Comparison of unstructured grid and overset grid approaches for flow computations around a ship with an energy-saving duct

Two approaches for CFD simulations for a complex geometry of a ship with an energy-saving duct are compared. One method is an unstructured grid method in which the single block grid can cover the whole geometry and the other is an overset grid method which uses multiple grid blocks for each component of the complex geometry. The computed results are compared with each other and with the experimental data for the resistance and the self-propulsion factors together with the flow fields. Based on these comparisons, two approaches are assessed from the practical point of view

A case of thoracic esophageal cancer undergone esophagectomy after induction chemotherapy in a Jehovah’s Witness

We report the case of a 50-year-old female Jehovah’s Witness with advanced esophageal cancer who underwent esophagectomy following induction chemotherapy. She visited our hospital complaining of dysphagia and was diagnosed of advanced esophageal cancer by upper endoscopy. She refused allogeneic transfusion. Induction chemotherapy was performed. Severe anemia occurred as an adverse event. A subtotal esophagectomy was performed after her anemia improved. During the surgery, a large volume of replacement fluid was injected, the blood was diluted, and intraoperative bleeding was relatively reduced. Intraoperative blood salvage was made using Cell Saver. The postoperative course were stable by using autologous blood and albumin infusion. The patient was discharged on postoperative day 27. Jehovah’s Witnesses with gastrointestinal malignancies can be treated safely by performing surgical therapy based on blood replacement therapy and autologous blood transfusion

ニンシンチュウ ニ チリョウ オ オコナッタ ニュウガン ノ 1レイ

The patient was 33-year-old woman, who was diagnosed as having left breast cancer at the 12th week of pregnancy and referred to our hospital. In palpation and ultrasonography, we found a tumor but no swelling lymph nodes in the C area of the left breast. Core needle biopsy showed invasive ductul carcinoma with ER(-), PgR(-) and HER2+(3+). At 16th week of pregnancy, partial resection and the sentinel lymph node biopsy of left breast were performed to the patient. After the surgery, she received 4 courses of doxorubicin+cyclophosphamide therapy (AC therapy), and at 35th week of pregnancy, she delivered her baby by cesarean section. During the pregnancy and operation, there had not been any problems with the patient and her baby. After the childbirth, she underwent 4 courses of docetaxel+trastumab therapy (TH therapy) and the remaining tumor was removed. Now, she is undergoing radiotherapy and neither recurrence nor metastasis is observed

アンシン カード オ モチイタ ガン カンジャ ノ キュウキュウ イリョウ タイセイ ノ コウチク ト ビョウビョウ ビョウシン レンケイ ノ ココロミ

Oncologic Emergency Medical（OCM）card is to guarantee medical care to be provided by Tokushima Municipal Hospital to advanced cancer patients who once receive medical care in the institution even after they are referred to other hospitals or when their medical condition is worsened. Forty-seven cancer patients have been issued with the OCM card between April２０１５ and March ２０１６. For those patients, we have retrospectively investigated the actual medical services provided by our hospital and cooperation with other hospitals and clinics. The card was issued for ３８ patients who were under palliative treatment. More than half of all the patients issued with the card were in the department of surgery, and eight of them were colon cancer patients, who consisted the largest portion. Exacerbation of pain was the most common reason for those who used the card at the emergency outpatient visit, but more than half of them could return home within the same day. Although seven of fourteen patients who were determined to be under home care were eventually re-hospitalized, all the fourteen patients were able to spend as long time as possible at their own home due to the card system. During one year after the introduction of the OCM card system, there has been no trouble with the acceptance of emergency outpatient visits and the cooperation of Tokushima Municipal Hospital with other hospitals and clinics