大腸癌同時性腹膜播種患者における治療方針の検討 1.切除困難同時性腹膜播種大腸癌患者において、オキサリプラチンと分子標的薬の使用は予後を改善させる 2.大腸癌同時性腹膜播種患者において、mGPSは早期の死亡を予測する

内容の要旨 , 審査の要旨広島大学(Hiroshima University)博士(医学)Doctor of Philosophy in Medical Sciencedoctora

Density-of-states fluctuation-induced negative out-of-plane magnetoresistance in overdoped Bi-2212

We analyzed the in-plane and out-of-plane magnetoresistance (MR) for overdoped Bi$_{1.6}$Pb$_{0.4}$Sr$_{2}$CaCu$_{2}$O$_{8+\delta}$ (Bi-2212) single crystals using superconductive fluctuation theory, which considers the density-of-states (DOS) contribution in layered superconductors with the conventional s-wave pairing state. The out-of-plane results are well reproduced by the theory, implying that the large, negative out-of-plane MR as well as the sharp increase in the zero-field out-of-plane resistivity $\rho_{c}$ near the superconducting transition temperature $T_c$ originate from the superconductive DOS fluctuation effect. On the other hand, the in-plane results are better reproduced without the DOS contribution (i.e., using only the Aslamazov-Larkin (AL) contribution), which may be explained in terms of the d-wave superconductivity of the layered superconductors.Comment: 4 pages, 3 figures, 27th International Symposium on Superconductivity, ISS 2014, to appear in Physics Procedi

Destruction of mesoscopic chemically modulated domains in single phase high entropy alloy via plastic deformation

Chemically modulated mesoscopic domains in a fcc single phase CrMnFeCoNi equi-atomic high entropy alloy (HEA) are detected by small angle diffraction performed at a synchrotron radiation facility, whereas the mesoscopic domains cannot be detected by conventional X-ray diffraction and 2D mappings of energy dispersive X-ray spectroscopy by scanning electron microscopy and scanning transmission electron microscopy. The mesoscopic domains are deformed and shrieked, and finally destructed by plastic deformation, which is supported by the comprehensive observations/measurements, such as electrical resistivity, Vickers hardness, electron backscattering diffraction, and hard X-ray photoemission spectroscopy. The destruction of the mesoscopic domains causes the decrease in electrical resistivity via plastic deformation, so called K-effect, which is completely opposite to the normal trend of metals. We confirmed that the presence and the size of local chemical ordering or short-range order domains in the single phased HEA, and furthermore, Cr and Mn are related to form the domains

Development of independent dose verification plugin using Eclipse scripting API for brachytherapy

In this study, an independent dose verification plugin (DVP) using the Eclipse Scripting Application Programming Interface (ESAPI) for brachytherapy was developed. The DVP was based on the general 2D formalism reported in AAPM-TG43U1. The coordinate and orientation of each source position were extracted from the translation matrix acquired from the treatment planning system (TPS), and the distance between the source and verification point (r) was calculated. Moreover, the angles subtended by the center-tip and tip-tip of the hypothetical line source with respect to the verification point (θ and β) were calculated. With r, θ, β and the active length of the source acquired from the TPS, the geometry function was calculated. As the TPS calculated the radial dose function, g(r), and 2D anisotropy function, F(r, θ), by interpolating and extrapolating the corresponding table stored in the TPS, the DVP calculated g(r) and F(r, θ) independently from equations fitted with the Monte Carlo data. The relative deviation of the fitted g(r) and F(r, θ) for the GammaMed Plus HDR 192Ir source was 0.5% and 0.9%, respectively. The acceptance range of the relative dose difference was set to ±1.03% based on the relative deviation between the fitted functions and Monte Carlo data, and the linear error propagation law. For 64 verification points from sixteen plans, the mean of absolute values of the relative dose difference was 0.19%. The standard deviation (SD) of the relative dose difference was 0.17%. The DVP maximizes efficiency and minimizes human error for the brachytherapy plan check

Laparoscopic extra-abdominal suturing technique for the repair of Larrey’s diaphragmatic hernia using the port closure needle (Endo Close®): A case report

AbstractIntroductionMorgagni’s or Larrey’s diaphragmatic hernias are relatively uncommon. If the defect is too large for primary closure, the use of a mesh is inevitable. Although primary closure is adaptable for relatively small defects, it is difficult to suture the hernial orifice in which the anterior rim is absent. Herein, we present the case of a patient with Larrey’s diaphragmatic hernia that was easily and securely repaired using the recently developed laparoscopic extra-abdominal suturing technique via the port closure needle (Endo Close®; Medtronic, Minneapolis, USA).Presentation of caseAn 89-year-old woman complaining of vomiting was transferred to our hospital. Computed tomography scan showed Larrey’s diaphragmatic hernia. Laparoscopic repair was performed after gastric decompression. We diagnosed Larrey’s hernia on the left side of the falciform ligament. The transverse colon was herniated through the defect. Since the hernial defect was located below the substernal space, there was no tissue to stitch at the anterior rim of the hernial orifice. We performed the extra-abdominal suturing technique, suturing the posterior rim of the hernia to the full thickness of the anterior abdominal wall using the port closure needle (Endo Close®) without the need for a mesh. The patient was discharged on the 8th postoperative day. There was no evidence of recurrence at 8 months postoperatively.DiscussionThe recently developed extra-abdominal suturing technique using Endo Close® to suture the full thickness of the anterior abdominal wall achieved secure mattress suture and easy extra-abdominal tying.ConclusionThis method may be useful in terms of easiness and security of suture