スイビブガン ノ ゾウ オ シメシタ スイナイ フクヒ ノ 1レイ

Intrapancreatic accessory spleens exhibit the same computed tomography （CT） findings as the spleen itself. We experienced a case in which an intrapancreatic accessory spleen mimicked pancreatic tail carcinoma. A ５４-year-old female who had a medical history of splenectomy presented with a pancreatic tail tumor, which exhibited low density in the arterial phase and slightly high density in the portal and equilibrium phases on CT. In addition, an accessory spleen was present in the greater omentum. We initially diagnosed the tumor as a pancreatic carcinoma, and scheduled distal pancreatectomy（DP）combined with lymph node dissection（LND）. Intraoperatively, the tumor was found to be elastic-soft, which indicated that it might be benign. We changed the planned procedure from DP combined with LND to DP without LND. The cut surface of the tumor had the appearance of spleen tissue, and the pathological diagnosis was an intrapancreatic accessory spleen. Intrapancreatic accessory spleens can display the same imaging findings as pancreatic carcinomas. Intraoperative palpation and gross pathological examinations were useful for selecting the optimal surgical procedure in the present case. It is important to differentiate pancreatic tail tumors that exhibit low density in the arterial phase on CT from accessory spleens

Successful cricothyrotomy for emergency airway management : a case report

A ６０ year-old male was brought to our emergency department by ambulance due to sudden onset of dyspnea. On examination, he was in coma since his level of consciousness decreased during transport, blood pressure was １９９／１１１mmHg, heart rate was１００ beats per minute, respirations were １０ per minute, blood oxygen saturation level（SpO２）was１００％ via assisted ventilation with Bag-Valve-Mask, and stridor was heard on auscultation. Those findings indicated airway emergency and endotracheal intubation was required. However, attempts at intubation were unsuccessful due to restriction of mouth opening. Muscle relaxant was then given to perform rapid sequence intubation, which caused vomiting. Failure to ventilation and intubation resulted in cardiopulmonary arrest. Chest compression was started immediately and decision for cricothyrotomy was made. １０ minute after cricothyrotomy, he revived. Subsequently, systemic management including therapeutic normothermia was performed at intensive care unit, then he regained consciousness. He was discharged １ month after admission

カイテイ タイセキブツ ノ カフン ブンセキガクテキ ケンキュウ 2 トウキョウワン トウキョウト

A core 443 cm long containing clay deposits was sampled from marine sedments at 14 m depth by a marine research ship (Bousei-maru) owned by Tokai University in Tokyo Bay (coordinates N 35°34\u2742", E135°47\u2750") in the Kanto district, eastern Japan. Pollen and spore analyses showed four local pollen assemblage zones (TO) coordinating one Japanese regional pollen zone (R) of the postglacial period. HI-4 Cyclobalanopsis, Betula, Fagus stages (443-320cm in depth, R-IIIa zone) HI-3 Cyclobalanopsis, Castanopsis stages (320-200cm in depth, R-IIIa zone) HI-2 Cyclobalanopsis, Castanopsis, Carpinus, Betula, Fagus stages (200-80cm in depth, R-IIIa zone) HI-1 Pinus, Cryptomeria, Cyclobalanopsis stages (80-0cm in depth, R-IIIb zone) Compared with the results of pollen analyses from the Kanto district shows that the present core contains a vegetational history spanning approximately 4,000 years before present. Although the sediments are marine, the pollen diadram has terrestorial characters. Caused by the fact that the boring point was located near the coast, Tokyo Bay is a closed bay having only the Uraga Channel and the ocean current is weak. Fossil pollen morphology of subgenus Cyclobalanopsis by scanning electron microscopy identified three species : Quercus sessilifolia, Q.glauca and Q.salicina

重傷外傷の認識が遅れ救急外来で緊急開腹術を行った１例

An８１-year-old man fell down and bruised his left abdomen. After a while the back pain got worse, and he admitted to the Emergency Department. At hospitals admission, several signs of shock were observed, and contrast-enhanced CT revealed a splenic injury. However, it took an hour and a half to diagnose and convene the trauma team because of the lack of information shared among medical staffs and the delay of the recognition as a severe traumatic injury. Since there was no available operation room at the time, nor there wasn’t time to transfer to another hospital, he was forced to undergo emergency open splenectomy at the Emergency Department. That decision saved his life as a result. In ２００２, it revealed that the deaths of about ４０％ of expired trauma patients who arrived at emergency centers were probably preventable. Since then, much progress has been made in establishing and generalizing the trauma care and evaluation guidelines. Our hospital is also making progress in organizing a trauma team and the massive transfusion protocol. However, even if they are well maintained, we won’t be able to decrease the number of preventable trauma deaths（PTD）unless we diagnose it. Improving clinical management as well as making efforts on teamwork, leads to a rapid definitive care in trauma patients

建学の精神の徹底を図る初年次教育の実践と課題 ―ホスピタリティ概論の分析から―

本研究は、2017年度から始まった本学の初年次教育を定着させるとともに、新入生が大学での教育を理解し、建学の精神に代表される理念やディプロマポリシーを自分のものとして捉え、その実現に向けた主体的な学修の基盤を構築するという初年次教育の目標の達成を図ることにある。このためには、彼らの特性をとらえるとともに、彼らが初年次教育をどのように捉え、理解したかを把握しなければならない。そこで初年次教育の科目の一つとして開設された「ホスピタリティ概論」を活用して、全受講生を対象とした2つの調査を3年間実施した。1つ目の調査は入学当初の学生像をとらえ授業展開に生かすために学生の特徴を把握するものであり、第1回目の授業で実施された。2つ目の調査は授業内容の理解度を評価するものであり、第10回目に実施された。これらの回答を年度と学科毎に集計、分析した。その結果、次のことが明らかになった。①オープンキャンパスへの参加や進学希望状況などの本学入学に至る経緯が学科によって異なること、そして、入学当初には心身に不安を抱いている学生が、どの学科にも相当数存在すること。3年間の調査によって各学科の学生の特色が明らかになり、学科毎の適切な学修支援方策の作成に向けた示唆が得られたこと。②この講義を受けて、建学の精神であるホスピタリティの獲得に大学が力を入れており、その実現が求められていると多くの学生が認識していること、及び、本科目の重点目標である多様性の理解力の育成につながる他学科の学生とのコミュニケーションの機会に意義を見出していること等から、授業の目標達成に向けた順調な歩みが見られること。これらの結果及び他の科目の報告から、初年次教育が定着しつつあること、そして、その目標達成に向けた歩みが順調であると判断した。ただ、更なる充実のための課題も浮かび上がっている

遠隔教育の実施と大学での教育に関する一考察 ―建学の精神を伝える授業のオンラインでの実施をもとに―

2019年末に端を発した新型コロナ感染症（COVID-19）の拡大によって、多くの大学は2020年度の新学期から遠隔教育の実施に踏み切った。本学においても遠隔教育の採用が決定され、ホスピタリティ概論も IT 機器を活用したオンラインでの実施となった。この中で大学教育の将来像に大きな影響を与えると考えられるオンライン授業の在り方を探る基礎調査を実施した。その結果、次のことが明らかになった。1）受講生の IT 環境の整備には、差がみられること、2）受講生の使用する機器は、パソコン、タブレット、スマートフォンに分かれること、3）オンライン授業に関しては、肯定する意見がある一方、改善を要望する意見も見られること、4）スマートフォンのみでの受講者とパソコンおよびタブレットでの受講者を比較分析した結果、画面の明瞭度や授業の進行、及び授業の理解などにおいて両者に差がみられ、スマートフォンのみでの受講者の方が有意に低い結果であったこと、5）遠隔授業に関する要望等の中には、遠隔教育の利点を述べている受講生の他に、授業以外の大学が持つ機能、つまり、友人獲得や相互啓発に関する不安も多くみられたこと。この結果等を踏まえ、オンライン授業のあり方、及び、将来社会における大学教育のあり方に関する提案を行った

SEM observations of pollen grains, fruits and seeds of the Pieniny Mountains (South Poland) endemic species Erysimum pieninicum (Zapał.) Pawł. (Brassicaceae)

Erysimum pieninicum (Zapał.) Pawł. (Brassicaceae) is an endemic species, growing only in Pieniny Mts. The aim of the presented work was to investigate its pollen morphology as well as its ultrastructural traits of pericarp and seed-coat. Pollen grains of this species were of small size, 3-zonocolpate with reticulate ornamentation. The external siliqua surface was of rugose sculpture, covered by numerous, stellate hairs. The internal surface of the fruit was naked and characterized by striate sculpture. The seed-coat ornamentation of E. pieninicum was of blister type

Environmental archaeology at the Chengtoushan site, Hunan Province, China, and implications for environmental change and the rise and fall of the Yangtze River civilization

Fortified settlements had emerged as early as 6400-6100 cal yr BP in the middle reaches of the Yangtze River during the early Daxi culture, particularly at the Chengtoushan site in Hunan Province, China. There were four major stages for the development of the Yangtze River civilization in the middle reaches of the Yangtze at ca. 6400-6100 cal yr BP (beginning of early Daxi culture); ca. 5800 cal yr BP (beginning of middle Daxi culture); ca. 5300 cal yr BP (beginning of Qujialing culture) and ca. 4500 cal yr BP (beginning of Shijiahe culture). These periods correspond to times of climate deterioration, especially of weakened summer monsoon. The decreased rainfall in summertime resulting from the weakened summer monsoon would have necessitated a system for securing water supply by irrigation, and this, in turn, may have lead to the rise and development of urban settlements and monarchs to govern the irrigation and new social systems. The Yangtze River civilization began to decline at 4200-4000 cal yr BP and the great settlements were abandoned. This event was also considered to be the consequence of a severe climate deterioration that swept through Eurasia ca. 4200-4000 cal yr BP