preliminary study of autologous blood predonation in pediatric open-heart surgery impact of advance infusion of recombinant human erythropoietin.

We applied an autologous blood predonation protocol using recombinant human erythropoietin in pediatric open-heart surgery. The study included 69 children weighing 8 kg or more. Twice before operation, 8 ml/kg of blood was taken. At each donation, 100 (group 1; n = 20), 200 (group 2; n = 11), or 300 (group 3; n = 13) units/kg of erythropoietin was given subcutaneously. In group 4 (n = 25), 300 units/kg of erythropoietin was given 1 week prior to the first donation, followed by 300 units/kg given at each donation. No harmful events occurred during the donation period. During the donation period, the patients' hematocrit decreased but the hematocrit 1 day after the operation remained at 32.1 +/- 0.6% and was 33.3 +/- 0.6% 2 weeks later. The decrease in hematocrit was minimal in group 4 (39.0 +/- 0.6% before donation to 37.5 +/- 0.5% before operation) compared with that of the other three groups. Among those who completed the protocol, 58 patients (93.5%) were discharged without homologous blood transfusion. We consider our protocol of autologous blood predonation using erythropoietin to be safe and effective for avoiding homologous blood transfusion in pediatric patients. The early infusion of erythropoietin prior to the first donation minimizes the decrease in hematocrit level before operation.

Extensive primary cardiac liposarcoma with multiple functional complications.

Cardiac liposarcoma in a patient manifested multiple cardiac functional complications. Three dimensional reconstruction of the heart with multidetector row computed tomography made apparent each of the cardiac complications that resulted from the tumour's invasion. On the basis of these findings, the floating mass in the pulmonary artery and the compressing mass around the superior vena cava and interatrial septum were successfully resected. Pathological examination of the mass was consistent with well differentiated liposarcoma.

Use of the short form of King's Health Questionnaire to measure quality of life in patients with an overactive bladder.

OBJECTIVE: To develop a short version of the King's Health Questionnaire (KHQ), as there is a practical need to have a shorter version to summarize the eight domain scores into fewer domains. PATIENTS AND METHODS: Data from 293 patients were obtained from a randomized, double-blind, placebo-controlled clinical trial in Japan of oxybutynin and tolterodine in patients with symptoms of an overactive bladder. The KHQ has two single-item and six multiple-item domains. To construct the short form of the KHQ one item was selected from the each of multiple-item domains, based on standardized structural coefficients estimated by confirmatory factor analysis (CFA) in a previous study. These six items include the domains: 'daily activities from role limitation', 'travel from physical limitation', 'social life from social limitation', 'family life from personal relationship', 'depressed from emotion' and 'tired from sleep and energy'. Based on the six selected items a series of psychometric analyses were conducted. RESULTS: Exploratory factor analysis (EFA) with promax rotation identified two factors 'limitation of daily life' (LDL) and mental health. LDL consisted of 'daily activities', 'travel' and 'social life', and mental health included 'family life', 'depressed' and 'tired'. Based on the results from the EFA, the second-order factor structure was tested by CFA. The model fitted the data well for both the male and female model. The KHQ short form showed excellent reliability with Cronbach's alpha coefficients for LDL and mental health for both genders. The domains in the short form were responsive to clinical efficacy variables, and had statistically significant sensitivity to change in the patients' perception of bladder condition in all domains. CONCLUSION: These analyses confirm the psychometric properties and clinical validity of the short-form KHQ, which appears to offer a practical, valid and reliable health-related quality-of-life instrument.

Concentrated platelets harvesting before cardiopulmonary bypass improved cardiac and pulmonary function.

BACKGROUND: Sequestration of concentrated platelets (P-con) during cardiopulmonary bypass (CPB) has been performed to preserve platelet function after cardiac surgery. Since P-con also harvests leukocytes simultaneously, there might be a possibility that the inflammatory effects or ischemia-reperfusion injuries associated with CPB, such as a cardiac or pulmonary dysfunction after cardiac surgery, are reduced with its use. METHODS: We retrospectively evaluated 53 patients who underwent cardiac surgery after the introduction of the P-con technique at our institute. There were 20 patients in the P-con group and 33 patients in the control group in whom concentrated platelet were not harvested. RESULTS: The patients characteristics and preoperative cardiac and pulmonary function did not differ between the two groups. The percentages of platelets and leukocytes sequestrated were 20.2+/-5.4% and 8.5+/-3.9% of the total estimated circulating cell counts, respectively. There were no significant differences in the postoperative dose of dopamine used, cardiac index, pulmonary capillary wedge pressure or intubation period between the two groups. However, the stroke volume index (p=0.005), left ventricular stroke work index (p=0.002), and ratio of the arterial oxygen tension to the inspired fraction of oxygen on extubation (p=0.02) were significantly greater in the P-con group as compared with those in the control. CONCLUSIONS: P-con improved cardiac and pulmonary function after CPB. Simultaneous sequestration of platelets and leukocytes by P-con during CPB may contribute to the improvement of cardiac and pulmonary function after cardiac surgery.

Removal of indigenous coliphages and fecal coliforms by a novel sewage treatment system consisting of UASB and DHS units.

A novel sewage treatment system, which consists of an upflow anaerobic sludge blanket (UASB) pre-treatment unit and the following downflow hanging sponge (DHS) unit for polishing up the UASB effluent, was developed as a cost-effective and easy-maintenance sewage treatment system for developing countries. A long-term experiment with actual sewage was conducted in order to evaluate its treatment efficiency of organic substances, nutrients, and pathogen indicator microorganisms such as total coliphages, F+-specific RNA coliphages (RNA coliphages), and fecal coliforms. The main objective of this paper is to investigate the removal efficiency of those indicator microorganisms by the UASB-DHS combined system. The results obtained from the continuous flow experiment indicated a fairly promising removal of the indicator microorganisms, i.e., the log10 reductions of total coliphages, RNA coliphages, and fecal coliforms (based on sewage and DHS effluent) achieved were 2.01 log, 2.02 log, and 2.57 log, respectively. The UASB-DHS combined system was superior to the conventional activated sludge process in the reduction of fecal coliforms, but in the reductions of total and RNA coliphages, the system showed somewhat less removal efficiency. The vertical reducing patterns of the indicator microorganisms along the DHS reactor were also discussed.

Guidelines for catheter intervention in coronary artery lesion in Kawasaki disease.

The Research Committee of Ministry of Health, Labour and Welfare 'Study of treatment and long-term management in Kawasaki disease' reported the guidelines for catheter intervention in coronary artery lesion in Kawasaki disease in this paper. The contents include: (i) background and natural history of coronary artery lesion in Kawasaki disease; (ii) indication of catheter intervention; (iii) types of procedure, and their indication and care; (iv) institute and backup system; (v) the management after procedure, evaluation and follow up; and (vi) prospects, especially in relation to bypass surgery.

Amygdala kindling develops without mossy fiber sprouting and hippocampal neuronal degeneration in rats.

Repeated electrical stimulation of limbic structures has been reported to produce the kindling effect together with morphological changes in the hippocampus such as mossy fiber sprouting and/or neuronal loss. However, to argue against a causal role of these neuropathological changes in the development of kindling-associated seizures, we examined mossy fiber sprouting in amygdala (AM)-kindled rats using Timm histochemical staining, and evaluated the hippocampal neuronal degeneration in AM-kindled rats by terminal deoxynucleotidyl transferase-mediated digoxigenin-11-dUTP nick end labelling (TUNEL). Amygdala kindling was established by 10.3 +/- 0.7 electrical stimulations, and no increase in Timm granules (neuronal sprouting) was observed up to the time of acquisition of a fully kindled state. However, the density and distribution of Timm granules increased significantly in the dentate gyrus compared with unkindled rats after 29 after-discharges or more than 10 kindled convulsions. In addition, no significant increase in TUNEL-positive cells was found in the hilar polymorphic neurons or in CA3 pyramidal neurons of the kindled rats that had fewer than 29 after-discharges. However, a significant increase of TUNEL-positive cells was found in the granule cell layer in the dentate gyrus of the stimulated side after 18 after-discharges or 10 kindled convulsions. Our result show that AM kindling develops without evidence of mossy fiber sprouting, and that mossy fiber sprouting may appear after repeated kindled convulsions, following death of the granule cells in the dentate gyrus.

Decreased risk of catheter infection in infants and children using subcutaneous tunneling for continuous caudal anesthesia.

Continuous caudal anesthesia has been commonly used for intra- and post-operative analgesia in infants and children. However, it has a potential risk of bacterial infection, especially in infants in whom the catheter site is easily contaminated with loose stool. To avoid infection, the authors applied a new procedure using subcutaneous tunneling for continuous caudal anesthesia. In the 18 cases studied with subcutaneous tunneling, clinical signs of infection were absent and bacterial colonization was not found on the catheter tip after 3.9 +/- 1.4 days of catheterization. The incidence of catheter colonization after continuous caudal anesthesia without tunneling had been reported. In their reports, the incidence of catheter colonization ranged from 20% to 37%. Therefore, caudal catheterization with subcutaneous tunneling is a simple and safe method, and has proved very effective to reduce the risk of epidural infection.

Maximum stenosis of extracranial internal carotid artery: effect of luminal morphology on stenosis measurement by using CT angiography and conventional DSA.

PURPOSE: To assess the luminal morphology of the extracranial internal carotid artery at three-dimensional (3D) computed tomographic (CT) angiography and how this factor affects measurement of maximum carotid arterial stenoses at conventional intraarterial digital subtraction angiography (DSA). MATERIALS AND METHODS: Prospectively, conventional intraarterial DSA and 3D CT angiography were performed in 42 carotid arteries in 21 patients with suspected carotid artery disease. The longest axis length-perpendicular axis length (L/P) ratios of the arterial lumen on the cross-sectional images at the most stenotic area and distal nonstenotic area were analyzed by acquiring multiplanar reconstruction (MPR) images at 3D CT angiography. The maximum stenosis was measured at each modality with North American Symptomatic Carotid Endarterectomy Trial criteria. RESULTS: The L/P ratios in the most stenotic areas ranged from 1.0 to 3.2 (mean, 1.5 +/- 0.5 [SD]). The mean difference in maximum percentage of stenosis between the two modalities for L/P ratios of 2.0 or greater was significantly greater than that for L/P ratios of less than 1.5 (P < .05). Three carotid arteries with 70%-99% stenosis, with grades determined only with 3D CT angiography, had L/P ratios of 2.0 or greater. CONCLUSION: On MPR images at 3D CT angiography, the lumen of extracranial internal carotid artery stenosis showed a wide range of shapes. When a carotid artery has a high L/P ratio, the luminal morphology of the carotid artery stenosis may affect the assessment of maximum stenosis of the internal carotid artery at conventional DSA.