Urinary Diversion in Patients Treated with Pelvic Irradiation : Transverse Colon Conduit Revisited

In patients receiving pelvic irradiation for gynecological or genitourinary malignancies, urinary diversion is sometimes required for complete resection of malignancies or treatment of urological complications by irradiation. We report our attempts to promote healing and prevent complications by urinary diversion using a transverse colon conduit in cases in which urinary reconstruction was performed with irradiated lower abdominal organs such as small intestine or distal ureters. Between 2008 and 2012, 9 patients with pelvic irradiation received transverse colon conduit urinary diversion. Six patients received diversion for genitourinary complications, while 3 patients received complete resection of pelvic malignancies. Colostomy formation and lithotripsy of vesical stones were simultaneously performed in 4 cases. Wallace method was adopted for ureterointestinal anastomosis. There was no operative mortality. Although acute pyelonephritis, ileus, wound dehiscence and pelvic abscess formation were seen as postoperative complications, all but two improved without any additional procedure. Cases of pelvic abscess or wound dehiscence were treated by abscess drainage. In observation periods, no patients required urinary stent placement and none suffered from defecation problems. We think that transverse colon conduit can be a viable option for patients with pelvic irradiation history, affording them reasonable quality of life postoperatively

Treatment of renal cell carcinoma extending into the right atrium with extra-corporeal circulation using high-grade hypothermia: a case report

68歳女.高度低体温・循環停止を用いて右腎細胞癌の心房内腫瘍塞栓摘出術を安全に施行した.この自験例から, 摘出後の復温に伴って大きな切開創から大量の出血がみられ, 充分な輸血の準備と手術後の注意深い循環動態の是正が重要であることを理解したA 68-year-old woman underwent surgical treatment for renal cell carcinoma associated with tumor thrombus extending into the right atrium. Although the tumor thrombus reached the level of the right atrium, there were no other apparent metastases. Combination therapy with interferon alfa plus tegafur/uracil (UFT) was attempted with the expectation of reducing the tumor thrombus, but there was no change. Successful management was achieved with right radical nephrectomy, right auriculotomy, and partial cavectomy using cardiopulmonary bypass under high-grade hypothermia. After removal of the tumor and thrombus, blood loss was 13, 900 ml during the patient's recovery. She had mild heart failure for about two weeks after the operation, but recovered. She was discharged on the 40th day after the operation. Proper preparation for blood transfusion is the key point of this operation

Elucidation of the liquid-liquid distribution behavior of ion associates of metal-halogeno complex anions with quaternary ammonium counter cations and its application to separation and analysis

第四級アンモニウムイオンを対イオンとする一価, 二価金属ハロゲノ錯陰イオンのイオン会合抽出挙動を把握し, 分離・分析的応用を図るために, 炭素数及び形状の異なる第四級アンモニウム陽イオンを用いて, 水-各種抽出溶媒 {1,2-ジクロロエタン, クロロホルム (CF), クロロベンゼン (Cl-B), ベンゼン (B), トルエン (T) 及び四塩化炭素 (CTC)} 系での抽出定数を求めた. 得られた抽出定数から次の知見を得た. (1) 配位子の抽出性に及ぼす影響 : 配位子がCl-, Br-, I-と変わるにつれ, この順に抽出性は良くなる. (2) 配位子数の影響 : 配位子数が多くなるに従い, 抽出性も良くなる. (3) 中心金属の影響 : 配位子数が同じ場合には, 抽出性はほぼ中心金属イオンの大きさの順となる. (4) 金属錯陰イオンの電荷の影響 : 一般に二価陰イオンよりも一価陰イオンのほうが抽出されやすい. (5) 対陽イオンのアルキル鎖のメチレン基の寄与 : メチレン基一つ当たり, 大体0.4～0.8の抽出定数 (log K(ex)) の増大となる. (6) 抽出溶媒の影響 : 抽出溶媒の抽出能は次の順となる : CTC<T<B<Cl-B<CF. (7) 金属ハロゲノ錯陰イオンの配位子の違いによる抽出定数の差 (Δlog K(ex)) は溶媒によらず, ほぼ一定である. これらの知見を基に, 金属ハロゲノ錯陰イオンと疎水性陽イオンとのイオン会合抽出を利用する幾つかの金属の分離・定量法を開発した.The distribution behavior of ion associates of both monovalent and divalent metal-halogeno complex anions with various quaternary ammonium cations between the aqueous phase and several organic phases {1,2-dichloroethane, chloroform (CF), chlorobenzene (Cl-B), benzene (B), toluene (T) and carbon tetrachloride (CTC)} was examined, and the extraction constants (log Kex) were determined. The larger is the size of the ligand (Cl-<Br-<I-) and the coordination number, the greater is the ion associability. For the same coordination number, in general, the larger is the size of the metal ion, the greater is the ion associability. In general, the extractability of monovalent metal-halogeno complex anions is larger than that of divalent metal-halogeno complex anions. A linear relationship was obtained between log Kex and the number of carbon atoms in quaternary ammonium ion, and the contribution of a methylene group to the extraction constant (Δlog K(ex)/-CH(2-)) was found to be about 0.4∼0.8. Among the ion associates examined, the order of the extractability of the extracting solvent was generally CTC<T<B<Cl-B<CF. Also, the order of the extractability of the ion associates for dihalogenocuprate (I), tetrahalogenoaurate (III) and tetrahalogenothallate (III) complex ions was as follows, respectively : CuCl(2)-<CuBr(2)-<CuI(2)- ; AuCl(4)-<AuBr(4)- ; TlCl(4)-<TlBr(4)-<TlI(4-). The values of Δlog K(ex) between the complex anions were almost equal, even though the extracting solvents were changed. From these results, several extraction-spectrophotometric methods for the determination of metal based on the formation of an ion associate of metal-halogeno complex anion with hydrophobic cations were developed

Experimental Study on Vibration Control of Structural Systems Subjected with Random Excitations by Observers

This paper presents the experimental study of vibration control for the five stories building model subjected to several excitations. The structural model is controlled by the active mass damper that is driven by the DC survomotor. On the control, the state feedback is employed, and state variables are estimated by the minimal order observers. The controller is realized by the DSP(digital signal processor). The experimental tests are performed for the structural model excited by the sinusoidal, impact and earthquake accelerations. The results shown that vibration control by the DSP is more effective than by the personal computer