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This study provides information on the disaster waste management practices and disposal methods employed in Kathmandu Valley for debris generated by the Gorkha Earthquake on April 25, 2015. We also quantify the amount of building debris generated and managed at destinations within the core city area of Kathmandu Valley, which was diverted from the government-proposed disposal site. This research involved field visits, interaction with communities, meetings with officers related to debris management, and reference to published reports. Disaster waste management in Nepal included the reuse/recycling of building materials in new construction or as filling materials in land development. Debris were also disposed on low-lying areas, down the cliff, and river bank; however, the disposal method was open dumping. Of the estimated 3.23 million tons of potential debris generated in the core city area of Kathmandu Valley, 1.07 million tons were managed 2 years after the Gorkha Earthquake, of which 0.63 million tons were disposed on river banks, along the ring road, and in open spaces, and the remaining 0.44 million tons were salvaged for reuse or sold for recycling or disposed in other isolated areas. Approximately 2.17 million tons of building debris is yet to be managed.

Significant quantities of building waste were generated from collapsed residential and dilapidated buildings as a result of the disastrous Gorkha earthquake in Nepal on April 25, 2015. In this study, in relation to the field damage investigation of the earthquake hit area and based on the building types, different types of building waste produced from each building are estimated and evaluated. An estimation procedure was established to assess the amount of debris resulting from earthquake. In Kathmandu Valley, different types of buildings generated different quantities of building waste per unit area, and the values for these building types ranged from 1.90 to 3.23 ton m− 2 in weight and 0.89 to 1.57 m3 m− 2 in volume respectively. Residential buildings in Nepal generated a larger amount of waste per unit area (ton m− 2) than buildings in Japan and China. Waste amounts (excluding that in the foundation) generated by public reinforced concrete buildings in Nepal were similar to the amounts generated by reinforced concrete buildings in Japan and China. Wooden buildings had the highest volume per unit area of building waste in Japan, as compared to those in Nepal and Sri Lanka. These results can be used to estimate the amount of building debris that must be cleared for emergency response after a disaster. This information is vital to pre-disaster planning to establish disaster management protocols for smooth recovery operations.

In this study, the amount of prevented household waste in Kyoto city was quantified using three methods. Subsequently, the greenhouse gas (GHG) emission reduction by waste prevention was calculated in order to monitor the impact of waste prevention. The methods of quantification were "relative change from baseline year (a)," "absolute change from potential waste generation (b)," and "absolute amount of activities (c)." Method (a) was popular for measuring waste prevention, but method (b) was the original approach to determine the absolute amount of waste prevention by estimating the potential waste generation. Method (c) also provided the absolute value utilizing the information of activities. Methods (b) and (c) enable the evaluation of the waste prevention activities with a similar baseline for recycling. Methods (b) and (c) gave significantly higher GHG reductions than method (a) because of the difference in baseline between them. Therefore, setting a baseline is very important for evaluating waste prevention. In practice, when focusing on the monitoring of a specific policy or campaign, method (a) is an appropriate option. On the other hand, when comparing the total impact of waste prevention to that of recycling, methods (b) and (c) should be applied.

Since end-of-life vehicles (ELVs) contain toxic substances, they have to be treated properly. The purpose of this study was to obtain useful information for ELV management from the viewpoint of toxicity. We focused on lead as a representative toxic substance contained in vehicles and investigated the dynamic substance flow of lead contained in ELVs and its content in automobile shredder residue (ASR). A population balance model was used to estimate the number of ELVs generated between FYs (fiscal year) 1990–2020, employing a Weibull distribution for the lifespan distribution. Sixteen lead-containing components of the vehicle were considered. It was estimated that the annual number of ELVs generated would be 2.9 million as of FY2020. The results implied that it is hard to remove Pb completely. This is because 5,000–11,000 t-Pb will still remain in vehicles in use in FY2020 even though most components in new model vehicles could be replaced by lead-free alternatives. As of FY2010, the substance flow showed that Pb contained in ELVs amounted to 4,600–5,700 t-Pb. Of this, 13.2–14.0 % was contained in ASR. The Pb content in ASR could be dramatically decreased by FY2020, but it will continue to contain 240–420 mg-Pb/kg if the treatment system is not improved.

高度の電解質・酸塩基平衡異常を呈する例では，時に透析療法が必要とされる場合がある．われわれは，劇症肝炎治療後に著明な電解質異常を呈し血液透析にて改善した1例を経験した．症例は31歳，男性，心房細動加療中．全身倦怠感を訴え近医受診．肝逸脱酵素の著明な上昇を認めたため当院を紹介．劇症肝炎と診断され入院のうえ血漿交換を第1～3病日に連日行い，引き続きステロイド大量療法を施行し，新鮮凍結血漿を投与した．肝障害は改善傾向であったが，電解質・酸塩基平衡異常が進行し，HCO3- 47.5 mmol/L，Na 164 mEq/L，K 2.0 mEq/Lと著明な代謝性アルカローシス，高Na血症，低K血症を呈した．電解質異常の原因として血漿交換やステロイド治療，グリチルリチン投与などの医原的要因が考えられた．腎不全（血清Cr 2.5 mg/dL）および心機能低下を合併し，保存的加療での補正は困難と考えられた．第8，9病日に血液透析を行い，電解質異常を補正することにより，全身状態は改善した．

Power consumption in unbaffled and baffled agitated vessels with propeller and pfaudler type impellers is measured over a wide range of Reynolds numbers from laminar to turbulent flow regions. The power correlation for the propeller and pfaudler type impellers is derived from modification of the previously proposed power correlation for a paddle impeller. The calculated correlation values agree well with experimental ones, and the same correlation can be applied to both propeller and pfaudler type impellers.

今回我々は，化学・放射線療法が著効し，原発巣には根治手術を行うことなく長期生存中のEwing/PNETの1例を経験したので報告する．症例は17歳，男性．右股関節痛を主訴に受診し，MRIにて右恥坐骨，右第7肋骨，頭蓋骨に腫瘍性病変を認めた．肋骨病変における生検の結果，直ちに化学・放射線療法を開始し各病巣は消退傾向を示したが，初診より1年9ヶ月後に左腸骨，右大腿骨に新たな転移性病変が出現した．その後も3年7ヶ月に渡り化学・放射線療法を継続し，いずれの病変においても腫瘍のviabilityの低下を認めたため，組織学的確認を兼ねて左腸骨転移病変に対してのみ切除術を施行し，組織学的には腫瘍細胞の100％壊死が確認された．初診時より8年8ヶ月の現在，各病変の再発ならびに新たな転移性病巣の出現を認めていないが，今後も慎重な経過観察を要するものと考える．

自動車用鉛バッテリーのリサイクル・廃棄フローモデルを作成し, インターネットアンケート調査から退蔵バッテリー残存率関数を定め, 静脈フローを推定した。補修用バッテリー販売時の廃バッテリー回収率は, ガソリンスタンド・整備業では10割に近く, カーショップで約8割, ホームセンターで約5割, 平均回収率は85%で, 約230万個/年が未回収と推定された。不要となった後も家庭内で保管 (退蔵) されるバッテリーのストック数は約500万個, 平均滞留年数は約2.2年と推定された。これらの結果と統計等を元に推定した2003年度の不要バッテリーのリサイクル率は, 精錬業で原料利用した国内再生率84%, 国内解体率87% (解体後に得られる巣鉛の輸出を含む) , 中古バッテリー輸出を含む国内回収率89%であった。残る11%は, 中古車上の車載輸出 (約5%) , 焼却・埋立, 不法投棄, 退蔵純増に至ると推定された。

バイオ資源・廃棄物等について, 各市町村の統計データを基に賦存量を推定し, 資源品目毎に1自治体あたりおよび1人あたり賦存量と人口規模との関係を整理した。農産系・林産系・畜産系バイオマスでは人口規模が小さいほど1人あたり量や累積賦存量 (一定の人口規模の自治体での総量) が多くなるのに対して, 廃棄物系バイオマスでは逆の傾向を示すことが明らかになった。また, 厨芥類を対象として, 燃料電池でのバイオガス利用を含む4つの処理シナリオを設定し, 人口規模小の地域 (農村部) および人口規模大の地域 (都市部) をモデルに温室効果ガスを評価項目としたケーススタディを行った。焼却や堆肥化と比較してメタン発酵によるバイオガス回収・発電利用はCO2排出量が少ないこと, 燃料電池はガスエンジンよりもCO2削減効果が大きいこと, 農村部と都市部の違いがシナリオの評価に影響することが示された。

We report a case of a 41-year-old Japanese man who presented with rapidly progressive glomerulonephritis, chronic sinusitis, and positive cytoplasmic-antineutrophil cytoplasmic antibody (c-ANCA). Renal biopsy showed crescentic glomerulonephritis, and he was diagnosed as having Wegener's granulomatosis. During the clinical course, he suffered from pulmonary bleeding, and combination therapy of steroid, immunosuppressant, and double filtration plasmapheresis (DFPP) was started. He rapidly entered remission after assistance through DFPP, suggesting the potential efficacy of DFPP for Wegener's granulomatosis, especially with pulmonary bleeding.

We reviewed the results of 10 patients (10 hips) after revision total hip arthroplasty with use of cement for 6 aseptic loosenings, 2 septic loosenings, 1 femoral shaft fracture, and 1 component fracture. Three patients were men and 7 women. Their mean age was 73 years (range 56 to 86). The mean duration from primary operation to revision was 64 months (range 13 to 180). The mean duration of follow-up was 41 months (range 8 to 84). The mean J. O. A. score significantly improved from 41.9 points to 70.7 points at the time of the latest follow-up examination.

Forty-five patients who had surgery to repair a full thickness rotator cuff tear (45 shoulders) were followed for an average of 35.5 months (range, 6 to 72). Thirty were men and 15 women. The average age of the patients was 56 years (range, 31 to 67 years). After anterior acromioplasty, tendon to bone repair was accomplished in 37 shoulders, tendon to tendon repair in three, and repair with Teflon felt in five. It was necessary to transfer the subscapularis in three shoulders and to advance supraspinatus in one shoulder. Generally patients were placed in abduction braces to hold the shoulder in 60° to 90° flexion and abduction after the operation. Patients received passive ROM (range of motion) exercises to the shoulder for the initial 4 to 6 weeks. This therapy was followed by active assisted ROM and finally by active ROM as strength was regained. Using JOA score, excellent or good results were achieved in 93% of the patients with small or medium tears (5cm≥, N=29). However, excellent or good results were achieved in 70% of large or massive tears (5cm

Five patients with axillary nerve injuries and four patients with suprascapular nerve entrapment were treated. Diagnosis was confirmed by physical examination and electromyographic studies. As an ancillary test, myelography of the cervical spine and arthrography and MRI of the shoulder joint were performed. Two patients with isolated axillary nerve injuries, in whom the nerve was in continuity, were treated by neurolysis. Three patients with axillary and suprascapular nerve injuries required nerve grafts. One patient operated upon up to one year two months after trauma required trapezius and latissimus dorsi transfer. In three patients with suprascapular nerve entrapment, we performed a release of the transverse scapular ligament and spinoglenoid notch resection. One patient with suprascapular nerve entrapment due to spinoglenoid notch ganglion was treated by removal of the ganglion. All patients achieved good results.

We recorded somatosensory evoked potentials (SEP) in 6 normal volunteers and 5 patients with spinal cord disorders by stimulating nerve roots with a round coil.Amplitudes of normal volunteers' SEP were 2 to 4 times as large as those of electric stimulation. The waveshapes of all 5 patients' SEP had normal amplitudes and normal durations with stimulation of nerve roots above the lesions, and small amplitudes and long durations below the lesions.SEP with electric stimulation is in common use for a diagnosis of C. N. S., but does not identify the level of the spinal cord lesion. In comparison, SEP with round coil magnetic stimulation can detect the level of the spinal cord lesion.

A 67-year-old, hepatitis C virus (HCV)-positive woman was admitted to our hospital because of proteinuria and leg edema. Laboratory examination showed decreased serum albumin and complement activity and positive cryoglobulin. The HCV RNA genotype was 1b with high viral load. Kidney biopsy showed membranoproliferative glomerulonephritis (MPGN) with capillary deposition of C3, IgM, and IgG, indicating HCV-associated glomerulonephritis. In addition to interferon (IFN) therapy, double-filtration plasmapheresis (DFPP) was performed to reduce HCV RNA blood levels in the early stage of IFN therapy. This treatment greatly reduced the viral load and induced clinical remission of MPGN, suggesting that DFPP plus IFN combination therapy may represent a potentially effective modality for refractory-type HCV-associated glomerulonephritis.

Unit-charging programs known as pay-as-you-throw (PAYT) for municipal solid waste in Japan were surveyed. The number of municipalities that have implemented PAYT for combustible waste totaled 954 (30%) in 2003. The introduction of PAYT programs peaked in the early 1970s and again in the 1990s. PAYT has tended to be adopted by municipalities with small populations (less than 30,000). PAYT charging systems can be roughly divided into two groups: simple unit-pricing programs and two-tiered pricing programs. It is difficult to see the relationship between PAYT and waste reduction by simple inspection of the overall changes throughout Japan. Case studies of four municipalities showed that the implementation of PAYT programs reduced the amount of residual waste generated by 20% to 30%. In combination with other measures, especially the recycling of containers and packaging, PAYT programs can bring about a dramatic reduction in waste.

End-of-life vehicles (ELV) have become a global concern as automobiles have become popular worldwide. An international workshop was held to gather data and to discuss 3R policies and ELV recycling systems, their background and present situation, outcomes of related policies and programs, the framework of recycling and waste management, and case studies on related topics in several countries and regions, as well as the essential points of the comparison. Legislative ELV recycling systems are established in the EU, Japan, Korea, and China, while in the US, ELV recycling is managed under existing laws on environmental protection. Since automobile shredding residue (ASR) has a high calorific value and ash content, and includes heavy metals as well as a mass of unclassified fine particles, recycling ASR is considered highly difficult. Countries with a legislative ELV system commonly set a target for recovery rates, with many aiming for more than 95 % recovery. In order to reach this target, higher efficiency in ASR recovery is needed, in addition to material recycling of collectable components and metals. Environmentally friendly design was considered necessary at the planning and manufacturing stages, and the development of recycling systems and techniques in line with these changes are required for sound ELV management.

出血性胃十二指腸潰瘍75例の治療成績から予後に影響を及ぼす背景因子について検討を加えた. 潰瘍入院総数に対する出血率は22.4%で, 手術の内訳は緊急32例, 待期27例で, 死亡率は緊急21.9%, 待期3.7%と緊急の予後が著しく悪かった. また加齢につれて死亡率は上昇し70歳以上の高齢者では19例中6例 (31.6%) であった. 予後に影響を及ぼす重要な背景因子は年齢と併存症で, シメチジン出現以後, 年度別の出血例は減少したが, 入院数に占める出血率には変化なく, 緊急手術率は前期に比べて増加した.従って, 併存症を有する高齢者に対しては保存治療に固執することなく手術適応を考慮して手術時期を失しないよう迅速に対処することが必要である.

The results of treatment of eight cases of ulcerative colitis and five cases of Crohn disease experienced in our department were investigated. Five of the eight cases of ulcerative colitis achieved remission by conservative treatment alone, and the mean proportion of relapse into the active stage of the lesion, reckoned in months after discharge was 32%. As for surgical cases, total colorectectomy-ileostomy, subtotal colectomy-anastomosis of the ascending colon and rectum and the Kock method were respectively performed in each case. On the other hand, two of the five cases of Crohn disease showed postoperative relapse. In one case presenting relapse in the duodenum and pyloristenosis, gastrectomy (the Billroth II method) was performed and another case achieved remission using Salazopyrin. Many cases of ulcerative colitis are benign and are found in juveniles, necessitating the positive consideration of the conservative method of spontaneous anus. With regard to the surgery for Crohn disease, the cause of relapse is unknown, and there have also been cases of relapse reported from microlesions so small that they are impossible to diagnose during surgery. It may therefore be necessary to deal cautiously with excision of a skip lesion in which there is no complication or en bloc excision of each lymph node.

In the past 15 years, 101 cases of peptic ulcer in patients over 60 years of age were treated in our department. Of 101 patients, 76 had gastric ulcer, 16 had duodenal ulcer and 9 had combined gastric and duodenal ulcer. The number of peptic ulcers treated surgically has been decreasing recently, while the percentage of peptic ulcers in the aged has been increasing. Of these 101 cases, 52.4% of the patients had no past history of ulcer, and 49.3% had suffered from the disease for less than six months. In regard to symptoms, 71.3% of patients complained of abdominal pain, and 36.6% showed gastrointestinal hemorrhage. The indications for laparotomy were hemorrhage, perforation and stenosis in 48.6% and intractability in 47.2%. The rate of preoperative complications and the rate of emergency operations tended to increase with age. Although there was a complete absence of mortality in the patients without preoperative complications, that among patients with preoperative complications in emergency operations was a high 46.2%. How to avoid emergency operations in the aged remains a problem to be solved in the future.

慢性膵炎手術46例を対象として, 膵内外分泌能と酸分泌能を対比し, さらに潰瘍成因について防御因子の面より粘膜ウロン酸を測定した. 潰瘍合併率は30.6%と高率であったが, MAOは正酸から低酸を示すのがほとんどで, 潰瘍合併例のMAOは非合併例よりも低値を示す症例が多かった. P-S試験, OGTT insulinogenic indexを指標として, 膵内外分泌障害の程度とMAO, ガストリンを比較したが相関はなかった. 胃粘膜ウロン酸量は胃潰瘍例と似た値を示し, 防御能の低下が示唆された. 潰瘍合併例に対する術式は潰瘍を含む胃切除を基本とし, 迷切術の併用は胃防御能を低下することから好ましくないと思われた.

A retrospective study of patients with peptic ulcer admitted to the First Department of Surgery, School of Medicine, Kobe University, was made into the actual conditions of the surgical treatment of the ulcer after the introduction of cimetidine. The patients were divided into two groups, the first belonging to the period between 1976 and 1980 and the second belonging to that between 1981 and 1985 (July). A remarkable decrease was seen in the second group in the number of cases and operations. Especially noticeable was a decline in the number and rate due to intractability among such cases. But an increase was noted in the number of operations for complications of the ulcer (hemorrhage, perforation). There was a higher rate of complications in the second group in comparison with the first. There was no difference in the rate of occurrence of ulcers or shock. In cases of serious hemorrhage with duplicated complications, a barrier was observed in the efficacy of cimetidine, and the rate of cases requiring urgent surgery was still as high as 42.1%.

Venography, peridurography, Conray-myelography and discography are a X-ray diagnostic technique for a lumbar disc lesion. Twenty patients of lumbar disc lesion, all of whom were studied with these X-ray diagnostic technique, and treated by anterior remeval of disc and interbody fusion. The value of these techniques as a diagnostic aid was discussed. The discussion was supported by the result of comparative investigations between the findings of these special constrast studies and operation. The rate of coincidence between the two was as follows:1) in 10 cases of L4-5 disc lesion: venography, peridurography and discography were 100%. Conray-myelography was 40%.2) in 7 cases of L5-S disc lesion: venography, peridurography and Conray-myelography were 71%. Discography was 100%.3) in 3 cases of L4-5. L5-S, double disc lesions: venography, peridurography, Conraymyelography and discography were 100%.The rate of coincidences of these special constrast studies in these 20 cases were as follows: venography (90%), peridurography (95%), discography (100%) and Conray-myelography (60%). From these comparative investigations, discography is seemed to be the most believable diagnostic technique for both L4-5 and L5-S disc lesions.