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A case of salvage supracricoid laryngectomy with cricohyoidoepiglottopexy after failed radiation therapy and vertical partial laryngectomy had successful oncological and functional outcomes. This is the first reported application of salvage supracricoid laryngectomy with cricohyoidoepiglottopexy after the failure of two major treatments.
A 65-year-old man was referred for salvage supracricoid laryngectomy with cricohyoidoepiglottopexy. The right recurrent hemilarynx was successfully resected. After pexis, the right lobe of the thyroid gland was repositioned to overlap and reinforce the pexis gap and fill the devoid portion of the strap muscular closure. Multiple scattered foci (recurrent tumour–node–metastasis stage T2) were identified around the arytenoid cartilage and beneath the musculocutaneous flap. Four years after supracricoid laryngectomy with cricohyoidoepiglottopexy, the patient's recovery was following a favourable course and he had satisfactory laryngeal function.
Appropriate case selection and proficient surgical skills were essential for a successful outcome. Head and neck surgeons should not be afraid to adopt functional preservation open surgical procedures in well-selected and well-motivated patients. A requirement for more challenging surgical procedures and meticulous rehabilitation processes should not exclude appropriate treatments from a surgeon's repertoire.
This study used Langmuir-Schaefer (LS) method to produce thermo-responsive poly(N-isopropylacrylamide) (PIPAAm) modified surface. Block copolymer composed of polystyrene (PSt) and PIPAAm was synthesized by RAFT polymerization. PSt-block-PIPAAm (St-IP) with various chemical compositions was dropped on an air-water interface and formed Langmuir film by compression. Then, the Langmuir film changing a density was transferred on a hydrophobic modified glass substrate to produce St-IP transferred surface (St-IP LS surface). From the observation of atomic force microscope images, a nanostructure was observed on the transference of Langmuir films. Cell adhesion and detachment were also evaluated on the LS surfaces in response to temperature. Cell adhesion on LS surfaces at 37 °C was controlled by changing the chemical compositions and densities. After reducing temperature to 20 °C, adhering cells rapidly detached themselves with lower Am and higher composition of PIPAAm. Our method should be proved novel insights for investigating cell adhesion and detachment on thermo-responsive surfaces.
An ultra-small tactile sensor with functions of signal processing and digital communication has been prototyped based on MEMS-CMOS integration technology. The designed analog-digital mixed signal ASIC allows many tactile sensors to connect each other on a common bus line, which drastically reduces the number of wire. The ASIC capacitively detects the deformation of a force sensor and sends digital data to the common bus line when the force exceeds a threshold. The digital data contain a physical ID of each sensor, 32-bit sensing data and 16-bit cyclic redundancy check (CRC) code. In this study, a novel wafer-level integration and packaging technology were developed, and a chip-size-packaged tactile sensor with a small footprint (2.5mm×2.5mm) and a low profile (0.27mm) was prototyped and tested. The sensor autonomously sends digital data like a tactile receptor of human.
We investigated structural and magnetic properties of Fe/Zr Multilayer films using high-resolution transmission electron Microscopy, X-ray diffraction and vibrating sample Magnetometry. For films with wavelength (Λ) ≥ 80Å, the interface region between the Fe and Zr layers exhibits a 15–20Å thick amorphous structure. The Magnetization curves of these films showed a monotonous decrease in the saturation magnetizations with Λ, whose trend is well explained by a simple asymptotic model that assumes the interface amorphous layer to be non-ferromagnetic. Films with Λ≤40Å exhibit a compositionally-Modulated amorphous structure. The latter films are paramagnetic except for the one with Λ=40Å, which showed a superparamagnetic behavior.
Supracricoid laryngectomy with cricohyoidoepiglottopexy is an organ-preserving procedure used to treat laryngeal cancer. However, the post-operative neoglottis tends to be variable in form and difficult to predict.
We retrospectively analysed three-dimensional images reconstructed from multidetector-row computed tomography data for 21 patients, assessing arytenoid motion and minimum neoglottic gap cross-sectional area.
While mean transverse and coronal motion was similar for bilateral and unilateral arytenoids, movement along the sagittal axis was greater for unilateral than bilateral arytenoids. The neoglottic gap during respiration was wider in patients with bilateral arytenoids, but both groups had a similar neoglottic gap during phonation.
Anterior shifting of the unilateral arytenoid plays an important role in compensating for the inability to achieve neoglottic closure. These two results demonstrate that the unilateral arytenoid alone is capable of achieving sufficient neoglottic narrowing to compensate for the resected arytenoid. Three-dimensional analysis was useful to evaluate the physiological status of the neoglottis after supracricoid laryngectomy with cricohyoidoepiglottopexy.
Supracricoid partial laryngectomy is a reliable laryngeal preservation procedure for tumour stage 2 and selected stage 3 to 4 laryngeal cancers. Of 70 patients thus treated, two (3 per cent) had ‘flaccid neoglottis’, i.e. redundant mucosa at the inner arytenoid edge which intermittently obstructed the neoglottis. We discuss the mechanism and management of this complication.
The two cases are presented. A navigation system was used to assist surgery. Neoglottal spatial alteration (specifically cross-sectional area) was assessed pre- and post-operatively using three-dimensional computed tomography. Voice was also evaluated.
Inspiratory stridor and delayed stomal closure were the main symptoms. Minimum neoglottal cross-sectional area was smaller in case one than in non-affected patients. Both patients had relatively rougher and breathier voices, but had adapted well to this.
Flaccid neoglottis is mainly due to excessive anterior retraction of residual laryngeal mucosa and to excessive mucosal pliability with age. A navigation system was useful for confirmation, but the potential for incorrect image recognition should be kept in mind. Flaccid neoglottis was treatable, with improved laryngeal function.
After the Great Hanshin-Awaji Earthquake, the disaster countermeasures concerning medical care in Japan changed drastically. In 2005, the Japanese government began to develop a domestic, rapid, medical response system called Disaster Medical Assistance Team (DMAT) for the purpose of rapid medical correspondence in the acute phase. As of 12 July 2010, 393 institutions and 734 teams (3,700 persons) were trained. A DMAT is important not only to the response to large disasters such as earthquakes, but also the response to local disasters. It is important to establish the DMAT system of each prefecture and district.
The DMAT system at the local level was described at the 15th World Congress on Disaster and Emergency Medicine. During the present Congress, the development and activities of the DMAT system over the past three years will be reported.
Results and Conclusion
Eight local districts in the DMAT system have been developed, and progress has been made in the fields of policy, operative plans, and agreement among each province. The system of inter-prefecture mutual aid must be built upon in the near future.
Two types of shape and contrast features of superconducting vortices in a Lorentz micrograph were obtained by the newly developed 1-MV field-emission transmission electron microscope on a Bi2Sr2CaCu2O8+8(Bi-2212) thin specimen containing tilted columnar defects. The shape and contrast features could be consistently interpreted by the simulation that some vortices were pinned along tilted columnar defects and others were unpinned. The interesting property for temperature change of vortex core inside the material was also observed.
A single crystalline Bi2Sr2CaCu2O8+8 which has columnar defects in its inside are observed by Lorentz microscopy using the newly developed 1-MV field emission electron microscope at the first time. The superconducting vortices are observed with higher contrast than ever. Simultaneous observation of vortices and columnar defect is succeeded in real time.
The austenitic stainless steels so-called, the EHP steels with the extra high purity, are developed for improving the reliability of nuclear equipments materials used in the heavily corrosive irradiation environments. By considering the impurities segregation mechanism, the major impurities included in the EHP steels is controlled less than 100ppm by the new melting technology. It is two-step refining process composed of CCIM and EB for effectively removing both non-volatile and volatile harmful elements. The risk to cracking on melting and welding processes is also effectively minimized by enhancing both the eutectic point and the metallic bonding at grain-boundaries. In the EHP steels, it is possible to select the appropriate composition of Ni and Cr for stabilizing austenitic phase and enhancing corrosion resistance. The characteristics of the welding joints are as good as those of the base metal because the same filler metal is sed without the formation of residual delta ferrite. The resistance to IGC and SCC of the EHP steels is markedly improved by minimizing the refining effects, except for type 316 steels with Mo. The welding technique and the chemical composition range are selected for standardizing the EHP.
The effect of carbon incorporation into a-Si:H has been investigated in terms of gap states. The shallow and deep states are measured by a combination of two methods of the time-of-flight and the depletion discharge transient spectroscopy. The results show that the carbon incorporation of 10Z into a-Si:H leads to a slight increase in the conduction-band tail states and an extention of the deep states distribution. However, the increase in the shallow states affects little change in the electron transport properties. The origin of the deep states is also discussed.
New multilayered photoreceptor consisting of all layers of a-Si1−xCx:H (x=0.1−0.8) has been developed on the basis of a high rate deposition process established using a glow discharge in a mixture of SiH4 and C2H2. This SiC photoreceptor is for negative charging and shows the excellent spectral sensitivity that is high in a short wavelength region and is reduced at the wavelengths longer than 600nm, suitable for the plain paper copier. The charge acceptance more than 40V/μn is achieved for the thickness less than 20μm. The charging characteristics are discussed in terms of deep emission states in the a-SiC:H.
Electrical properties of heavily Be-doped GaAs grown by molecular beam epitaxy were investigated systematically in a wide range of Be-concentration from 1× 1014 up to 2× 1020 cm-3 by using yan der Pauw technique. Probable carrier scattering mechanisms observed in this work are discussed by taking into account the radiative mechanisms of several new photoluminescence emissions previously observed in the band-edge-emission region of the samples. All samples were checked their electrical properties first at room-temperature. Five selected samples out of them were measured from 10° K up to room-temperature. Samples having the carrier concentration from 1014 to 1018 cm3 presented typical semiconductor-like conduction with finite carrier excitation energy. For samples having carrier concentration 7× 1016 cm -3, the conduction mechanism at high temperature region above 30β K was dominated by holes thermally excited into valence band. At low temperature region below 30° K . it was dominated by holes hopping from neutral to ionized acceptors with the assistance of phonons. Hole mobilities of samples having the carrier concentration from 1017 to 1018 cm-3 showed an anomalous behavior in the low temperature region, which suggests the presence of a new type of carrier scattering mechanism. A radiative center denoted by lg-gl observed in this concentration region will be a candidate scattering center to explain these electrical behaviors. Samples having the carrier concentration larger than 1019 cm-3 demonstrated typically metallic electric conduction not owing to thermally excited carriers, which means that an impurity band is formed but merged with valence band. The density of state of this combined valence band mixed with impurity band can be supposed to reflect carrier concentration dependence of the PL emission bands observed in this region, i.e. [g-g]α , [g-g]β and [g-g]γ .
A new A4-size contact-type image sensor with 8 elements per millimeter (1,728 elements) was developed by using amorphous silicon alloy pin photodiodes as the light receiving elements. The matrix switching method is employed for signal reading. This method can read the signals from all of the 1,728 photodiodes using a 54 (54-channel input) x 32 (32.channel output) matrix switching scheme. It is advantageous in that the required input and output external circuits can be simplified. To prevent signal crosstalk between the diodes in the matrix, amorphous silicon alloy pin diodes, which are made in the same process as the photodiodes for maintaining a low cost, are connected in series to each photodiode in reverse polarity as blocking diodes.
To achieve superior signal-to-noise ratio and response at the same time, amorphous silicon alloy pin diodes are optimized to satisfy both a high photo-to-dark ratio and a high rectification ratio. The image sensor can operate at up to 2 MHz signal reading clock, maintaining a signal-to-noise ratio of over 24 dB under 0. 1–1x sec exposure.
Magnetocaloric effect of nanocomposites composed of iron-oxide or iron-nitride grains dispersed in a silver matrix was studied by calculating magnetic entropy change ΔS induced by a change in applied magnetic field H. These nanocomposites were synthesized by the inert gas condensation technique and nitridation by heat treatment in an ammonia gas stream. Average sizes of the iron-containing grains were 10-35 nm. Magnetic phases in the materials were Fe3O4 or γ -Fe2O3 for the oxide-composites and γ-Fe4N or ε -Fe3N for the nitride-composites. Values of the ΔS were obtained by applying a thermodynamic Maxwell's relation, (∂S / ∂H)T = (∂M / ∂T)H, to data set of magnetization M measured at various temperatures T. They clearly indicated significant enhancement due to the nanostructure as predicted.
New DC bias method for the electron cyclotron resonance (ECR) plasma chemical vapor deposition (CVD) is demonstrated, where the highly photosensitive a-Si:H film of the device grade is deposited on the dielectric substrate. The measurement of plasma parameters using a probe technique indicates that the impinging of ion H+ on the growing surface is the key to the high quality a-Si:H film and this DC bias method controls the film properties by the ion density rather than the ion energy.
The heating-rate dependence of crystallization temperature, Tc, and the glass transition temperature, Tg, is studied from the view points of nucleation and fragmentation processes in disordered structures. Tc and Tg are expected to increase monotonically with heating rate. Such behaviors of Tc and Tg are classified into four characteristic regions with respect to the heating rate. Results are summarized in the Transient Phase Diagram where Tc and Tg are given as a function of heating rate. The scaling rule in the Transient Phase Diagram is given.
Sorption behaviors of neptunium (V) on naturally-occurring magnetite (Fe3O4) and goethite (α-FeOOH) in 0.1M NaN03 electrolyte solution under aerobic conditions were interpreted using the surface complexation model (SCM). The surface properties of these materials were experimentally investigated by C02-free potentiometric titration, and SCM parameters for the constant capacitance model, such as protonation/deprotonation constants of the surface hydroxyl group, were determined. The number of negatively charged sorption sites of goethite rapidly increased with the increase of the bulk solution pH compared with that of magnetite and this tendency was similar to the pH dependence of neptunium sorption. This implies that the neptunyl cation, NpO2+, plays a dominant role in possible sorption reactions. Assuming that the dominant surface complex is XO-NpO2, modeling by means of SCM was carried out, and the results were found to agree with experimental data.
Brief reviews on corrosion and coercivity mechanisms of sintered Nd-Fe-B magnets are given. Results of recently undertaken transmission electron microscopic study of Nd15 - Fe78-xCoxB7 sintered magnets (x = 3, 6 and 10) are presented. Micro-beam electron diffraction patterns obtained from Nd-Co phases in these magnets could be indexed according only to an orthorhombic cell of Nd3 Co among the binary Nd-Co compounds for x = 3 to 10. Relations of coercivity and magnetizability of this type of magnets to their microstructure are discussed in connection to the effects of V or Mo addition which are to enhance coercivity and to improve magnetizability. It is suggested that a decrease in the local demagnetization effects resulting from a decrease in the width of the grain size distribution due to these-additives is the origin of the enhancement of coercivity and the improvement of magnetizability.