Suffering from chronic retinal diseases that lead to blindness causes a significant decrease in the quality of life. In addition, retinal diseases are common in the elderly; developing pathological analyses and treatments for retinal diseases has become an urgent issue especially in super-aging countries such as Japan. The principal drug delivery route currently in use is topical eye drop administration, but it delivers only low drug levels to the retina. Although intravitreal delivery allows for high concentrations of a drug to be delivered directly to the retina, the necessary procedure often requires repeated injections that can cause serious side effects. Therefore, transscleral delivery has emerged as a more attractive method for treating retinal disorders because it can deliver a drug locally and is less invasive. Here, a transscleral drug delivery system that is implantable in the episclera and allows for controlled release of various molecular weight drugs will be presented.

Blood pressure estimation methods have been proposed on the basis of the physiological knowledge that the PPG changes depending on the state of the cardiovascular system. In previous studies, various features which are extracted the wave height and the elapsed time from the rising point of the pulse wave to feature points have been used to the machine learning for the BP estimation. However, the accuracy is still not adequate as medical equipment because their features cannot express fully information of the pulse waveform which changes according to the BP. And, no other effective knowledge about pulse waveform for BP estimation has been found yet. Therefore, in this study, we focus on the autoencoder which can extract complex features and add new features of the pulse wave form for the BP estimation.

Repeated sudden blood pressure changes in daily life are reported to raise the risk of cerebrovascular diseases in people even if they are not hypertensive patients. This syndrome is difficult to detect in usual medical examinations. Our research group is developing a contact-less measurement method for monitoring blood pressure changes using the video image of the human body, which is called a video plethysmography. This technique enables us to monitor blood pressure easily and constantly in a normal living environment. In our previous study, we showed that the pulse transit time calculated from the video plethysmography recorded in two different body areas reflected blood pressure changes. In this study, we show the possibility of estimating blood pressure changes based on the waveform of the video plethysmography recorded only in one body area.

Cuffless blood pressure estimation is performed based on the waveform of PPG. In this presentation, we report the result of investigating the relation between PPG waveform and blood pressure, and we describe the prospect of cuffless blood pressure estimation.

The noninvasive blood pressure standard is the value measured by the mercury sphygmomanometer (Hg-BP). The estimate of a blood pressure (BP-EST) is calculable from a pulse wave using photosensor modules. This is expected towards realization of a Cuff-less sphygmomanometer. We calculated the BP-EST during the blood-pressure measurement by a mercury sphygmomanometer, and compared the Hg-BP with the BP-EST. We placed the photosensor module inside the manchette of a subject's upper right brachium area. The place was a position which touches an upper right brachial artery. The continuity BP-EST by a photosensor module was stabilized within about 20 seconds after the cuff compression and the decompression. We measured blood pressure 2 times, and calculated the average value. The Bland-Altman plot considered the relationship of the Hg-BP, and the BP-EST. The Hg-BP and the BP-EST showed the high relationship, by measurement of the resting state.

The cuffless blood pressure (BP) monitor is an application of the wearable healthcare device, and now several commercial devices are on the market. The device is easily produced, but BP monitor is a medical device which need to approve by governmental agency. Meanwhile, we have developed as IEEE standard 1708 in 2014. The contents were followed by cuff-based BP (ANSI/AAMI/ISO 86010-2) but medical safety issues were missing. Thus, we need to revise as below points. The discussion points are sampling size, motion artifact, posture measurement, dynamic blood pressure range reference (gold standards device) calibration period and medical safety. Furthermore, recently American Heart Association recommended new criteria for hypertension. We deeply discuss cuffless BP monitor at ISO/TC121/S3. as well as IEEE Standards Association.Wearable healthcare devices need to develop in elderly society and standards is required for accuracy, reliability and validity.

Ca²⁺/calmodulin-dependent protein kinase II (CaMKII) is a multifunctional kinase that can phosphorylate proteins involved in regulating Ca²⁺-storage and -release, transcription factors, and ion channels. While CaMKII is reversibly activated upon beat-to-beat elevation of intracellular Ca²⁺ (Ca²⁺-dependent form), it is converted into a constitutively-active Ca²⁺-independent form by cardiac stressors, such as fast activation rate, chronic adrenergic stimulation and oxidative stress. Moreover, there is a synergetic interaction between upregulated CaMKII and functional changes in Na⁺-channels (enhanced late Na⁺-current) and ryanodine receptor channels (increased diastolic sarcoplasmic reticulum Ca²⁺-leak), further augmenting persistent Ca²⁺-independent activity via a proarrhythmic CaMKII-Na⁺-Ca²⁺ positive feedback loop. The CaMKII overactivity is connected to a variety of cardiac diseases including heart failure, myocardial infarction, ischemia/reperfusion and arrhythmias. Here we review the pathophysiological roles of CaMKII, together with our findings from an experimental model of electrical storm featuring repetitive defibrillator-firings for recurrent ventricular tachyarrhythmias.

Pulmonary vein (PV) isolation is a cornerstone of catheter ablation in patients with paroxysmal atrial fibrillation. The balloon-based ablation provides more reproducible results and reduced procedural times than the conventional radiofrequency catheter ablation. In addition to Cyroballon, Hotballoon and Laserballoon ablation have recently been introduced as new ablation modalities for balloon-based catheter ablation. Cryoballoon delivers cryoenergy over an occluding balloon system to create circumferential lesions around PVs, resulting in lesions characterized by dense homogeneous fibrosis with well-delineated border zones. The Hotballoon catheter is inflated and filled with contras medium and normal saline, and radiofrequency energy is delivered between a coiled electrode in the balloon and cutaneous patches on the patient's back. The Hotballoon membrane material is elastic and compliant, fitting the variable PV anatomy. Laserballoon allows real-time endoscopic visualization of the PV antrum during energy delivery. The feature of each balloon-based ablation system will be shown in this presentation.

Background: Intra-atrial electrogram-based modulation of atrial fibrillation (AF) drivers has been proposed as an effective ablation strategy for non-paroxysmal AF (Non-PAF). However, whether the modulated areas really contain real AF drivers is unclear.

Methods: A recently-developed AF imaging system (ExTRa Mapping) was applied to 28 Non-PAF patients. Non-passively-activated areas (NPAs) assumed to contain Non-PAF drivers were determined. We investigated the correlation between NPAs and indirect indicators of Non-PAF drivers, and the effectiveness of the NPA ablation.

Results: (1) In NPAs, typical wave dynamics during Non-PAF were rotational activations in the forms of meandering rotors and/or multiple wavelets. (2) The NPAs did not always coincide with indirect indicators of Non-PAF drivers, and we found no significant correlation among them (P>0.05). (3) The freedom from Non-PAF after the NPA ablation was 79%.

Conclusion: Real-time mapping of AF dynamics, rather than mapping of indirect indicators, might be more useful for detecting Non-PAF drivers.

Spiral wave (SW) plays a significant role in tachyarrhythmia. The common aim of various arrhythmia therapies is prevention and termination of SWs. Although elucidation of the complex SWs dynamics accompanying generation, shift, and annihilation is important for effective therapy, objective tracking of SW center has been difficult. In this session, we introduce the novel technique named phase variance analysis which we developed for quantitative analysis of SW dynamics. In this method, SW center is defined as a peak of a distribution which shows the variance of phase values around each point. This method improved the accuracy of SW center tracking dramatically (99.8%). Moreover, the mean value map of fluctuating phase variance value at each point visualized the region over which SW center moves frequently. These results indicate that phase variance analysis enables objective analysis of complex SW dynamics and it is valuable as a diagnostic indicator for arrhythmia therapies.

Rotors (i.e. 2-dimensional: spiral waves, 3-dimensional: scroll waves) are rapid functional reentrant activities, like hurricane and/or tornado, which may play a key role in the maintenance of atrial fibrillation (AF). The optimal ablation strategy for persistent AF remains a matter of debate with recent emphasis put on electrogram-based strategies targeting high dominant frequency of excitation, complex fractionated atrial electrograms and localized sources including rotors. The experimental models of persistent AF in sheep clearly demonstrated that high frequency rotors exist in the AF-driving atrial regions. Recently, we reported evidence that spatio-temporal dispersion of multipolar electrograms in persistent AF patients represents an electrical footprint of waves emanating from rapid rotational activities and propagating within a heterogeneous atrial muscle. Whether novel AF ablation targeting spatio-temporal electrograms deipersion leads to termination of persistent AF will be discussed.

The high waiting-list mortality rate is a critical problem in lung transplantation. One promising approach is to utilize artificial gas-exchange device to bridge to transplant. However, there is no gas-exchange device available for a long-term support (eg, more than a month). The membrane lungs available in the market now are limited to use for up to only several hours, making the bridge-to-transplant concept unrealistic, although some experienced centers have tried to use them on a case-by-case basis. We have started to develop a novel gas-exchange system that consists of silicone-based membrane lungs with new anti-thrombotic polymer coating. Our goal is to offer more opportunities and safer surgical interventions to those who are waiting for lung transplants. We believe the new gas-exchange system allows more mobility and activeness in patients of the waiting period for transplants, which ultimately leads to better overall post-transplant outcome with smooth rehabilitation.

While lung transplantation remains the last resort for the patients with end-stage lung failure (LF), it is limited by the shortage of donor lungs. There is growing interest in long-term artificial lungs (AL), that can be used not only as a bridge therapy but also as a destination therapy for the patients with advanced LF. Surface-induced coagulation limits lifetime of AL. Zwitterionic polymer coating reduces protein fouling by electrostatically attracting a layer of water molecules that repels proteins. The coating over artificial lung surfaces may reduce contact activation of the coagulation cascade and slow clot formation. Nitric oxide (NO) diffuses into platelet cells, suppresses expression of the platelet receptors, and prevents platelets from being activated. We will discuss our rabbit studies for evaluating the effects of the coating and NO. The studies suggested that combined use of the coating and NO reduced clotting activity and clot weight.

ECMO system has been used for over days to weeks. However, its performance deterioration, poor antithrombogenicity and large apparatus are still problematic issue. In this study, we developed a compact ECMO system with built-in monitors and evaluated its prototype in chronic animal experiments. This system is consisted of a pre-connected blood circuit unit, a pump driver unit integrating with measurement instruments and a gas bomb unit. The circuit was consisted of a centrifugal pump (BIOFLOAT NCVC), an oxygenator (BIOCUBE) and built-in sensors. A driver was made as extremely compact (W290 x D205 x H260 mm, 6.6 kg). ECMO with the prototype was conducted for 4 weeks using 3 adult goats. In all cases, the ECMO could run for 28 days without device exchange and monitored stably. Thrombus formation was hardly observed in the each circuits. The prototype demonstrated durability, stability of monitors and thrombo-resistant property for mid-long term.

Currently, many of patients waiting for lung transplant dies before suitable donor lungs became available in Japan. A 40-year-old man with interstitial lung disease who was listed for LTx 3 years previously, experienced progressive deterioration of respiratory function. He was intubated and was mechanically ventilated at another hospital and was transported to our hospital for veno-venous ECMO. He was extubated soon, conscious, could consume food and liquids, and could exercise normally while awaiting LTx. Lungs from a marginal donor became available on day 18. He was transported to the transplantation center and underwent LTx successfully. Bridge to lung transplant with ECMO is still being debated. Current ECMO system is associated with serious complications such as hemorrhage and infection. For long term bridge, we need to develop new implantable artificial lung device. Also, we need to establish more flexible allocation system for lung transplantation.

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Health policy in Japan defines that the number of hospital beds should be reformed by the following hospital function in the community, and work-sharing should progress among hospitals. Therefore, work-sharing should be advanced among relevant professionals (e.g. nurses and other healthcare providers). The Inpatient Devices Working Group (IDWG) thought about the importance on the issue, while having discussed what kind of nursing work could be reduced by using inpatient devices. By the result of the discussion, IDWG suggested that the assistive technology is now used in writing records, talking to other nurses and/or health providers and sharing information (including reading records). Hence, it should be discussed whether it is better for nurses to use inpatient devices (various cameras and sensors) while reducing the number of visits to the bedside in light of both effective and ethical issues.

Sleep Apnea Syndrome (SAS) causes various diseases such as circulatory diseases and cerebrovascular diseases. However, the number of patients who are diagnosed in medical institution is about 15% of the estimated number of potential SAS patients. SAS patients have little subjective symptoms. There are several studies to detect respiratory arrest using HRV or pulse rate variability (PRV). However, these methods are not suitable for daily life because it is necessary to attach some sensors to subjects. Therefore, this study was performed to develop a non-contact monitoring system, which was applicable to daily life, for screening potential sleep apnea syndrome patients. In order to meet the system requirements, pulse rate variability, which was calculated from infrared imaging, was used for detecting respiratory arrest events. Ten subjects were recruited to participate in the experiment. As the results, respiratory arrest events were detected with a maximum sensitivity of 0.65.

Measuring daily vital signs unconsciously is useful for early detection and prevention of diseases. We have proposed to measure the pulse rate and respiration rate during sleep noncontactly by using the near infrared image. Since body movements occur during sleep, a method of determining an appropriate calculation position of optical flow was studied. Optical flow and reliability at each position of the entire image were calculated using the Lucas-Kanade method. Next, the x component and the y component of the optical flow at each position were calculated, and a low pass filter was applied to this to obtain a respiration waveform. Near-infrared images during sleep while wearing a respiration sensor was recorded. As a result of investigating the data between 150s before and after turning over, respiration could be detected with accuracy of about 90% by using respiration waveform in shoulder region and high reliability region.

In recent years, the number of wireless devices dramatically increases in hospitals; however, if the devices are not properly managed, users may face some problems that result in medical accidents. MIC has been collaborating with relevant organizations, such as the Ministry of Health, Labor and Welfare (MHLW), and Electromagnetic Compatibility Council Japan (EMCC) in order to conduct educational activities for the achievement of safe electromagnetic environment. This presentation will show activities promoting safe electromagnetic environment in the medical area. For example, the task force of EMCC made the "guidance for trouble" examples, and their methods when using medical telemeters, wireless LAN and mobile phones. It also made the guideline for safety use of radio waves in hospitals. Additionally, to expand the educational activities in local regions, the eleven regional councils, established last September, collect their good practices and incident reports wirelessly in hospitals, and hold many seminars throughout Japan.

The Ministry of Internal Affairs and Communications has aimed to establish "the council to promote radio wave utilization in hospitals" at every Bureau of Telecommunications. The council in the Kyushu area was established on September 29, 2017. In the end of 2017, this council is constituted by the medical staffs in Kumamoto Prefecture where Kyushu Bureau of Telecommunications locates, except for the chairman and a vice-chairman. In this presentation, I explain the situation of the council in Kyushu, and the move towards future development. In addition, I am the vice-chairman of "the committee to promote safe use of radio waves in hospitals" in Electromagnetic Compatibility Conference Japan. This committee is making a training course for keeping the electromagnetic environment safe in a hospital, and also a course for training a person who performs the coordination for using wireless communications safely. Then, I explain the motion.

In 1980's, PCs began to spread to general use, and was spread to clinical laboratory and accounting in hospital. But, it was limited to some users. Since 1990 computer communication became popular, and users were expanded by user interface improvement. The Internet made spread for ordering and medical records, then all medical workers have been PC users. And it was major change about television and telephone after 2000, other devises have been converging to ICT, too. Until then, information was shared by wire, but wireless connections was spreading general use. So it was same use in hospitals, but prevented by legacy 400 MHz bands. However, in November. 2016, the PMDA allowed for the use of ISM (2GHz-). For more than 10 years ago, there were some wireless products in abroad. To be popular such devices, domestic companies are encouraged. We search and collect data to clarify the safety academically.

Promotion of Telecommunications to Achieve Convinent Medical Environment for Patients

High gamma activity (HGA) between 80 and 140 Hz on electrocorticogram (ECoG) is assumed to reflect localized cortical processing, while cortico-cortical evoked potential (CCEP) can reflect bidirectional responses between language cortices when there is no patient cooperation. 20 patients with an intraaxial tumor in their dominant hemisphere, underwent lesion resections. We performed functional localization for the receptive language area, using real-time HGA mapping by listening to linguistic sounds. Furthermore, single electric pulses were delivered to the identified receptive temporal language area to detect CCEP in the frontal lobe. All mapping results were validated by ECS. Linguistic HGA mapping quickly identified the language area in the temporal lobe. Electric stimulation to the temporal receptive language area evoked CCEP on the frontal lobe. The combination of linguistic HGA and frontal CCEP did not need any patient cooperation or effort.

It is considered that the place cell is a fundamental neural basis for such spatial understanding. The previous studies proposed neural network models that can sustain the internal states corresponding to the spatial positions as attractors of dynamical systems. However, it is an open question how the place cell and spatial recognition can emerge from the subjective experiences of motion and sensory inputs without referring to the spatial position. To this question, we show that place-cell-like neurons are self-organized in our proposed hierarchical recurrent neural network which is trained to predict the future visuomotor states. It will be discussed about the spatial representation and neural network modelling in my talk.

The auditory cortex (AC) is the final stage of the sound processing in the brain. However, its functional role and mechanism have not been fully understood. Because the AC consists of multiple subfields and laminar structure, it is necessary to analyze the characteristics of neural responses in each subfield and layer. Here, we first propose a new method of identifying subfields using the transcranial flavoprotein fluorescence imaging, then implanting an electrode into the identified site and conducting chronic neural recording. Next, we show that the response properties in each AC subfield dynamically modulated by behavioral contexts. Finally, we focus on tinnitus as a typical form of auditory dysfunction, and analyze neural activities in each AC subfield and layer of the mice with pharmacologically induced tinnitus. These series of results will give us important knowledge for neural mechanism of sound information processing in the AC and auditory dysfunctions such as tinnitus.

A ciliate, Paramecium, is often called a swimming neuron as the electrophysiological studies done after 1960s have indicated the similar properties of membrane potential to that in neuron. A model equation for dynamics of membrane potential was proposed and is of Hodgkin-Huxley type that was originally proposed for squid neuron. Because ciliary motion that produces swimming force in ciliate is tightly regulated by the membrane potential, we expect that any kinds of behaviors, for instance, smart behaviors adaptive to environment, are organized by some modulation of model equation for membrane potential. Here we will introduce an adaptive behavior of a ciliate and discuss a possible mechanism of the adaptability based on the model equation for membrane potential.

The Darwinian principle is one of the most likely mechanisms that underlie intelligence and problem-solving ability of living organisms. In the cerebral cortex, the theory of neural Darwinism predicts that variation and selection within neural populations are crucial to adaptive computation. We attempted to examine the Darwinian principle in both in vivo and in vitro experiments.

It is currently subject to regulation formaldehyde, which has been used in hospitals. Then removal of harmful and unpleasant smell technique is an important. Therefore, we have studied that the odor removal system with photocatalyst which is safely and easily. When electrons in photocatalyst titanium oxide are excited by the ultraviolet, the odor molecule are oxidized and decomposed into CO2 and H2O by photochemical reaction. For quantitative measurement of odor was done by CO2 and vapor sensor and the organic concentration sensor. We made odor reduction system 21 cells of ultraviolet LDEs (wavelength of 375nm) mounted in box (total output 571 mW, with battery 12V), with a fan (flow rate 38 mL/min). For organic matter related to humans, CO2 was increased and the odor intensity was reduced within 30 minutes. In this way, decomposition of odor of acetic acid, formic acid, isovaleric acid, ammonia, formaldehyde could be decomposed.

The purpose of this study is to propose a signal amplification method for immunosensor using photo-responsive micro-capsules. A concept of photo-responsive micro-capsule which can be adapted as a signal amplification element to many kinds of biosensors was proposed. A photo-responsive micro-capsule is consisted from i) inner shell, ii) lipid bilayer, iii) outer shell, and iv) antibody layer. The inner shell was fabricated by the alternate assembly of poly(sodium 4-styrenesulfonate) (PSS) and poly(diallyldimethylammonium chloride) (PDDA) on a melamine-formaldehyde (MF) particle (3 micro-meters of diameter). A highly branched protonated polyamine, poly(ethyleneimine) (PEI), was used as the first layer. The MF particle was removed by dissolution with HCl. Next, the outer shell was fabricated by TiO2. Finally, a 5-carboxy-1-pentanethiol was used to from a self-assembled monolayer (SAM) membrane and immobilize an antibody. The templating MF cores was decomposed with HCl to yield PSS/PDDA multilayer micro-capsules.

The electric impedance was measured related to the controlled orientation of cells in vitro. The parallel line-and-space pattern of micro ridges (0.001 mm height, 0.003 mm width and interval) have been made between a pair of the surface titanium electrodes (1.2 mm interval) at the surface of the scaffold of glass by the photolithography technique. C2C12 (mouse myoblast cell line) was cultured for 4 days on the micro-patterned scaffold in the medium of D-MEM (Dulbeccos Modified Eagle Medium). The electric impedance between electrodes was measured once a day with the sinusoidal electric waves (frequency, 1 Hz - 1 MHz; amplitude, 0.1 V - 5 V). The experimental result shows that electric impedance has frequency characteristic and that the impedance at 0.1 MHz increases with proliferation of myoblasts. The orientation of myoblasts was able to be detected by the impedance between the surface electrodes.

We made an extracorporeal circulation (ECC) with light emitting diode (LED) irradiation system on adult male SD rats. We used three wave lengths of each LED which main wave lengths are 365nm, 465nm, 515nm. ECC was derived to ECC with irradiation. This system is consisted of a tubing line, a roller pump and an irradiation device. Animals were divided into not-irradiated group and other groups. We took the blood tests at pre-circulation with irradiation and post-circulation with irradiation. We compared Experimental data between pre-circulation with irradiation and post- circulation with irradiation.

We describe a LAMP microdevice for the early detection of viral infections. We succeeded in reducing the device, including the entire control system, to the size of the palm of a hand, and improved the portability of the microdevice. Also, this allows our LAMP microdevice to run all control systems using only a 9 V battery. The LAMP reaction is performed in 200 nl/well samples, and 16 samples can be analyzed simultaneously. We also created a simplified system that can apply 16 samples to the wells of the reactor simultaneously through capillary action, and we can easily analyze sub-microliter scale samples. Using this device, we confirmed the simultaneous LAMP reactions by analyzing 16 samples. Furthermore, we performed a dengue virus detection experiment to demonstrate the practical use of the device. We confirmed the specificity of this reaction when we applied the sample containing the dengue virus RNA.

In this research, we aim to establish a method of real-time high accuracy endoscopic image overlay of the tip of surgical instruments for control of a forceps robot. In general, the relationship between the position of an object in the three-dimensional space and its projection onto the camera image can be represented by a single camera model. However, the closer an endoscope gets to surgical instruments, the larger the projection error becomes. The proposed system introduces virtual multi camera models according to the distance between an endoscope and surgical instruments for alleviating the projection error.

The purpose of this study is to develop a procedure for visual tracking of surgical instruments for control of an endoscopic robot. The proposed method is mainly based on the color features, which are including R, G and B of the RGB color space and S (Saturation) of the HSV color space and used for recognition of surgical instruments in endoscopic images. For verification, our method was applied to two endoscopic surgery videos with different color features.

We are currently developing a research to control a thin catheter by forming acoustic radiation force in human body, where it is necessary to constantly monitor the position of the catheter in blood vessel to perform effective control. In this study, we propose a method to detect the tip position of the catheter by analyzing time variation of brightness, which reflects the distribution of microbubbles scattered from the tip in ultrasonic volumes. We used the four-dimensional mode of the echography. The acquired volumes were transformed into two dimensions of the xy, yz, zx planes to estimate the position of the tip. As the result, the maximum error perpendicular to the axial direction was 1.5 mm, whereas that in the axial direction was 5.5 mm, because of the diffusion of microbubbles. Considering that the beam width of the acoustic radiation distribution is about 5 mm, the position detection result is useful.

A noninvasively and endoscopically diagnosis technology called Optical Biopsy has a limitation in the clinical application because of the motion-artifact caused by the external disturbance of the tissue and the endoscope. In this research, we are aiming to develop a spectroscopic and robust fluorescence lifetime imaging with the external disturbance compensating system. The fluorescence lifetime is estimated by the histogram of the arrival times of each single photon emitted from the sample. In principle, the fluorescence decay waveform and lifetime are varied due to the external disturbance such as the vibration because of the optical path change resulting in the change of the arrival time of the photons. Therefore, we proposed a tissue motion tracking method to compensate the signal distortion by moving the mirror to follow the surface of the tissue. In this presentation, the validity of the proposed method for the highly robust fluorescence lifetime measurement is reported.

This paper introduces a preliminary study on constructing a multi-organ statistical deformation model that can reconstruct respiratory displacements including shape differences between patients. For statistical modeling, we use multi-organ surface data that have been manually extracted from 4D-CT data measured during radiation therapy. Patient-specific organ models with the same number of vertices and topological structure are automatically generated using Affine transform and discrete Laplacian shape editing. We confirmed that shape registration could be achieved within 1mm Hausdorff distance error and mean respiratory motion of five organs could be represented.

For a solution to serious donor organ shortage in organ transplantation, we've aimed to develop innovative therapeutics of extracorporeal organ regeneration therapies, in which damaged organs are treated to recover or to regenerate under machine perfusion. In this approach, it is required to develop non-invasive and real-time monitoring methods of the state of organs during perfusion. Therefore, we focused on ultrasonic echo imaging.Porcine kidneys stored for several hours after sacrifice were used. We tried to examine contrast-enhanced ultrasonography to evaluate vascular perfusion after initial perfusion with saline. Uniform-sized microbubbles as contrast agent were produced using SPG membrane from polyvinyl alcohol solution. A mean diameter of microbubbles was 13 μm just after the preparation. Additionally, we successfully imaged vascular perfusion thanks to custom-made Digital Subtraction Angiography conversion program. We believe our method would be applicable as one of effective non-invasive monitoring methods for perfusion status of organs during extracorporeal perfusion.

We have developed microplate-based rapid assays for urinary biomarkers to determine urea, uric acid and creatinine, and more simple visual semi-quantitative methods such as the urine test strip. Here, a new reaction system was investigated for highly sensitive detection in the concentration range of 150 mg/L or less for microalbumin (Alb), which is a urinary protein test item recommended for early detection of kidney diseases. In this study, a reaction in which formazan showing orange or blue color was formed depending on the pH is used when the colorless water-soluble tetrazolium salt was reduced by protein under alkaline conditions. The final pH of the reaction solution was changed; in addition to quantification by absorbance at around 600 nm, the visual method was constructed. The blue green color of formazan as the final product required 10 min at 37 °C and corresponding to the Alb concentration was visible.

The urine test strip method is widely used as a screening test since its results are a quick indicator of renal function. This method can be also used at home but results may vary due to personal error. The ultimate goal of our study was development of a simple and rapid semi-quantitative test system for urine component using a smartphone. It can be useful for early detection of symptoms of kidney diseases. In this study, we used a smartphone to take pictures of the urine test strip for albumin, with a color chart. GIMP was used to acquire the RGB value. The standard concentration of bovine serum albumin was diluted with distilled water to prepare 4 concentration samples. In this experiment, we showed the possibility of being able to assess the albumin level by comparing parameters of each color component extracted from the urine test strip and the color chart.

In robotic prostatectomy, it is extremely important not to damage the urethral sphincter to keep urinary constraints. In the vesicourethral anastomosis, the creation of a urethral applied force display system plays an important role in surgical technique learning. We created a pelvic vesicourethral anastomosis model combining the force sensor and created an environment that can measure the applied force for urethra. Thirteen experts and 15 novices were tasked to suture the cystourethra in whole circumference, and the applied force was evaluated for each suture site. The average applied force was 2.5N for experts and 3.5N for novices. According to the directional examination considering in difficulty by the anastomotic site, the value of experts was small at 8-10, 11-1 o'clock position and no difference was observed at 2-4, 5-7 o'clock position. Furthermore, we created a system that superimposing displays applied force in three dimensionally by adding processing to the stereo image.

Blood pressure decreases to a state of hypotension in some patients during hemodialysis. Medical worker provides temporary measures to increase blood pressure for such patients. Typically, medication, fluid replacement, and passive leg raising are used. As each strategy has pros and cons, we attempted to find simple and fast-acting measures. Fifteen male participated in this study. Continuous blood pressure, stroke volume, electrocardiograms, and plethysmograms were obtained. The protocol consisted of 15 min of acclimation in a supine position, 5 min performance of one of the methods to increase blood pressure for 5 or 15 min, and then resting for 1 min. The following methods were selected: active one-leg-bending exercise, applying medical stocking and waist corset, and playing game. Systolic and mean blood pressure increased significantly only for active one-leg-bending exercise. Further, heart rate increased significantly for active one-leg-bending exercise and playing game. No other investigated parameters showed changes.

Although evaluation of attentional state will be important in the field of medical and mental care, the most appropriate method to evaluate attentional state has not been clarified yet from a viewpoint of practical application. Therefore, we examined multi-modal brain activity signals in relation to the attentional state. In this study, we hypothesized that the attentional state is closely related to the task score of memory task. Then we classified the score based on electroencephalogram (EEG), cerebral blood flow measured by near-infrared spectroscopy (NIRS), and pupil diameter during word memory task according to three types of time scale. As indicators of attentional state, we analyzed amplitudes of P300 on EEG signal, functional connectivity on NIRS signals, and pupil diameter changes. As a result of logistic regression analysis, the highest accuracy was demonstrated by different indicators depending on the time scales, and a combination of indicators demonstrated higher accuracy.

Monitoring plastic change in nerve system during functional recovery from brain damage is important for establishing evidence-based rehabilitation methodology. Developing an fNIRS system with originally designed fNIRS optodes on the skull surface, the cerebral activation during macaque monkey's food retrieval by using alternated left and right hand was measured. Associating with the food retrieval, simultaneous increase in oxygenated hemoglobin and decrease in deoxygenated hemoglobin in both hemispheres were observed. Conducting the paired t-test on the hemodynamic difference between left vs right hand use, statistically significant regions were well localized at M1 area in both hemispheres. After the functional recovery from a brain damage in internal capsule, the ipsilesional premotor area showed additional activation during contralateral hand use. This finding coincides with a previous study using PET (Murata, 2015). The developed system allows for the accurate and stable monitoring of activity changes in the motor-related areas of unrestrained, awake macaque monkeys.

A fNIRS probe samples the signal from brain tissues just below the probe position and the surrounding, which indicates the probe should be accurately mounted just above the targeting brain region. We developed an easy-to-use navigation system for mounting fNIRS probe on the subject head. Positions of the probe and 3D facial landmarks were defined on the coordinate system of the anatomical volume MRI in advance. A fast algorithm was employed to automatically detect the facial landmarks on each movie frame. The transformation matrix from MRI space to movie space was obtained from the pair of landmark positions. The probe position was transferred using the matrix and was superimposed on the movie capturing the face and head of the subject. The navigation system was implemented on a tablet computer with video camera. The display position of the fNIRS probe was updated following the movement of the head without noticeable delay.

It is important to discuss both patents and standardization activity, for both businesses and researches. However, there is little information about these, especially for researchers. Standardization has two meanings. One is conforming to the standards which already exist, and the other is making new standards. Their activities are different. We need to know about standardization and its activities, at first. For this purpose, the homepage of the Japanese Industrial Standards Committee (JISC) is very helpful. Our Japanese committee proposed the New Work of the functional Near Infrared Spectroscopy (fNIRS) standard at an IEC Nuremberg meeting in 2011. It was accepted through the international voting, and, our standardization activity started. It had been discussed by a Joint Working Group with ISO, and the standard was published as ISO/IEC 80601-2-71 in 2015. I will discuss the relationship between the standardization establishment and the research activity.