Objectives:This study aimed to clarify the significance of therapeutic timing on the effectiveness of nivolumab for treating metastatic renal cell carcinoma.Marterials and methods:Fifty-eight patients with metastatic ...Objectives:This study aimed to clarify the significance of therapeutic timing on the effectiveness of nivolumab for treating metastatic renal cell carcinoma.Marterials and methods:Fifty-eight patients with metastatic renal cell carcinoma treated with nivolumab monotherapy were retrospectively studied.Patients who were treated with nivolumab as second-line therapy were included in the second-line group,while the others were included in the later-line group.The clinicopathological characteristics,effects of nivolumab,and prognoses of these groups were compared.Results:Twenty and thirty-eight patients were included in the second-line and later-line groups,respectively.There were no significant differences in the distribution of International Metastatic Renal Cell Carcinoma Database Consotium risk and other clinicopathological characteristics between the 2 groups.The proportion of patients whose objective best response was progressive disease in the second-line group was significantly lower than that in the later-line group(15%vs.50%,p=0.0090).The 50%progression-free survival with nivolumab in the second-line group was significantly better than that in the later-line group(not reached and 5 months,p=0.0018).Multivariate analysis showed that the second-line setting was an independent predictive factor for better progression-free survival(p=0.0028,hazard ratio=0.108).The 50%overall survival after starting nivolumab in the second-line and later-line groups was not reached and 27.8 months,respectively(p=0.2652).Conclusions:The therapeutic efficacy of nivolumab as second-line therapy is expected to be better than that of later therapy.展开更多
Since the automobile turbochargers are installed in an engine compartment with limited space, the ducts upstream of the turbocharger compressor may be curved in a complex manner. In the present paper, the effect of a ...Since the automobile turbochargers are installed in an engine compartment with limited space, the ducts upstream of the turbocharger compressor may be curved in a complex manner. In the present paper, the effect of a curved duct upstream on performance of small centrifugal compressors for automobile turbochargers is discussed. The computational fluid dynamics (CFD) analysis of a turbocharger compressor validated for the compressor model with the straight pipe applied to the compressor with the curved pipe are executed, and the deterioration of the performance for the curved pipe is confirmed. It is also found that the deterioration of compressor performance is caused by the interaction of the secondary flow and the impeller.展开更多
A 71-year-old Japanese man with acute cholecystitis and an incarcerated gallbladder （GB） stone was admitted. Plain ultrasonography （US） incidentally detected a mass-like lesion in the fundus. Doppler US revealed t...A 71-year-old Japanese man with acute cholecystitis and an incarcerated gallbladder （GB） stone was admitted. Plain ultrasonography （US） incidentally detected a mass-like lesion in the fundus. Doppler US revealed that this elevated lesion had no blood flow. Computed tomography showed a relatively low-density mass, measuring 5 cm x 4 cm in diameter, with no positive enhancement. Magnetic resonance imaging showed a mass in the fundus with a slightly low intensity on Tl-weighted images and a slightly high intensity on T2-weighted images. We were agonized in making the qualitative diagnosis of mass-like lesions of the fundus, such as a benign tumor, cancer, or debris. We performed laparoscopic cholecystectomy, because the incarcerated GB stone clearly caused acute cholecystitis. Intra-operative cholangiography clearly revealed pancreaticobiliary maljunction. Amylase levels in the common bile duct and gallbladder were quite high. The elevated lesion in the fundus dearly showed severe necrosis. Although this necrotic nodule included non-viable adenocarcinoma cells, viable cancer cell nests were located in the muscularis propria and subcutaneous layer. Histopathological examination confirmed a solid adenocarcinoma. Thus, we diagnosed it as a gallbladder cancer, based on histopathological analysis of the resected specimen. We therefore undertook radical surgery, including wedge resection of the liver, radical dissection of regional lymph nodes, and resection of the extrahepatic bile duct. Histopathological findings revealed no cancer, hyperplasia or dysplasia in the additionally resected specimens. The patient was finally staged as T2, N0, H0, P0, M（-）, stage Ⅱ. We present the first case of spontaneous necrosis of solid gallbladder adenocarcinoma, with a review of previous studies.展开更多
Paleoclimatic settings have been reconstructed for the Campanian using original oxygenisotopic analyses of well-preserved molluskan and foraminifera shells from Russian Far East, Hokkaido, USA, Belgium and some DSDP h...Paleoclimatic settings have been reconstructed for the Campanian using original oxygenisotopic analyses of well-preserved molluskan and foraminifera shells from Russian Far East, Hokkaido, USA, Belgium and some DSDP holes （95, 98, 102, 390A, and 392A） in North Atlantic. Early Early Campanian climatic optimum has been recognized from data on high bottom shelf water paleotemperatures in middle latitudes of both the western circum-Pacific （to 24.2℃） and the eastern circum-Pacific （to 26.4℃） areas and high bottom shallow water paleotemperatures in high latitudes of the Koryak Upland （22.4-25.5℃）, which agrees with the data on the Campanian Barykovskaya flora in high latitudes （Golovneva and Herman, 1998） and Jonker flora and its equivalents in middle latitudes. Judging from the data on comparatively high bottom shallow water paleotemperature values in high latitudes, South Alaska （19.4℃） and the Koryak Upland （22.4-25.5℃）, we also expect Latest Campauian temperature maximum, which has not been confirmed, however, for low and middle latitudes by neither of isotopic nor paleobotanic data now. Main dimatic tendency during the Campanian （with the exception of Latest Campanian） has been learned from isotopic composition of Campanian aragonitic ammonoid shells from the Hokkaido-South Sakhalin （Krilyon） marine basin. In contrary to Huber＇s et al. （2002） assumption, we expect warm greenhouse conditions during the most part of the Campanian.展开更多
The numerical model was developed using a SPH (Smoothed Particle Hydrodynamics) method and the projected transfer phenomena during a GMA (Gas Metal Arc) welding were simulated by the model to clarify mechanisms of the...The numerical model was developed using a SPH (Smoothed Particle Hydrodynamics) method and the projected transfer phenomena during a GMA (Gas Metal Arc) welding were simulated by the model to clarify mechanisms of the phenomena. As a result, the droplet transfer mode obtained from this calculation was regarded as a projected transfer mode in which the liquid column grew about 1 mm and a droplet grew up until its diameter became large the same as a wire diameter,?after that it was detached from the tip of the column. In addition, 10 droplets were formed for 0.1 s through these growth and detachment processes at the tip of a wire. To compare with the numerical results, actual GMA welding was carried out and molten metal droplet transfers were taken by high speed camera. The diameter of a wire, the length of a liquid column, the velocity of a droplet right before it reached a weld pool obtained by simulation showed good agreement with experiment.展开更多
Background:Participation in physical activity supports greater cardiorespiratory fitness(CRF),a correlate of cognitive control.However,the relationship between muscular fitness(MF)and cognitive control is less clear.T...Background:Participation in physical activity supports greater cardiorespiratory fitness(CRF),a correlate of cognitive control.However,the relationship between muscular fitness(MF)and cognitive control is less clear.The present study investigated the differential relationship of CRF and MF with cognitive control in older adolescents.Methods:This cross-sectional study involved students(1517 years old,n=541,43%female)from 20 secondary schools who completed tests of inhibition(modified flanker task),working memory(n-back task),CRF(Progressive Aerobic Cardiovascular Endurance Run),and MF(standing long jump and push-up test).Multilevel analyses tested the association between CRF or MF and cognitive outcomes while accounting for the influence of the other fitness variable and relevant demographic factors.Results:CRF predicted response accuracy during incongruent flanker trials,the condition requiring greater inhibition.For the working memory task,CRF predicted greater target accuracy and greater d’scores on the 1-back task,requiring lesser amounts of working memory.In the 2-back task,which requires greater amounts of working memory,CRF also predicted greater target and non-target accuracy and d’scores.Comparatively,MF did not predict any cognitive outcomes after adjustment for CRF.Conclusion:CRF was selectively related to better performance during task conditions that require greater amounts of inhibition and working memory.This finding suggests that CRF,but not MF,may benefit cognitive control in older adolescents.This selective influence of CRF on older adolescents’cognition highlights the value of aerobic physical activity.展开更多
Cavernous hemangiomas can arise in any region of the body, including the central nervous system. Spinal cavernous hemangiomas account for 5% - 12% of all cases of vertebral vascular malformation. Most of these are of ...Cavernous hemangiomas can arise in any region of the body, including the central nervous system. Spinal cavernous hemangiomas account for 5% - 12% of all cases of vertebral vascular malformation. Most of these are of vertebral origin, and cases that are non-vertebral in origin are rare. We encountered a patient with a relatively rare spinal epidural cavernous hemangioma of the thoracic spine that was non-vertebral in origin. The patient was a 63-year-old man. He had become aware of bilateral leg pain and numbness about 2 months earlier, and gait disturbance appeared gradually thereafter. On MRI, a lesion showing iso-intensity on T1-weighted imaging and high intensity on T2-weighted imaging was detected at the 7th thoracic vertebra. On gadolinium contrast-imaging, the lesion was found to be a homogenously-enhanced dumbbell-shaped extradural spinal neoplasm protruding from the left 7th/8th thoracic intervertebral foramen. A neurogenic tumor was suspected based on myelography and MRI findings, and complete tumorectomy was performed, which improved the lower limb symptoms and gait disturbance. The histopathological diagnosis was cavernous hemangioma. Epidural hemangiomas arise from the vertebra in many cases, and pure spinal epidural cavernous hemangiomas are rare. It is difficult to make a preoperative diagnosis because there are no specific imaging findings that can differentiate these tumors. It may be important to consider this disease before surgery in the differential diagnosis of epidural tumors.展开更多
The purpose of this study was to estimate the Coniacian latitudinal thermal gradient in the Northern Hemisphere. Both hemipelagic （ammonoids） and benthic （brachiopods and bivalves） δ18O and δ^13C records were us...The purpose of this study was to estimate the Coniacian latitudinal thermal gradient in the Northern Hemisphere. Both hemipelagic （ammonoids） and benthic （brachiopods and bivalves） δ18O and δ^13C records were used. They originated from Coniacian shallow-water sequences across a wide range of paleolatitudes, from the Koryak upland （northern Kamchatka, Russian Far East） in the north, to Hokkaido （Japan） in the south. Among Coniacian ammonoids, both migrants from Hokkaido living in high latitudes （Kamchatka） and endemic forms dwelling in middle-low latitudes （Hokkaido） indicate seemingly close optimal growth temperatures. Nevertheless, certain differences in climatic conditions, prevailing during high-latitude coldest seasons, undoubtedly provoked growth cessation in some groups of ammonites. Our isotopic study suggests latitudinal temperature changes of only 0.12 ℃ per degree of latitude for the Northern Hemisphere in Coniacian times, while the average annual temperature in North Kamchatka seems about 3.3 ℃ lower than that in Hokkaido.展开更多
Primary liposarcoma outside thighs is rare.We present two forensic autopsy cases of clinically undiagnosed primary liposarcoma(Case 1:Mediastinum,Case 2:Mesentery).Case 1 was a thin male in his 60s who had a well‑diff...Primary liposarcoma outside thighs is rare.We present two forensic autopsy cases of clinically undiagnosed primary liposarcoma(Case 1:Mediastinum,Case 2:Mesentery).Case 1 was a thin male in his 60s who had a well‑differentiated liposarcoma(850 g,23 cm×20 cm×10 cm)in the superior mediastinum.Case 2 was a thin female in her 50s who had a pleomorphic liposarcoma(10 kg,40 cm×25 cm×11 cm)in the abdominal cavity with liver metastases.The cause of death in Case 1 was airway obstruction due to liposarcoma of the neck;that in Case 2 was complications of liposarcoma with metastasis.Because liposarcoma often appears in deeper tissue without pain,it will grow quite large before it is noticed.展开更多
background We previously reported a pilot study of temporary umbilical loop colostomy for neonates with intermediate-type anorectal malformations(ARM)and recommended this technique because of its cosmetic excellence.W...background We previously reported a pilot study of temporary umbilical loop colostomy for neonates with intermediate-type anorectal malformations(ARM)and recommended this technique because of its cosmetic excellence.We herein report the postoperative complications of umbilical stomas(US)compared with traditional abdominal stomas(AS).Methods From our institutional prospective database,we analyzed the patients with ARMs who underwent stoma creation at Kansai Medical University Hospital from January 1995 to November 2016.The surgical technique used to create the US had been performed since 2004.results US and AS were made for 12 and 27 patients with ARMs,respectively.The postoperative complication rates in patients who underwent US and AS had no significant difference(17%and 11%,p=0.6).The complications comprised a wound infection(one case of US),ileus(one case each of US and AS),mucosal prolapse(one case of AS),and depression(one case of AS).No emergency surgery was required for these complications.Conclusion For patients with ARMs,the umbilicus appears to be a safe alternative site for temporary loop colostomy.展开更多
3D time-dependent simulations are performed using a computational method suitable for thermal plasma flows to capture a turbulent field induced by a thermal plasma jet and steep gradients in nanopowder distributions. ...3D time-dependent simulations are performed using a computational method suitable for thermal plasma flows to capture a turbulent field induced by a thermal plasma jet and steep gradients in nanopowder distributions. A mathematical model with a simple form is developed to describe effectively simultaneous processes of growth and transport of nanopowder in/around a thermal plasma flow. This growth-transport model obtains the spatial distributions of the number density and mean diameter of nanopowder with a lower computational cost. The results show that an argon thermal plasma jet induces multi-scale vortices even far from itself. A double-layer structure of high-temperature thicker vortex rings surrounded by low-temperature thinner vortex rings is generated in the upstream region. As the vortex rings flow downstream, the high-temperature thicker vortex rings deform largely whereas the low-temperature thinner vortex rings break up?into smaller vortices. Nanopowder is generated at the fringe of plasma and transported widely outside the plasma region. The nanopowder grows up collectively by coagulation decreasing particle number as well as homogeneous nucleation and heterogeneous condensation. When a uniform magnetic field is applied in the axial direction, a longer and straighter thermal plasma jet is obtained because of Lorentz force and Joule heating. Larger nanopowder is produced around the plasma because turbulent diffusions of silicon vapor and nanoparticles by vortices are suppressed as well.展开更多
Aphasia is a higher brain dysfunction that affects the production or comprehension of speech and the ability to read or write. The purpose of this research is to establish support guidelines based on a questionnaire s...Aphasia is a higher brain dysfunction that affects the production or comprehension of speech and the ability to read or write. The purpose of this research is to establish support guidelines based on a questionnaire survey and a language activity analysis of rehabilitation training so that volunteers can more easily assist disabled persons with aphasia. The focus of this study was the non-profit community-based intervention group Yokohama Aphasia Partner Group, which consists of members with aphasia, their families, speech-language-and-hearing therapists, psychiatric social workers, and volunteers. The following results were obtained. (1) Members with aphasia participate in the Partner Group because they can meet others with aphasia on a regular basis as well as participate in the aphasia rehabilitation program with the recovery of language functions. In addition to medical treatment, the community-based support, which improves the environment and other life contextual factors, is important for rehabilitation. (2) An individual with aphasia shows different language actions, and so an individually different support system in accordance with language activity is necessary.展开更多
We encountered a patient with thoracic disc herniation that extruded to the dorsal epidural space. The patient was a 78-year-old man in whom listlessness of the lower limbs developed without an inducer and walking bec...We encountered a patient with thoracic disc herniation that extruded to the dorsal epidural space. The patient was a 78-year-old man in whom listlessness of the lower limbs developed without an inducer and walking became difficult. The patient was diagnosed as having a thoracic spinal cord tumor on MRI by a physician, and was referred to our hospital. Since ring enhancement was observed on contrast MRI performed at our hospital, the patient was diagnosed with disc herniation and surgery was performed. A hernia continuous with the intervertebral space that extruded to the dorsal epidural space was excised. At the final follow up, 1 year and 4 months after surgery, the patient could walk with a cane. Among thoracic disc herniation cases, hernia extruded to the dorsal epidural space is rare and difficult to diagnose by imaging before surgery, but evaluation using contrast MRI is useful in the diagnosis. When a space-occupying lesion is observed in the spinal canal in the lower thoracic spinal region, it is necessary to evaluate it by contrast MRI in consideration of thoracic disc herniation.展开更多
This study uses statistical evaluation by correlation analysis to examine the effects of thermal environment on the frequency of convective precipitation in the Greater Tokyo Area between 12:00 and 18:00 on summer day...This study uses statistical evaluation by correlation analysis to examine the effects of thermal environment on the frequency of convective precipitation in the Greater Tokyo Area between 12:00 and 18:00 on summer days from 1997 to 2006. To extract the frequency of convective precipitation we used Automated Meteorological Data Acquisition System radar data to obtain detailed rainfall distribution maps, and to extract the urban thermal environment we used surface temperature data from a National Oceanic and Atmospheric Administration weather satellite. Results were a coefficient of determination of 0.01, indicating no clear relation between surface temperature and convective rain frequency in the study area. Examining the convective rain frequency distribution map in conjunction with an elevation map of the area indicates that higher elevation is a better predictor of increased frequency of convective rainfall than is surface temperature. Because this indicates that orographic precipitation has a large influence in the study area, we used an elevation map to exclude hilly and mountainous regions, regions bordering flat areas (under the assumption that wind could easily move orographic precipitation to such areas), and regions containing marine areas. Doing so resulted in a coefficient of determination of 0.38, a clear signal that differences in the thermal environment in the Greater Tokyo Area have an effect on the frequency of convective precipitation. We next focused on metropolitan Tokyo, the most developed part of the region and the part experiencing the most frequent occurrences of convective precipitation, and we performed correlation analysis considering parameters related to buildings. Results indicate that orographic precipitation has a strong influence in metropolitan Tokyo as well, so we excluded those areas that were excluded from the Greater Tokyo Area analysis and again performed correlation analysis. However, we found no clear relation of convective precipitation frequency with surface temperature o展开更多
文摘Objectives:This study aimed to clarify the significance of therapeutic timing on the effectiveness of nivolumab for treating metastatic renal cell carcinoma.Marterials and methods:Fifty-eight patients with metastatic renal cell carcinoma treated with nivolumab monotherapy were retrospectively studied.Patients who were treated with nivolumab as second-line therapy were included in the second-line group,while the others were included in the later-line group.The clinicopathological characteristics,effects of nivolumab,and prognoses of these groups were compared.Results:Twenty and thirty-eight patients were included in the second-line and later-line groups,respectively.There were no significant differences in the distribution of International Metastatic Renal Cell Carcinoma Database Consotium risk and other clinicopathological characteristics between the 2 groups.The proportion of patients whose objective best response was progressive disease in the second-line group was significantly lower than that in the later-line group(15%vs.50%,p=0.0090).The 50%progression-free survival with nivolumab in the second-line group was significantly better than that in the later-line group(not reached and 5 months,p=0.0018).Multivariate analysis showed that the second-line setting was an independent predictive factor for better progression-free survival(p=0.0028,hazard ratio=0.108).The 50%overall survival after starting nivolumab in the second-line and later-line groups was not reached and 27.8 months,respectively(p=0.2652).Conclusions:The therapeutic efficacy of nivolumab as second-line therapy is expected to be better than that of later therapy.
文摘Since the automobile turbochargers are installed in an engine compartment with limited space, the ducts upstream of the turbocharger compressor may be curved in a complex manner. In the present paper, the effect of a curved duct upstream on performance of small centrifugal compressors for automobile turbochargers is discussed. The computational fluid dynamics (CFD) analysis of a turbocharger compressor validated for the compressor model with the straight pipe applied to the compressor with the curved pipe are executed, and the deterioration of the performance for the curved pipe is confirmed. It is also found that the deterioration of compressor performance is caused by the interaction of the secondary flow and the impeller.
文摘A 71-year-old Japanese man with acute cholecystitis and an incarcerated gallbladder （GB） stone was admitted. Plain ultrasonography （US） incidentally detected a mass-like lesion in the fundus. Doppler US revealed that this elevated lesion had no blood flow. Computed tomography showed a relatively low-density mass, measuring 5 cm x 4 cm in diameter, with no positive enhancement. Magnetic resonance imaging showed a mass in the fundus with a slightly low intensity on Tl-weighted images and a slightly high intensity on T2-weighted images. We were agonized in making the qualitative diagnosis of mass-like lesions of the fundus, such as a benign tumor, cancer, or debris. We performed laparoscopic cholecystectomy, because the incarcerated GB stone clearly caused acute cholecystitis. Intra-operative cholangiography clearly revealed pancreaticobiliary maljunction. Amylase levels in the common bile duct and gallbladder were quite high. The elevated lesion in the fundus dearly showed severe necrosis. Although this necrotic nodule included non-viable adenocarcinoma cells, viable cancer cell nests were located in the muscularis propria and subcutaneous layer. Histopathological examination confirmed a solid adenocarcinoma. Thus, we diagnosed it as a gallbladder cancer, based on histopathological analysis of the resected specimen. We therefore undertook radical surgery, including wedge resection of the liver, radical dissection of regional lymph nodes, and resection of the extrahepatic bile duct. Histopathological findings revealed no cancer, hyperplasia or dysplasia in the additionally resected specimens. The patient was finally staged as T2, N0, H0, P0, M（-）, stage Ⅱ. We present the first case of spontaneous necrosis of solid gallbladder adenocarcinoma, with a review of previous studies.
文摘Paleoclimatic settings have been reconstructed for the Campanian using original oxygenisotopic analyses of well-preserved molluskan and foraminifera shells from Russian Far East, Hokkaido, USA, Belgium and some DSDP holes （95, 98, 102, 390A, and 392A） in North Atlantic. Early Early Campanian climatic optimum has been recognized from data on high bottom shelf water paleotemperatures in middle latitudes of both the western circum-Pacific （to 24.2℃） and the eastern circum-Pacific （to 26.4℃） areas and high bottom shallow water paleotemperatures in high latitudes of the Koryak Upland （22.4-25.5℃）, which agrees with the data on the Campanian Barykovskaya flora in high latitudes （Golovneva and Herman, 1998） and Jonker flora and its equivalents in middle latitudes. Judging from the data on comparatively high bottom shallow water paleotemperature values in high latitudes, South Alaska （19.4℃） and the Koryak Upland （22.4-25.5℃）, we also expect Latest Campauian temperature maximum, which has not been confirmed, however, for low and middle latitudes by neither of isotopic nor paleobotanic data now. Main dimatic tendency during the Campanian （with the exception of Latest Campanian） has been learned from isotopic composition of Campanian aragonitic ammonoid shells from the Hokkaido-South Sakhalin （Krilyon） marine basin. In contrary to Huber＇s et al. （2002） assumption, we expect warm greenhouse conditions during the most part of the Campanian.
文摘The numerical model was developed using a SPH (Smoothed Particle Hydrodynamics) method and the projected transfer phenomena during a GMA (Gas Metal Arc) welding were simulated by the model to clarify mechanisms of the phenomena. As a result, the droplet transfer mode obtained from this calculation was regarded as a projected transfer mode in which the liquid column grew about 1 mm and a droplet grew up until its diameter became large the same as a wire diameter,?after that it was detached from the tip of the column. In addition, 10 droplets were formed for 0.1 s through these growth and detachment processes at the tip of a wire. To compare with the numerical results, actual GMA welding was carried out and molten metal droplet transfers were taken by high speed camera. The diameter of a wire, the length of a liquid column, the velocity of a droplet right before it reached a weld pool obtained by simulation showed good agreement with experiment.
基金Support for this project was provided by the National Health and Medical Research Council(APP1120518)。
文摘Background:Participation in physical activity supports greater cardiorespiratory fitness(CRF),a correlate of cognitive control.However,the relationship between muscular fitness(MF)and cognitive control is less clear.The present study investigated the differential relationship of CRF and MF with cognitive control in older adolescents.Methods:This cross-sectional study involved students(1517 years old,n=541,43%female)from 20 secondary schools who completed tests of inhibition(modified flanker task),working memory(n-back task),CRF(Progressive Aerobic Cardiovascular Endurance Run),and MF(standing long jump and push-up test).Multilevel analyses tested the association between CRF or MF and cognitive outcomes while accounting for the influence of the other fitness variable and relevant demographic factors.Results:CRF predicted response accuracy during incongruent flanker trials,the condition requiring greater inhibition.For the working memory task,CRF predicted greater target accuracy and greater d’scores on the 1-back task,requiring lesser amounts of working memory.In the 2-back task,which requires greater amounts of working memory,CRF also predicted greater target and non-target accuracy and d’scores.Comparatively,MF did not predict any cognitive outcomes after adjustment for CRF.Conclusion:CRF was selectively related to better performance during task conditions that require greater amounts of inhibition and working memory.This finding suggests that CRF,but not MF,may benefit cognitive control in older adolescents.This selective influence of CRF on older adolescents’cognition highlights the value of aerobic physical activity.
文摘Cavernous hemangiomas can arise in any region of the body, including the central nervous system. Spinal cavernous hemangiomas account for 5% - 12% of all cases of vertebral vascular malformation. Most of these are of vertebral origin, and cases that are non-vertebral in origin are rare. We encountered a patient with a relatively rare spinal epidural cavernous hemangioma of the thoracic spine that was non-vertebral in origin. The patient was a 63-year-old man. He had become aware of bilateral leg pain and numbness about 2 months earlier, and gait disturbance appeared gradually thereafter. On MRI, a lesion showing iso-intensity on T1-weighted imaging and high intensity on T2-weighted imaging was detected at the 7th thoracic vertebra. On gadolinium contrast-imaging, the lesion was found to be a homogenously-enhanced dumbbell-shaped extradural spinal neoplasm protruding from the left 7th/8th thoracic intervertebral foramen. A neurogenic tumor was suspected based on myelography and MRI findings, and complete tumorectomy was performed, which improved the lower limb symptoms and gait disturbance. The histopathological diagnosis was cavernous hemangioma. Epidural hemangiomas arise from the vertebra in many cases, and pure spinal epidural cavernous hemangiomas are rare. It is difficult to make a preoperative diagnosis because there are no specific imaging findings that can differentiate these tumors. It may be important to consider this disease before surgery in the differential diagnosis of epidural tumors.
基金supported by the International Field Expedition Programme of Japan (No. 10041109)DVO RAN (No. 09-III-A-08-402)
文摘The purpose of this study was to estimate the Coniacian latitudinal thermal gradient in the Northern Hemisphere. Both hemipelagic （ammonoids） and benthic （brachiopods and bivalves） δ18O and δ^13C records were used. They originated from Coniacian shallow-water sequences across a wide range of paleolatitudes, from the Koryak upland （northern Kamchatka, Russian Far East） in the north, to Hokkaido （Japan） in the south. Among Coniacian ammonoids, both migrants from Hokkaido living in high latitudes （Kamchatka） and endemic forms dwelling in middle-low latitudes （Hokkaido） indicate seemingly close optimal growth temperatures. Nevertheless, certain differences in climatic conditions, prevailing during high-latitude coldest seasons, undoubtedly provoked growth cessation in some groups of ammonites. Our isotopic study suggests latitudinal temperature changes of only 0.12 ℃ per degree of latitude for the Northern Hemisphere in Coniacian times, while the average annual temperature in North Kamchatka seems about 3.3 ℃ lower than that in Hokkaido.
文摘Primary liposarcoma outside thighs is rare.We present two forensic autopsy cases of clinically undiagnosed primary liposarcoma(Case 1:Mediastinum,Case 2:Mesentery).Case 1 was a thin male in his 60s who had a well‑differentiated liposarcoma(850 g,23 cm×20 cm×10 cm)in the superior mediastinum.Case 2 was a thin female in her 50s who had a pleomorphic liposarcoma(10 kg,40 cm×25 cm×11 cm)in the abdominal cavity with liver metastases.The cause of death in Case 1 was airway obstruction due to liposarcoma of the neck;that in Case 2 was complications of liposarcoma with metastasis.Because liposarcoma often appears in deeper tissue without pain,it will grow quite large before it is noticed.
基金This study was supported by the research fund of the Department of Surgery of Kansai Medical University.
文摘background We previously reported a pilot study of temporary umbilical loop colostomy for neonates with intermediate-type anorectal malformations(ARM)and recommended this technique because of its cosmetic excellence.We herein report the postoperative complications of umbilical stomas(US)compared with traditional abdominal stomas(AS).Methods From our institutional prospective database,we analyzed the patients with ARMs who underwent stoma creation at Kansai Medical University Hospital from January 1995 to November 2016.The surgical technique used to create the US had been performed since 2004.results US and AS were made for 12 and 27 patients with ARMs,respectively.The postoperative complication rates in patients who underwent US and AS had no significant difference(17%and 11%,p=0.6).The complications comprised a wound infection(one case of US),ileus(one case each of US and AS),mucosal prolapse(one case of AS),and depression(one case of AS).No emergency surgery was required for these complications.Conclusion For patients with ARMs,the umbilicus appears to be a safe alternative site for temporary loop colostomy.
文摘3D time-dependent simulations are performed using a computational method suitable for thermal plasma flows to capture a turbulent field induced by a thermal plasma jet and steep gradients in nanopowder distributions. A mathematical model with a simple form is developed to describe effectively simultaneous processes of growth and transport of nanopowder in/around a thermal plasma flow. This growth-transport model obtains the spatial distributions of the number density and mean diameter of nanopowder with a lower computational cost. The results show that an argon thermal plasma jet induces multi-scale vortices even far from itself. A double-layer structure of high-temperature thicker vortex rings surrounded by low-temperature thinner vortex rings is generated in the upstream region. As the vortex rings flow downstream, the high-temperature thicker vortex rings deform largely whereas the low-temperature thinner vortex rings break up?into smaller vortices. Nanopowder is generated at the fringe of plasma and transported widely outside the plasma region. The nanopowder grows up collectively by coagulation decreasing particle number as well as homogeneous nucleation and heterogeneous condensation. When a uniform magnetic field is applied in the axial direction, a longer and straighter thermal plasma jet is obtained because of Lorentz force and Joule heating. Larger nanopowder is produced around the plasma because turbulent diffusions of silicon vapor and nanoparticles by vortices are suppressed as well.
文摘Aphasia is a higher brain dysfunction that affects the production or comprehension of speech and the ability to read or write. The purpose of this research is to establish support guidelines based on a questionnaire survey and a language activity analysis of rehabilitation training so that volunteers can more easily assist disabled persons with aphasia. The focus of this study was the non-profit community-based intervention group Yokohama Aphasia Partner Group, which consists of members with aphasia, their families, speech-language-and-hearing therapists, psychiatric social workers, and volunteers. The following results were obtained. (1) Members with aphasia participate in the Partner Group because they can meet others with aphasia on a regular basis as well as participate in the aphasia rehabilitation program with the recovery of language functions. In addition to medical treatment, the community-based support, which improves the environment and other life contextual factors, is important for rehabilitation. (2) An individual with aphasia shows different language actions, and so an individually different support system in accordance with language activity is necessary.
文摘We encountered a patient with thoracic disc herniation that extruded to the dorsal epidural space. The patient was a 78-year-old man in whom listlessness of the lower limbs developed without an inducer and walking became difficult. The patient was diagnosed as having a thoracic spinal cord tumor on MRI by a physician, and was referred to our hospital. Since ring enhancement was observed on contrast MRI performed at our hospital, the patient was diagnosed with disc herniation and surgery was performed. A hernia continuous with the intervertebral space that extruded to the dorsal epidural space was excised. At the final follow up, 1 year and 4 months after surgery, the patient could walk with a cane. Among thoracic disc herniation cases, hernia extruded to the dorsal epidural space is rare and difficult to diagnose by imaging before surgery, but evaluation using contrast MRI is useful in the diagnosis. When a space-occupying lesion is observed in the spinal canal in the lower thoracic spinal region, it is necessary to evaluate it by contrast MRI in consideration of thoracic disc herniation.
文摘This study uses statistical evaluation by correlation analysis to examine the effects of thermal environment on the frequency of convective precipitation in the Greater Tokyo Area between 12:00 and 18:00 on summer days from 1997 to 2006. To extract the frequency of convective precipitation we used Automated Meteorological Data Acquisition System radar data to obtain detailed rainfall distribution maps, and to extract the urban thermal environment we used surface temperature data from a National Oceanic and Atmospheric Administration weather satellite. Results were a coefficient of determination of 0.01, indicating no clear relation between surface temperature and convective rain frequency in the study area. Examining the convective rain frequency distribution map in conjunction with an elevation map of the area indicates that higher elevation is a better predictor of increased frequency of convective rainfall than is surface temperature. Because this indicates that orographic precipitation has a large influence in the study area, we used an elevation map to exclude hilly and mountainous regions, regions bordering flat areas (under the assumption that wind could easily move orographic precipitation to such areas), and regions containing marine areas. Doing so resulted in a coefficient of determination of 0.38, a clear signal that differences in the thermal environment in the Greater Tokyo Area have an effect on the frequency of convective precipitation. We next focused on metropolitan Tokyo, the most developed part of the region and the part experiencing the most frequent occurrences of convective precipitation, and we performed correlation analysis considering parameters related to buildings. Results indicate that orographic precipitation has a strong influence in metropolitan Tokyo as well, so we excluded those areas that were excluded from the Greater Tokyo Area analysis and again performed correlation analysis. However, we found no clear relation of convective precipitation frequency with surface temperature o
