Laparoscopic Pyelolithotomy in a Horseshoe Kidney

A 66-year-oldwoman hada 22 mm right kidney stone accompaniedwith a horseshoe kidney. The size of this stone had been increasing gradually from 7 mm to 22 mm during the past 5 years. Although apparent pelviuretic junction stenosis couldnot be identifiedby intravenous urography, external pelvis was dilated in both kidneys. Complete excretion of fragmented stones by extracorporeal shockwave lithotripsy seemedto be difficult because impairedurinary passage from the renal pelvis to the ureter was suspected. Percutaneous nephrolithotomy was also difficult due to malrotation of the pelvic-caliceal system and possible interposition of bowel loops between kidney and abdominal wall. Therefore, we chose laparoscopic pyelolithotomy. This procedure made it possible to remove the stone completely with minimum invasiveness. We assume that laparoscopic pyelolithotomy is a safe andeffective approach for renal pelvic stone in case of horseshoe kidney

長野県内医療機関の女性医師及び女性看護師への職場復帰支援の現状

要旨：長野県内の医療機関へ女性医師および女性看護師の出産・育児支援への現状と、育児休暇の取得、出産・育児休暇からの復職の現状を調査した。回収率は73.1％（57/78）、女性医師数は平均7.5人、8割は20～40歳であり8施設は女性医師がいなかった。女性看護師は平均175.4人、その7割は20～40歳だった。院内保育施設を有しているのは4割ほどだったが、当直免除や夜間呼び出しの免除は6割の施設で実施していた。平成20～22年に育児休暇から復職した女性医師は37施設で0人であり、女性看護師は11施設で0人だった。院内保育施設のある医療機関は女性医師の復職がしやすいようであった。Article信州公衆衛生雑誌 7(1): 60-61(2012)journal articl

Comparative double-blind trial of KN-7 tablet and Robaveron injection in the treatment of neurogenic bladder

37施設で, 神経因性膀胱233例を対象に, ロバベロン注射剤を標準薬とし, KN-7錠剤の経口投与による排尿障害に対する有用性を, 二重盲検群間比較試験で比較検討した.解析対象例はKN-7群108例, ロバベロン群107例である.KN-7群は1日6錠投与した.改善度の効果判定では改善以上K群40.7%, R群38.7%, やゝ改善以上それぞれ76.9%, 72.6%と有意差はなかった.臨床所見中改善の良かった項目は, 尿意, 残尿感, 尿失禁, 排尿までの時間, 排尿時間, 尿勢-排尿力と尿線中断の改善などで, これらの改善以上はK群35.8%, R群30.8%で, 有意差はなかった.副作用はK群0.9%, R群6.8%, K群が有意に少なかった.両剤とも主として下痢で, R群ではその他頭痛, 頻脈, 肝機能障害, 発熱感などを少数例認めた.臨床検査値ではGOT, GPTの上昇が2例あった.有用度有用以上はK群46.3%, R群45.8%で有意差はなかった.疾患別では, 末梢神経疾患, 膀胱の性状では弛緩性, 時期では12ヵ月以内の例で特に改善率が高かった.以上から, KN-7錠剤は, ロバベロン注射剤に比べ, 同等の効果が期待でき, 安全性も高く, 長期投与あるいは外来患者の治療にも適するThe clinical effectiveness, safety and usefulness of KN-7 tablet as a new oral application of the prostatic extract, on urinary dysfunction of neurogenic bladder were compared with those of Robaveron injection by the double-blind test method. In the study, 2 tablets t.i.d. and a shot of intramuscular injection 1 ml a day were given successively for 3 weeks. A total of 233 cases were reported from 37 facilities belonging to the KN-7 Clinical Research Group. Some of them were excluded or dropped out. The number of cases used for analysing the effectiveness, safety and usefulness were 214, 232 and 215, respectively. There was no bias between the two groups with a significant homogeneity in the background. In the overall clinical effectiveness, the effective rate including excellent, moderate and slightly effective was 76.9% with KN-7 and 77.4% with Robaveron. In the clinical usefulness, the rate of usefulness of slightly useful or above was 75.0% with KN-7 and 75.7% with Robaveron. There was no significant difference between the two groups in the clinical effective and useful rates at a significant level of 5%. Side effects were observed in 1 of the 114 (0.9%) patients given KN-7 and 8 of the 118 (6.8%) patients given Robaveron. The incidence of adverse reactions with KN-7 was significantly lower than that with Robaveron. Based on the results, it was concluded that KN-7 tablets, 2 tablets t.i.d., would be as effective and useful as a Robaveron injection 1 ml daily and safer than the latter in the treatment of neurogenic bladder

Review on CBM Desorption/Adsorption Mechanism

通过对国内外制约煤层气开发的因素和能源需求的分析,指出了研究煤层气的解吸吸附机理的意义。通过分析国内外解吸吸附机理的研究历史和现状,将煤层气的解吸吸附机理归纳综合为单分子层吸附和多分子层吸附两大类;将煤层气的解吸吸附机理模型归纳为五类,即Lang-muir等温吸附及其扩展模型、BET多分子层吸附模型、吸附势理论模型、吸附溶液模型和实验数据拟合分析模型等。对影响煤层气解吸吸附的因素,如煤层的性质、孔隙性结构、煤层气的组分、压力条件和温度条件等进行了详细的分析说明指出,解吸吸附机理未来研究的重点方向是在考虑目前已认识的复杂因素条件下,以研究煤层气吸附状态和煤层气的解吸动态过程为主,尤其是甲烷与水和煤层中碳分子的结合与分离的方式

多维多阶调制格式产生方案的比较研究

随着带宽需求的不断增长,多维多阶调制格式成为目前研究的热点。文章对8PSK（3阶相移键控）、8QAM（3阶正交调幅）和16QAM（4阶正交调幅）的实现方式从原理和拓扑结构上进行了综合性的比较研究。使用已商用的调制器件,通过串行或串并混合的结构配置,可以得到8PSK、8QAM和16QAM的调制光信号;而使用并行结构的配置方式,可以提高系统的集成度和信号的传输性能,但往往需要多个并行配置调制的新结构,对系统集成的成本和工艺提出了苛刻的要求

正交调制中多阶相位调制信号的误码率分析

光通信中如何提高传输速率和光谱效率已成为目前研究的热点,采用先进的调制格式是实现上述要求的关键途径,其中正交调制格式就是方法之一。文章介绍了一种研究计算多维多阶正交调制信号误码率的方法,首次推导出了多阶相位调制信号的解析表达式以及基于这种计算方法的仿真结果,并讨论了消光比等参数对误码率的影响

Numerical Study on Seepage Field in Coalbed With Cavity Well

提出了煤层气井洞穴完井的物理模型,将完井洞穴看成一个在煤层气井井底附近渗透率远大于外区煤层的高渗区域,并假定该区域中的流体流动仍然符合Darcy流动。在此基础上建立了煤层气井洞穴完井的渗流数学模型,通过有限元求解方法得到了洞穴完井煤层气井在圆形煤层和任意四边形煤层中的渗流场分布。为了与裸眼完井煤层气井的渗流场进行对比,模拟了圆形存在一口洞穴完井煤层气井和一口裸眼完井煤层气井及一口洞穴完井煤层气井和两口裸眼完井井的渗流场,明显看出了洞穴完井煤层气井渗流场与常规裸眼完井井的差异。该研究成果对更好地了解洞穴完井煤层气井的流体流动规律及压力分布状态有积极的意义

新型环树融合的无源光网络的应用研究

随着接入网带宽需求和业务支持需求的快速发展,环形结构的无源光网络（PON）的应用越来越重要,更长距离、支持更多光网络单元、与环形网络无缝融合已经成为PON在城域网中继续发展的3大要求。文章详细论述了新型环树融合拓扑结构的PON的原理及关键技术,讨论了这种新型结构的典型应用,总结了不同方案的优缺点,为未来接入网与城域网更深层次的融合发展的研究提供参考