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Introduction The abdominal desmoid tumor shows invasive development and high local recurrence rate. The primary treatment method is complete removal of the tumor because of the high recurrence rate; however, the problem for the surgeon is the reconstruction of the abdominal wall after resection of the abdominal desmoid tumor. Case Presentation A 63-year-old man underwent open drainage and ileostomy for the perforation of ileocecal tumor. After 3 months, he underwent right hemicolectomy and ileostomy closure. Pathological examination revealed no malignancy, and the ileocecal tumor showed the presence of abscess. He noticed a palpable mass in the left abdomen. Enhanced abdominal computed tomography (CT) revealed a large abdominal incisional hernia and an enhanced mass of 40 mm in the left rectus muscle. Needle biopsy was performed and the diagnosis was desmoid tumor. He underwent resection of the desmoid tumor and repair of hernia. We performed wide local resection, with a 2-cm surgical margin. The hernia was repaired by simple closure, and the defect in the left abdomen was repaired with reconstruction using the fascia lata patch through plastic surgery. Conclusion We encountered a case of abdominal wall desmoid tumor combined with a large abdominal incisional hernia. We selected the use of autologous fascia based on the risk of recurrence. The patient has not shown recurrence of incisional hernia or desmoid tumor 22 months after surgery. The use of fascia lata patch can be considered as a satisfactory alternative for such reconstruction cases.

Patients with liver metastases from colorectal cancer (CRLMs) frequently receive chemotherapy prior to liver resection. Histopathological assessment of the resected specimen can evaluate the response to chemotherapy. The present study analyzed the association between histopathological changes in the primary site and liver metastases. The present study comprised 45 patients with resectable CRLMs at the Surgical Oncology Department of Gifu University School of Medicine (Gifu, Japan) between January 2006 and August 2015. The study included 24 men and 21 women. The primary colonic tumor was located in the right side in 13 (28.9%) patients and the left side in 32 (71.9%) patients. The present study evaluated patients with metastatic colorectal cancer (31/45) after excluding those in whom histopathological heterogeneity between the primary and liver metastasis changed to grade 3 after chemotherapy. The group that underwent hepatectomy after chemotherapy (n=25) was compared with the group that underwent hepatectomy alone (n=6). In 16 (53.3%) out of 25 patients, histopathological heterogeneity of the liver metastasis was lost (P=0.04). In conclusion, chemotherapy appeared to change histopathological heterogeneity. The present study suggested that the histopathological change of intratumoral heterogeneity is reflected by the response to chemotherapy.

Ayana Goto, Nobuhisa Matsuhashi, Takao Takahashi, Toshiyuki Tanahashi, Satoshi Matsui, Hisashi Imai, Yoshihiro Tanaka, Kazuya Yamaguchi, Kazuhiro Yoshida Department of Surgical Oncology, Gifu University School of Medicine, Gifu City 501-1194, JapanCorrespondence: Nobuhisa MatsuhashiDepartment of Surgical Oncology, Gifu University School of Medicine, 1-1 Yanagido, Gifu City 501-1194, JapanTel +81-58-230-6233Fax +81-58-230-1074Email nobuhisa517@hotmail.comIntroduction: The abdominal desmoid tumor shows invasive development and high local recurrence rate. The primary treatment method is complete removal of the tumor because of the high recurrence rate; however, the problem for the surgeon is the reconstruction of the abdominal wall after resection of the abdominal desmoid tumor.Case Presentation: A 63-year-old man underwent open drainage and ileostomy for the perforation of ileocecal tumor. After 3 months, he underwent right hemicolectomy and ileostomy closure. Pathological examination revealed no malignancy, and the ileocecal tumor showed the presence of abscess. He noticed a palpable mass in the left abdomen. Enhanced abdominal computed tomography (CT) revealed a large abdominal incisional hernia and an enhanced mass of 40 mm in the left rectus muscle. Needle biopsy was performed and the diagnosis was desmoid tumor. He underwent resection of the desmoid tumor and repair of hernia. We performed wide local resection, with a 2-cm surgical margin. The hernia was repaired by simple closure, and the defect in the left abdomen was repaired with reconstruction using the fascia lata patch through plastic surgery.Conclusion: We encountered a case of abdominal wall desmoid tumor combined with a large abdominal incisional hernia. We selected the use of autologous fascia based on the risk of recurrence. The patient has not shown recurrence of incisional hernia or desmoid tumor 22 months after surgery. The use of fascia lata patch can be considered as a satisfactory alternative for such reconstruction cases.Keywords: abdominal desmoid tumor, incisional hernia, abdominal wall reconstruction, autologous fascia

Okada, Y., Kiguchi, T., Irisawa, T. et al. Association between low pH and unfavorable neurological outcome among out-of-hospital cardiac arrest patients treated by extracorporeal CPR: a prospective observational cohort study in Japan. j intensive care 8, 34 (2020). https://doi.org/10.1186/s40560-020-00451-6, Background: We aimed to identify the association of pH value in blood gas assessment with neurological outcome among out-of-hospital cardiac arrest (OHCA) patients treated by extracorporeal cardiopulmonary resuscitation (ECPR). Methods: We retrospectively analyzed the database of a multicenter prospective observational study on OHCA patients in Osaka prefecture, Japan (CRITICAL study), from July 1, 2012 to December 31, 2016. We included adult OHCA patients treated by ECPR. Patients with OHCA from external causes such as trauma were excluded. We conducted logistic regression analysis to identify the odds ratio (OR) and 95% confidence interval (CI) of the pH value for 1 month favorable neurological outcome adjusted for potential confounders including sex, age, witnessed by bystander, CPR by bystander, pre-hospital initial cardiac rhythm, and cardiac rhythm on hospital arrival. Results: Among the 9822 patients in the database, 260 patients were finally included in the analysis. The three groups were Tertile 1: pH ≥ 7.030, Tertile 2: pH 6.875-7.029, and Tertile 3: pH < 6.875. The adjusted OR of Tertiles 2 and 3 compared with Tertile 1 for 1 month favorable neurological outcome were 0.26 (95% CI 0.10-0.63) and 0.24 (95% CI 0.09-0.61), respectively. Conclusions: This multi-institutional observational study showed that low pH value (< 7.03) before the implementation of ECPR was associated with 1 month unfavorable neurological outcome among OHCA patients treated with ECPR. It may be helpful to consider the candidate for ECPR.

Additional file 1: S-Table 1. The characteristics of patients with missing BGA. S-Table 2. Original cohort (N=260). S-Table 3. Expected outcome among the excluded patients in the assumption (N=123). S-Table 4. The crude and adjusted ORs of other covariates. S-Table 5. The results of sensitivity analysis. S-Figure. Flow chart in sensitivity analysis.

Additional file 1.

学位の種別: 課程博士, 審査委員会委員 : （主査）東京大学教授 秋山 徹, （副査）東京大学教授 宮島 篤, 東京大学准教授 入江 直樹, 東京大学教授 深田 吉孝, 東京医科歯科大学教授 仁科 博史

Dry gas cleaning was performed using five different commercial activated carbons (ACs) at 150-300°C. Phenol, o-cresol, naphthalene, and 1-methylnaphthalene were employed as the tar model compounds that produced from biomass gasification. The effect of the adsorption temperature and physical characteristics of ACs on the adsorption behaviors such as the breakthrough curves and adsorption capacities was investigated using a fixed-bed reactor. At 150°C, o-cresol and naphthalene were effectively removed; the adsorption capacities of the ACs were 13.4-19.4g-tar/(100g-AC) and 19.9-23.7g-tar/(100g-AC) in o-cresol and naphthalene, respectively. For effective tar removal, a larger surface area, a smaller average particle size, and an appropriate pore diameter were necessary. The effect of the tar model compounds on the adsorption behavior was investigated using the same AC at 150°C. The adsorption capacity was found to be 10.5-32.6g-tar/(100g-AC) in the following order : phenol

This paper presents a new dressing method, rotation type single point diamond dressing (RSPD dressing), in which a single point diamond dresser is rotated and fed to the direction of a wheel axis. The paper compares the dressing characteristics by this method with those of conventional single point diamond dressing (CSPD dressing). Main results obtained are as follows : (1) While the diamond edge form changes in CSPD dressing, it is almost maintained constant in RSPD dressing. (2) The wear of diamond edge in RSPD dressing is remarkably reduced compared with CSPD dressing. (3) In CSPD dressing, surface roughness changes as the wear of diamond edge. On the contrary, it is kept nearly constant in RSPD dressing because of the stability of the diamond edge form.

論文タイプ||論説, (経済学部号 = Economics)

論文タイプ||論説, (経済学部号 = Economics)

論文タイプ||論説

Made available in DSpace on 2022-04-28T18:54:25Z (GMT). No. of bitstreams: 0 Previous issue date: 1998-01-01 A 30-bp deletion in the Epstein-Barr virus (EBV) latent membrane protein 1 (LMP1) gene has been reported in nasopharyngeal carcinoma and EBV- associated malignant lymphomas. Information on this deletion in EBV- associated gastric carcinoma (EBVaGC) is limited. The association of gastric carcinoma (GC) with EBV was examined by EBV-encoded RNA (EBER) in situ hybridization in 510 patients from Japan and 80 patients from Brazil. We studied the prevalence of 30-bp LMP1 gene deletion in EBVaGC in Japan (29 cases) and Brazil (four cases) in comparison with the corresponding EBER1- positive metastatic lesions in lymph nodes (10 cases) and EBV-infected reactive lymphocytes from dissected nonmetastatic lymph nodes (22 cases), microdissected non-neoplastic gastric mucosa of EBVaGC (five cases), and EBV- nonassociated GC (25 cases). We studied the status of the LMP1 gene by Southern blot hybridization of polymerase chain reaction products obtained after amplification with primers flanking the site of the deletion. We also performed EBV typing and LMP1 protein immunohistochemistry. EBV DNA was amplified by polymerase chain reaction in 30 of 33 EBVaGC cases, 8 of 10 metastatic carcinomas, 14 non-neoplastic tissues from 27 EBVaGC cases, and 12 of 25 non-EBV-associated GC cases with EBER1-positive lymphocytes. The 30-bp LMP1 gene deletion was observed in 23 of 26 (88.5%) cases of EBVaGC from Japan and two of four (50%) cases of Brazilian EBVaGC as compared with EBER1- positive reactive lymphocytes from 11 of 14 (78.6%) EBVaGC cases and 9 of 12 (75%) cases of non-EBV-associated GC. The variant type (the 30-bp deletion variant or nondeleted wild type) of LMP1 gene was the same among reactive lymphocytes, primary and secondary lesions of EBVaGC in all cases for which all three tissue types were studied (six of six). There was no correlation between the presence of the 30-bp deletion with depth of cancer invasion or presence of metastasis. Type A was detected in all available EBV-positive cases. The similar high incidence of 30-bp deletion in LMP1 gene in both carcinoma cells and reactive lymphocytes in EBVaGC cases suggests that this deletion may not be relevant to the pathogenesis of EBVaGC. Department of Pathology City of Hope National Medical Center, Duarte, CA Iwakuni National Hospital, Iwakuni Okayama University Medical School, Okayama Okayama Saiseikai General Hospital, Okayama Jyugen General Hospital, Niihama State University of Sao Paulo, Botucatu Division of Pathology City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010