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ヘキサクロロベンゼン (HCB) 排出量の推定と動的環境挙動モデルによるHCBの運命予測を組み合わせ, 底質中HCB濃度トレンドを推定した。HCB発生源として農薬 (PCP, PCNB, TCTP) 不純物, テトラクロロエチレン蒸留残渣焼却, 都市ごみ焼却を考慮した。この底質トレンド推定結果を琵琶湖北湖東岸と大阪湾西宮沖の底質コア濃度実測値と比較した。底質到達への時間遅れにより, HCB排出量トレンドとHCB底質濃度トレンドの差違を部分的に説明できた。琵琶湖と大阪湾の底質トレンドの違いは, 発生源と流入経路の違いを反映したものと思われる。

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.

Television (TV) set components are highly flame resistant, with their added brominated compounds such as polybrominated diphenyl ethers (PBDEs). These compounds might be released indoors via dust, which presents a potential exposure pathway for humans in the home environment. In this study, we collected dust from inside TV sets and TV set component samples (parts of housing front cabinets, rear cabinets and circuit boards) of five sets used in Japan. We measured BFRs (i.e., PBDEs, tetrabromobisphenol A (TBBPA) and hexabromocyclododecanes (HBCDs)) and polybrominated dibenzo-p-dioxins/dibenzofurans (PBDD/DFs). Analytical results of the TV components showed that the concentrations of PBDEs, TBBPA and PBDFs (48,000 microg/g, 19,000 microg/g and 9600 ng/g as mean values, respectively) were all highest in the rear cabinets. The SigmaPBDD concentrations (460 ng/g as a mean value) detected were highest in the circuit board samples. The respective SigmaPBDE and SigmaPBDF concentrations in the dust samples were 67-500 microg/g (mean 300 microg/g) and 180-650 ng/g (mean 410 ng/g). Such concentrations were 2-3 orders of magnitude higher than those previously reported for house dust samples, which suggests that the brominated compounds are transferred from TV components into dust. Comparison of congener patterns of the brominated compounds in the dust identified the components as the source of these BFRs.

The Chinese Government ratified the Stockholm Convention on Persistent Organic Pollutants (POPs) on 25 June 2004. As a party to the Convention, China is preparing its National Implementation Plan (NIP), which must be finished and submitted to the Conference of the Parties before November 11, 2006. The emission inventory and strategy for reducing unintentionally formed products is a very complex and difficult part of the NIP. In this paper, we analyzed the potential sources of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans in China and calculated their possible emissions. We included municipal solid waste incineration, hazardous and medical waste incineration, pulp bleaching, sodium pentachlorophenate production and usage, illegal electrical and electronic waste ("e-waste") recycling, and ferrous and non-ferrous metal production, and prepared a preliminary analysis of dioxin emissions in China. The results show that ferrous metal production (104.2-6648.3g TEQ), non-ferrous metal production (2.6-3389.8 g TEQ), and sodium pentachlorophenate production and usage (120-368.0 g TEQ) should be major potential sources of dioxins and furans. Moreover, municipal solid waste and hazardous and medical waste incineration (35.5 g TEQ) should also be considered high priority sources owing to a rapidly increasing incineration ratio anticipated for the near future.

To investigate the effect of biofiltration (BF) on the ability of blood to supply oxygen to the peripheral tissues, a 2 week crossover study was conducted with bicarbonate hemodialysis (BcHD) and BF using 5 male patients with diabetic renal failure as subjects. BcHD and BF were performed for 4 h and 3.5 h per session, respectively. Blood gases, the pH of red blood cells (RBC-pH), and 2.3-diphosphoglycerate in RBC (RBC-2.3DPG) were measured during each treatment. After a 2 week BF treatment, the plasma HCO3− at the beginning of BF was significantly higher than that of BcHD (p < 0.01), and the blood pH improved with an elevated plasma bicarbonate level (p < 0.05). The RBC-pH at the beginning of BF was higher than that of BcHD (p < 0.05) although the RBC-pH at the end of both therapies increased to similar levels. The RBC-2.3DPG during BcHD remained unchanged, but during BF significantly increased (p < 0.05). Metabolic acidosis was significantly improved by BF with its effect reaching to the RBC intracellular level. The improved metabolic acidosis might occur as a result of the increase in RBC-2.3DPG during BF. This increase in RBC-2.3DPG has the effect of reducing the affinity of oxygen for hemoglobin and allows more oxygen to be delivered to the peripheral tissues although the increase in RBC-pH by dialysis restricts the dissociation of oxygen from hemoglobin.

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.

Irradiation with visible light induced a remarkable effect on the reactivity of a metal-carbon bond in (tetraphenylporphinato)aluminum methyl in the nucleophilic substitution reaction with protic compounds such as phenol. A similar photoacceleration effect was also observed in the reversible ligand exchange of (tetraphenylporphinato)aluminum phenoxide with phenol. As for the former reaction, comparable quantum yields were observed upon irradiation at the Soret band and at the Q-band. 22 refs., 5 figs.

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%.

1973年より1984年6月末までに当教室へ入院した肝硬変201例中42例 (20.9%) に潰瘍合併を認めた. 潰瘍合併群の胃酸分泌は非合併群よりも有意な差を認めないものの高い傾向を示した. しかしグリシン負荷によるガストリン値, セクレチン値には非合併群と差はなかった. 食道胃静脈瘤陽性群の潰瘍合併率は26.7%と静脈瘤陰性群の14.6%よりも高率で, しかも静脈瘤のgradeの悪化に従って潰瘍合併率は上昇した. また静脈瘤の有無およびその程度と胃酸分泌, ガストリン値, セクレチン値には差を認めなかった.

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.

[Purpose]Source-separated collection of food waste has been reported to reduce the amount of household waste in several cities including Kyoto, Japan. Food waste can be reduced by various activities including preventing edible food loss, draining moisture, and home composting. These activities have different potentials for greenhouse gas (GHG) reduction. Therefore, we conducted a life-cycle inventory analysis of household waste management scenarios for Kyoto with a special emphasis on food waste reduction activities. [Methods]The primary functional unit of our study was “annual management of household combustible waste in Kyoto, Japan.” Although some life-cycle assessment scenarios included food waste reduction measures, all of the scenarios had an identical secondary functional unit, “annual food ingestion (mass and composition) by the residents of Kyoto, Japan.” We analyzed a typical incineration scenario (Inc) and two anaerobic digestion (dry thermophilic facilities) scenarios involving either source-separated collection (SepBio) or nonseparated collection followed by mechanical sorting (MecBio). We assumed that the biogas from anaerobic digestion was used for power generation. In addition, to evaluate the effects of waste reduction combined with separate collection, three food waste reduction cases were considered in the SepBio scenario: (1) preventing loss of edible food (PrevLoss); (2) draining moisture contents (ReducDrain); and (3) home composting (ReducHcom). In these three cases, we assumed that the household waste was reduced by 5%. [Results and discussion]The GHG emissions from the Inc, MecBio, and SepBio scenarios were 123.3, 119.5, and 118.6 Gg CO2-eq/year, respectively. Compared with the SepBio scenario without food waste reduction, the PrevLoss and ReducDrain cases reduced the GHG emissions by 17.1 and 0.5 Gg CO2-eq/year. In contrast, the ReducHcom case increased the GHG emissions by 2.1 Gg CO2-eq/year. This is because the biogas power production decreased due to the reduction in food waste, while the electricity consumption increased in response to home composting. Sensitivity analyses revealed that a reduction of only 1% of the household waste by food loss prevention has the same GHG reduction effect as a 31-point increase (from 50% to 81%) in the food waste separation rate. [Conclusions]We found that prevention of food losses enhanced by separate collection led to a significant reduction in GHG emissions. These findings will be useful in future studies designed to develop strategies for further reductions in GHG emissions.

Irradiation with visible light induced a remarkable effect on the reactivity of a metal-carbon bond in (tetraphenylporphinato)aluminum methyl in the nucleophilic substitution reaction with protic compounds such as phenol. A similar photoacceleration effect was also observed in the reversible ligand exchange of (tetraphenylporphinato)aluminum phenoxide with phenol. As for the former reaction, comparable quantum yields were observed upon irradiation at the Soret band and at the Q-band. 22 refs., 5 figs.

Photochemical fixation of carbon dioxide is of much interest in connection with biological photosynthesis by green plants as well as from the viewpoint of carbon resource utilization. One of the important steps in the assimilation of carbon dioxide is the carboxylation of a carbonyl compound into ketocarboxylic acid, where the reaction proceeds via an enolate species as reactive intermediate. For example, in four carbon (C{sub 4}) pathway and Crassulacean acid metabolism (CAM) processes, pyruvate is converted with the aid of ATP into phosphoenolpyruvate, which is subsequently carboxylated to give oxaloacetate by the action of pyruvate carboxylase. In relation to this interesting biological process, some artificial systems have been exploited for the synthesis of {beta}-ketocarboxylic acid derivatives from carbon dioxide and ketones using nucleophiles such as metal carbonates, thiazolates, phenolates, alkoxides, and strong organic as well as inorganic basis, which promote the enolization of ketones in the intermediate step. We wish to report here a novel, visible light-induced fixation of carbon dioxide with the enolate complex of aluminum porphyrin, giving {beta}-ketocarboxylic acid under mild conditions.