This paper describes a novel method for detecting the bottleneck in a discrete event system by examining the average duration of a machine being active for all machines. The machine with the longest average uninterrupted active period is considered the bottleneck. The method is widely applicable and also capable of analyzing complex and sophisticated systems. The results are highly accurate, distinguishing between bottleneck machines and non-bottleneck machines with a high level of confidence. This approach is very easy to use and can be implemented into existing simulation tools with little effort, requiring only an analysis of the log file which is readily available by almost all simulation tools. This method satisfies not only academic requirements with respect to accuracy but also industry requirements with respect to usability.

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This paper provides a novel method for detecting bottlenecks in manufacturing systems and the shifting of these bottlenecks. All manufacturing systems are constrained by one or more bottlenecks. Improving the bottleneck will improve the whole system. Yet, finding the bottleneck is no trivial task. Furthermore, the system may change over time or due to random events, and subsequently the bottleneck may shift from one machine to another machine. The shifting bottleneck detection method determines the bottleneck based on the duration a machine i s active without interruption. The method is very robust, easy to apply and able to detect the primary and secondary bottlenecks in a wide range of production systems. This allows the use of simulation to predict bottlenecks for both steady state and variable systems. The measurement of the likelihood of a machine being the bottleneck aids in the decision-making regarding the allocation of the available resources.

Some Ki-1 lymphomas carry a specific chromosomal translocation, t(2;5)(p23;q35). We have recently found a novel hyperphosphorylated 80- kD protein tyrosine kinase, p80, in a human Ki-1 lymphoma with this translocation. Subsequent cDNA cloning showed that p80 is a fusion protein of two different genes on chromosome 2p23 and 5q35, the novel tyrosine kinase gene and nucleophosmin gene, respectively. In this study, we intended to detect p80 on lymphoma tissues with immunologic methods. Thus, we developed rabbit polyclonal antibody using a synthetic peptide corresponding to a part of its kinase domain. The antibody (anti-p80) immunoprecipitated and immunoblotted p80 specifically from AMS3. Then, to examine whether t(2;5)(p23;q35) was present on biopsied lymphomas, reverse transcriptase-polymerase chain reaction (RT-PCR) covering the fusion junction of p80 mRNA was performed. Among 10 Ki-1 lymphomas and 10 additional lymphomas other than the Ki-1 lymphomas, expression of p80 mRNA was detected in three cases exclusively. When these 20 cases and additional 30 lymphomas were immunostained with anti-p80, positive staining was noted exclusively in the three cases found by PCR to have harbored the p80 mRNA. Thus, the present immunostaining, as well as PCR, was shown to be efficient for detecting lymphomas producing this chimeric protein/mRNA.

Eradication of Helicobacter pylori (H. pylori) is an effective strategy for preventing various gastrointestinal diseases such as gastric cancer and mucosa-associated lymphoid tissue (MALT) lymphoma. However, the eradication success rate is decreasing because of a recent increase in drug-resistant strains of H. pylori. Here, we evaluated the success rate of eradication therapy with vonoprazan (VPZ), a new potassium-competitive acid blocker, against drug-resistant H. pylori. In total, 793 patients who received H. pylori eradication therapy were investigated retrospectively. All underwent esomeprazole (EPZ)-based triple therapy (n = 386) or VPZ-based triple therapy (n = 407) for first-, second- and third-line H. pylori eradication for 7 days. The overall success rates of first- and third-line H. pylori eradication were significantly higher for VPZ-based triple therapy (88.4% and 93.0%, respectively, per protocol (PP)) than for EPZ-based triple therapy (69.5% and 56.5%, respectively, PP). Moreover, the success rates of first- and third-line eradication of clarithromycin (CLR)- and sitafloxacin (STFX)-resistant H. pylori were significantly higher for VPZ-based triple therapy (72.0% and 91.7%, PP) than for EPZ-based triple therapy (38.5% and 20.0%, PP). In addition, patient age did not affect the eradication rate of VPZ-based first-line therapy, whereas the success rate of EPZ-based therapy was lower in patients under 65 years of age. Our results clearly demonstrated that VPZ-based therapy achieved a higher eradication rate even against CLR- and STFX-resistant H. pylori, and that patient age did not affect the eradication rate of VPZ-based therapy. These findings suggest that dual therapy using VPZ and amoxicillin may be sufficient for standard H. pylori eradication, and may thus also be beneficial for avoiding antibiotic misuse.

The case is presented of a 36-year-old woman with a plasma-cell granuloma arising in the fourth ventricle. The mass appeared on computerized tomography as a well circumscribed area of slightly high density that was markedly enhanced with contrast medium. Microscopic examination showed a mixed-cell population with a predominance of plasma cells, and the tumor was characterized immunohistochemically by polyclonal plasma-cell proliferation.