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To present the utility of the recently introduced Maniceps septum stitch device for suturing of the nasal septum.
This paper describes nasal septum suturing techniques using the Maniceps septum stitch device following septoplasty to prevent post-operative complications such as haematoma and nasal septum perforation.
Nasal septum suturing using the Maniceps septum stitch device appears to be a safe and easy surgical procedure to help prevent post-operative complications and may reduce the incidence of nasal septum perforation following septoplasty.
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.
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.
200 eV and 30 keV Si2+ FIB were implanted in an MBE-grown GaAs layer in a dose range of 1012 and 1013 cm-2. Successive overlayer regrowth of the GaAs cap layer and postannealing at 800 °C for 3 – 30 s was performed to form buried thin δ-doped like layers. From the measurement of the sheet carrier density and the mobility, it was observed that doped layers had a carrier density ranging from 5×1011 to 1×1013 cm-2 and mobilities which were almost the same order in magnitude as that of an MBE-grown δ-doped sample.
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.
To examine how did Hyogo prefecture renovate disaster medical services system from the lessons of the Great Hanshin -Awaji Earthquake.
Countermeasures after the experience of the Earthquake were 1. Establishment of disaster-related medical information network which was introduced to each of various institutions to collect and disseminate medical information at the time of disaster. 2. Designation of sixteen hospitals as Disaster Medical Centers, which were expected to play leading role in disaster management,and to receive many patients at a time of disasters. 3. Construction of Hyogo Emergency Medical Center which was designated as a main Disaster Medical Center to train medical staffs, to operate the Emergency Medical Information Control Center.
We have several training courses for medical staffs. The most important training course is the DMAT (Disaster Medical Assistant Team)training course. DMAT trainigs held at two main Disaster Medical Centers, east National Disaster Medical Center, west Hyogo Emergency Medical Center. More than three hundreds teams have been cultivated now. We experienced five disasters in Hyogo prefecture in these seven years. 2 were natural disasters by the typhoon. 3 were a collision of the ship, the collision of the truck, train derailments each. A big JR train accident occurred in Amagasaki city of Hyogo on April 25,2005. Hyogo Emergency Medical Center worked as the emergency information control center, dispatched doctor attended ambulance, performed on-site triage and first aid, dispatched second team by helicopter, received four severe cases by helicopters, dispatched third team in the evening and provided confined space medicine, and took initiative of surveillance study of the casualties.
Disaster medical services system from the lessons of the Earthqukake functioned at the time of the JR Train accident.
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.
New types of multilayered photoreceptors using photosensitive a-SiC:H and a-Si:H have been investigated. The a-Si1-xCx:H was deposited at high rate of 1–6 µm/h from SiH4-C2H2 by a plasma CVD and used as a carrier generation layer (CGL) or a carrier transport layer (CTL). The type with the a-SiC:H(x=0.1) as CGL for positive charging shows higher sensitivity at λ<700 nm than the a-Si:H photoreceptors, reflecting the higher photosensitivity and wider band gap of the a-SiC:H. Furthermore, the negative charging type using the a-SiC:H(x=0.1) as CTL shows excellent sensitivity over full visible rangq compared with other positive charging types, because the transport ability of electron is superior to that of hole in both a-Si:H and a-SiC:H.
Highly photosensitive a-SiC:H films exhibiting ημτ-product more than 10−6 cm2/V at the band gap of 1.9 eV are prepared under the high deposition rate around 6μm/h by a plasma decomposition of SiH4-C2H2 source mixture gas at higher rf power. It is also shown that the SiH4-C2H2 gas system has a feature of the carbon incorporation into the films with the content nearly equal to that in the source mixture gas and hence is suitable for the high rate deposition process. This advantage and in addition the requirement of the higher rf power for obtaining the films with good electrical performance are discussed in terms of the dissociation reaction of the source gas and the secondary gas phase reactions in the plasma.
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.
A new electron cyclotron resonance (ECR) plasma CVD system has been developed in order to obtain high deposition rates. By using this system, hydrogenated amorphous silicon (a-Si:H) films have been prepared at a deposition rate of 1.0. μ m/min. The utilization efficiency of SiH4 gas is 16% under such conditions. Films prepared at 1.0 μ m/min have high photoconductivity (σ ph) of 10-6 S/cm and low dark conductivity (σ d) of 10-12 S/cm, leading to a high photosensitivity of σ ph/σ d=106. Both high microwave power and high SiH4 gas flow rates are essential to the high rate deposition of sufficiently photosensitive a-Si:H films. Annealing at 300° C improves the photosensitivity up to σ ph/σ d=107.
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.
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.
We have developed a series of processes for preparing carbon nanotube devices of probes and tweezers that operate in scanning probe microscope (SPM). The main developments are a nanotube cartridge where nanotubes are aligned at a knife-edge to be easily picked up one by one and a scanning-electron-microscope manipulator by which a nanotube is transferred from the nanotube cartridge onto a Si tip under observing its view.
We have also developed the electron ablation of a nanotube to adjust its length and the sharpening of a multiwall nanotube to have its inner layer with or without an end cap at the tip. For the sharpening process, the free end of a nanotube protruded from the cartridge was attached onto a metal-coated Si tip and the voltage was applied to the nanotube. At a high voltage giving the saturation of current, the current decreased stepwise in the temporal variation, indicating the sequential destruction of individual nanotube layers. The nanotube was finally cut at the middle of the nanotube bridge, and its tip was sharpened to have an inner layer with an opened end. Moving up the cartridge before cutting enables us to extract the inner layer with an end cap.
It is evidenced that the maximum current at each layer during the stepwise decrease depends on its circumference, and the force for extracting the inner layer with ∼ 5nm diameter is ∼ 4 nN.
Mineralogical changes of cement and bentonite accompanied with their interaction wereexperimentally studied by mixing granulated hardened cement paste and bentonite, and aging the mixture for91 days at 50° C. Mineralogical changes of cement and bentonite were identified by XRD. Hydratedcalcium-silicate phases (C-S-H), Ca(OH)2, ettringite and monosulfate were identified in the unalteredhardened cement. While Ca(OH)2 and monosulfate decreased with aging and disappeared after 91 days,calcite and katoite (Ca3Al2(SiO4)(OH)8) were formed concurrently. Montmorillonite, quartz (and/orchalcedony), clinoptilolite, plagioclase, calcite, analcime and pyrite were identified in the unaltered bentonite.The XRD pattern showed that diffraction intensities of these minerals decreased with aging. It seems thatthese primary minerals dissolved in the course of the alteration. C-S-H appeared in bentonite during the agingas secondary phases, indicating the participation of silicon dissolved from the bentonite and calcium from thecement formed the C-S-H. The formation of C-S-H that had been predicted by previous modeling studieswas confirmed by the present experiments.
In addition, diffusivity of tritiated water in mixed specimen with granulated hardened cement andbentonite was determined by a through-diffusion method. The effective diffusivity of tritiated water decreasedwith aging. The result suggests that the mass diffusivity in the interface of cement-bentonite system willdecrease with their interactions. The results of the diffusion experiments are qualitatively consistent with thediffusivity change in cement-bentonite systems predicted by some computational studies.