Micro-Gravity Monitoring and Repeated GPS Survey at Hatchobaru Geothermal Field, Central Kyushu, Japan

ABSTRACT Hatchobaru geothermal field is located 5km northwest of Kuju volcano, central Kyushu, and it shows a fractured type of geothermal reservoir. We have been conducted GPS and micro-gravity monitoring to detect the ground deformations and mass fluid movement caused by the production and reinjection. Increases in gravity were observed in the reinjection zone and part of the production zone just after the commencement of No. 2 unit. After that, in the production area, a rapid decrease of gravity (up to 200 µgal) was observed. Since 1998 the gravity change became steady. A contour map of recent gravity changes show that the areas of gravity changes became very small. And these areas are limited in the part of the production and reinjection zone. We suppose that the recharge from surrounding area became gradually stable and reached a new equilibrium state. Changes of baseline up to 64 mm, were detected from August 2000 to October 2003. We tried to estimate the location of pressure source applying a point source model on the changes in length of baselines. The location of a pressure source is estimated to be Komatsuike sub fault and approximately 750m in depth. This pressure source is located the upper zone of reservoir. There is possibility of detecting the pressure change of reservoir. As a result of observations, the sufficient accuracy proved to be achieved in this case of sort baseline observation

ソウダン エンジョ ジッシュウ ノ ジッシュウ ヒョウカ ニ カンスル ヒハンテキ コウサツ ジッシュウ ヒョウカ ノ モクテキ タイショウ シュタイ ホウホウ

「ソーシャルワーク実践力」をもつ人材の養成が社会的な課題となっている．しかし，相談援助実習において「『実習評価表』の評価が高い学生は，高い実践力を有しているのか」という疑問がある．そこで相談援助実習における「実習評価」の目的，対象，主体・方法について社会福祉教育セミナーの報告書，テキスト，研究論文を整理・検討しつつ「実習評価」についての理論的・実践的な到達点を探った．その結果，優先する実習評価の対象が専門職養成の立場は「専門性」と考え，現場実習を受け入れる施設の立場は「人間性」と考えるという違いがあることが明らかになった．その理由・背景を考えてみるとソーシャルワーク実習での「利用者との援助関係の形成」の基盤を，人として「共に生きる人びとの世界」の社会関係と捉えるか，専門職としての社会関係として捉えるかという立場の違いであると考察した．その立場の違いを関係者で認識・協議しつつ実習評価を行う仕組みを整えること，生活主体である利用者の立場から実習目標を設定することが，相談援助実習・実習指導における今後の課題であるとした

Quantification of pulmonary perfusion using LSIM-CT correlates with pulmonary hemodynamics in patients with CTEPD

BackgroundLung subtraction iodine mapping (LSIM)-CT is a clinically useful technique that can visualize pulmonary mal-perfusion in patients with chronic thromboembolic pulmonary disease (CTEPD). However, little is known about the associations of LSIM images with hemodynamic parameters of patients with CTEPD. This study investigates a parameter of LSIM images associated with mean pulmonary arterial pressure (mPAP) and validates the association between pulmonary vascular resistance, right atrial pressure, cardiac index, and exercise capacity in patients with CTEPD.MethodsThis single-center, prospective, observational study involved 30 patients diagnosed with CTEPD using lung perfusion scintigraphy. To examine the correlation of decreased pulmonary perfusion area (DPA) with mPAP, areas with 0–10, 0–15, 0–20, and 0–30 HU in lung subtraction images were adopted in statistical analysis. The DPA to total lung volume ratio (DPA ratio, %) was calculated as the ratio of each DPA volume to the total lung volume. To assess the correlation between DPA ratios of 0–10, 0–15, 0–20, and 0–30 HU and mPAP, Spearman's rank correlation coefficient was used.ResultsThe DPA ratio of 0–10 HU had the most preferable correlation with mPAP than DPA ratios of 0–15, 0–20, and 0–30 HU (ρ = 0.440, P = 0.015). The DPA ratio of 0–10 HU significantly correlates with pulmonary vascular resistance (ρ = 0.445, P = 0.015). The receiver operating characteristic curve analysis indicated that the best cutoff value of the DPA ratio of 0–10 HU for the prediction of an mPAP of ≥30 mmHg was 8.5% (AUC, 0.773; 95% CI, 0.572–0.974; sensitivity, 83.3%; specificity, 75.0%). Multivariate linear regression analysis, which was adjusted for the main pulmonary arterial to ascending aortic diameter ratio and right ventricular to left ventricular diameter ratio, indicated that the DPA ratio of 0–10 HU was independently and significantly associated with mPAP (B = 89.7; 95% CI, 46.3–133.1, P < 0.001).ConclusionThe DPA ratio calculated using LSIM-CT is possibly useful for estimating the hemodynamic status in patients with CTEPD

Use of the index of pulmonary vascular disease for predicting long-term outcome of pulmonary arterial hypertension associated with congenital heart disease

AimsLimited data exist on risk factors for the long-term outcome of pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD-PAH). We focused on the index of pulmonary vascular disease (IPVD), an assessment system for pulmonary artery pathology specimens. The IPVD classifies pulmonary vascular lesions into four categories based on severity: (1) no intimal thickening, (2) cellular thickening of the intima, (3) fibrous thickening of the intima, and (4) destruction of the tunica media, with the overall grade expressed as an additive mean of these scores. This study aimed to investigate the relationship between IPVD and the long-term outcome of CHD-PAH.MethodsThis retrospective study examined lung pathology images of 764 patients with CHD-PAH aged <20 years whose lung specimens were submitted to the Japanese Research Institute of Pulmonary Vasculature for pulmonary pathological review between 2001 and 2020. Clinical information was collected retrospectively by each attending physician. The primary endpoint was cardiovascular death.ResultsThe 5-year, 10-year, 15-year, and 20-year cardiovascular death-free survival rates for all patients were 92.0%, 90.4%, 87.3%, and 86.1%, respectively. The group with an IPVD of ≥2.0 had significantly poorer survival than the group with an IPVD <2.0 (P = .037). The Cox proportional hazards model adjusted for the presence of congenital anomaly syndromes associated with pulmonary hypertension, and age at lung biopsy showed similar results (hazard ratio 4.46; 95% confidence interval: 1.45–13.73; P = .009).ConclusionsThe IPVD scoring system is useful for predicting the long-term outcome of CHD-PAH. For patients with an IPVD of ≥2.0, treatment strategies, including choosing palliative procedures such as pulmonary artery banding to restrict pulmonary blood flow and postponement of intracardiac repair, should be more carefully considered

Efficacy of tyrosine kinase inhibitors in patients with non-small-cell lung cancer with performance status 4: a case series and review of the literature

Abstract Background Current guidelines for non-small-cell lung cancer (NSCLC) recommend that each tyrosine kinase inhibitor (TKI) is indicated even for driver mutation-positive patients with a poor performance status (PS). In previous studies, most patients had a PS of 2–3, but those with a PS of 4 were very few. Therefore, the efficacy of TKIs in patients with NSCLC with a PS of 4 remains unclear. Case presentation We retrospectively reviewed the clinical records of four patients with NSCLC with PS 4 treated with TKIs: an 89-year-old Japanese woman (Case 1), a 80-year-old Japanese woman (Case 2), an 50-year-old Japanese man (Case 3), and a 81-year-old Japanese woman (Case 4). Genetic alterations were epidermal growth factor receptor (EGFR), MET exon 14 skipping, BRAFV600E, and ROS1 proto-oncogene receptor tyrosine kinase (ROS1). One case with ROS1 fusion showed a significant response with the recovery of PS. However, in the remaining three cases (i.e., EGFR, MET exon 14 skipping, and BRAFV600E mutations), patients died despite the administration of TKIs. These three patients had to be hospitalized at the end of their life to receive treatment. Conclusions This is the first case series to summarize the efficacy of TKIs in patients with NSCLC with a PS of 4. Additionally, this case series poses a question concerning the indication of TKIs for older patients with a PS of 4