DIREITOS FUNDAMENTAIS: RESTRIÇÕES E COLISÕES

O presente trabalho expõe as diferentes formas de conformação e restrição aos direitos fundamentais, além de abordar o fenômeno da colisão entre tais valores, objetivados em normas do tipo princípio. A distinção entre fenômenos jurídicos díspares é o berço de uma dogmática precisa, sendo esse o móvel e a justificativa da distinção entre conformações, restrições e as subespécies desta última. Levado a cabo essa tarefa, muito mais adequada se mostrará as técnicas para solução das colisões entre direitos fundamentais, sejam elas a ponderação, a razoabilidade ou a proporcionalidade

Comparison of Visual Evoked Potential Components between Laser and Cathod-Ray Tubes Stimulation in Healthy Human Subjects

We studied the differences in latency and amplitude between the laser stimulated visual evoked potentials (VEPs) and the cathode-ray tubes (CRTs) stimulated VEPs to estimate the risk of inducing photosensitive epilepsy by laser displays. Twenty healthy subjects were recruited for the study. Red and blue light stimulations were flashed in 1, 7.5 and 15Hz. The latency of P1, N1, P2 and N2 in 1 Hz stimulation revealed no significant difference by a paired t test between laser and CRT stimulation. The peak-to-peak amplitude was significantly smaller with red or blue laser stimulation than with red or blue CRT stimulation, for PI-N1 and N1-P2 at 7.5Hz stimulation, and for N1-P2 and P2-N2 at 15Hz stimulation. We therefore postulate that laser does not produce more excitability to occipital cerebral cortex than CRT does. There was no evidence to say that laser stimulation is more dangerous as the risk of inducing photosensitive epilepsy than conventional CRT stimulation

肺癌根治手術治療成績の男女別検討

1998年から2004年までの間に原発性肺癌にて根治手術を施行した81例,男性59例,女性22例を対象として,男女間に肺癌病態の違いがあるかについて検討した.背景因子の比較では女性では腺癌が有意に多かった.5年健存率を比較すると,男性は53.9%であるのに対し,女性は73.1%と高かったが,有意差は認めなかった.Cox比例ハザードモデルで多変量解析をおこなうと,p-stageのみが有意な予後因子であり,性差は独立した予後因子とはいえなかった.Clinicopathological features and outcomes of 59 male and 22 female patients with primary lung cancer treated between 1998 and 2004 were analyzed. A comparison of the characteristics according to gender showed that adenocarcinoma was more frequent in women than in men but there was no significant difference in the distribution of other clinicopathological factors. The 5-year disease free rate of the women was not significantly higher than that of the men, being 73.1% vs 53.9%. A multivariate analysis of survival revealed that the p-stage was a significant prognostic factor, but gender was an insignificant determinant of survival

大学ラグビー選手の骨密度や体脂肪率と体格や体力との関係

By separating the B group (backs) and the F group (forwards) for the university rugby football players, factors related to the bone density and percent body fat were examined. The following results were obtained from the study. 1) There was no significant difference in the bone density between B group and F group, whereas the F group was higher for the percent of body fat. 2) Correlation between slowness of short run and bone density was found for B group. 3) Correlation between slowness of 3000 m run and bone density was found for F group. 4) Correlation between body fat percent and weight as well as chest and arm girth were found for both groups. 5) There was a relationship between body fat percent and slowness of 3000m run for F group. From these results, body fat percent is a more effective indicator of physical fitness than bone density

当院におけるYUMESUMA e-net(Medical e-Learning システム)の導入と意義

Medical e-Leamingシステム(YUMESUMA e-net:Yokohama City University,MedicalCenter,Medical e-Learning System founded by Sugiyama and Matsuse,e-net)を導入する機会を得たので,オフライン環境下での試行から本番系システムによる実施にいたる概要を報告し,Medical e-Leamingの意義,問題点,今後の方向性などを検討した.その結果,いわゆるe-LeamingシステムどしてのYUMESUMAは,単に学習のIT化という位置づけにおいてのみ有効性が高いのではなく,情報を迅速に伝える手段として,高い確実性を持ちうることが実証された.従って,毎年,多数の専門職が新規に採用され人事異動の頻繁な大学附属病院において,Medical e-Leamingは,情報の周知,安全管埋徹底に極めて有用なシステムと思われた.A medical e-learning system (YUMESUMA e-net) was introduced at our hospital. Here, the processes from its trial in an off-line environment to its application to a real working system are outlined, and the significance, problems, and direction of future development of medical e-learning are evaluated. YUMESUMA as an e-learning system was found to be effective not only as an information technology to assist medical learning but also as a highly reliable tool for rapid transmission of information. Therefore, at a university hospital, where many experts are newly employed every year and personnel changes are frequent, medical e-learning is considered to be a useful system for transmission of information and safety management

大量の肝内門脈ガス像を呈した広範小腸壊死1例

大量の肝内門脈ガス像を呈した広範小腸壊死1例を報告する.82歳,女性.既往歴は,高血圧,胆石,逆流性食道炎と20年前に帝王切開。平成15年12月5:30,全身倦怠感,水様性下痢,嘔吐を主訴に他院受診.腹部造影CTで肝左葉の門脈内に樹枝状に広がる空気像,腹部大動脈周囲後腹膜に空気像を認め,当院へ転送された.意識レベルはJCS-1,収縮期血圧42mmHg,脈拍数146,呼吸数32,直腸温36.9℃,腹部は板状硬で圧痛を認めた.白血球数は9,270/mm^3,CRPは16.4mg/dlと上昇しており,血小板は4.1万/mm^3,PTは45%などDIC状態だった.アルブミン1.5g/dlと低栄養,BE-10.8mEq/lとアシドーシスを認めた.造影CTで上腸間膜動脈内の血栓は明らかではなかった.開腹すると,腐敗臭を伴う腹水を認め,E.coliが同定された.小腸は,Treitz靱帯より約1mから境界明瞭に壊死状態,肛門側は横行結腸中央部付近まで全層性壊死,下行結腸とS状結腸は虚血状態であった.穿孔は認められなかった.全身状態が劣悪であったため,小腸広範囲切除,結腸亜全摘,上位空腸痩造設,S状結腸断端の腹壁開腹創への固定しか施行しなかった.切除標本の病理では腸管の末梢動脈攣縮像が認められた.術後,サイトカイン吸着術,大量輸血,CHDFを含む集中治療を行ったが翌日多臓器不全で死亡した.This is a case report of grossly necrotic bowel with hepatic-portal venous gas. An 82-year-old woman with a history of hypertension, gallstone, reflux esophagitis and caesarian section, was brought to a hospital because of general fatigue, watery diarrhea, and vomiting. She was transferred to our center because abdominal contrast enhanced computed tomography (CE-CT) scan showed arborescent dialation of the hepatic-portal venous gas and air around the abdominal aorta. Her conscious level was JCS-1, systolic blood pressure 42mmHg, pulse rate 146, respiration rate 32, and her body temperature 39.6℃. She had abdominal tenderness and muscle guarding. CE-CT did not reveal any thrombus in the superior mesenteric artery. An emergency operation was performed and we found transmural bowel necrosis from 1 m distal to the Treitz ligament to the middle transverse colon and ischemic and cyanotic change of the descending and sigmoid colon. There was no perforation. We resected the necrotic bowel. Pathological examination showed small arterial spasms in the involved bowels. Although intensive care, including cytokine absorption therapy, blood transfusion, and continuous hemofiltration dialysis (CHDF) was given, she died the following day of multiple organ dysfunction syndrome (MODS)

Mesodiverticular bandによる絞扼性イレウスの一例

症例は14歳,男児.開腹歴を含め,既往歴に特記すべきものなし.下痢,腹痛を主訴に来院し,抗生剤投与で一時軽快したが,その後腹部膨満感出現し,緊急入院となった.入院時血液検査所見で炎症反応の異常高値とCT検査上絞拒性イレウスの所見を認めたため緊急開腹手術を施行した.術中所見は回腸から約60cm口側にメッケル憩室を認め,そこに付着したmesodiverticular bandにより回腸が内ヘルニアを形成していた.小腸は広範囲に壊死しており,小腸部分切除を行った.mesodiverticular bandによるイレウスは稀で,術前診断は困難であるため手術歴のないイレウスの原因として考慮すべきであると考えられた.The patient was a 14-year-old boy who was admitted to our hospital because of abdominal pain and diarrhea. Blood tests showed strong inflammation, and plain CT showed the presence of air and fluid in the ileum. In physical findings, pan-peritonitis was suspected with muscle guarding, and so on emergency operation was performed. During the operation, we found that the ileum was compressed by a herniation of the mesodiverticular band and Meckel\u27s diverticulum. The a long segment of the ileum was necrotic, so these portions were resected and an end to side anastomosis was made. In a pathological study, neither gastric mucosa nor pancreatic tissue were observed, but microvessels were seen. Diagnosis is difficult before operation, so we should consider the mesodiverticular band when we see young ileus cases

Investigation of nonlinear contact problem in pneumatic tyres interacting with road surface

The racing situation requires a high performance tuned vehicle incorporating a high performance engine, aerodynamic body, and tyres. Among these three important factors the tyre is the only component which can transmit the vehicle force to the road, and is the most difficult part to tune, since it involves complex phenomena and a wide range of operating conditions. Development of a theoretical tyre model is necessitated to predict the tyre forces and moments according to various road conditions. Many empirical tyre models have been studied in the past as it is efficient to conduct experimental curve-fittings. However, these carry inherent problems from the unrealistic tyre testing equipment and conditions. On the other hand, the theoretical tyre model can purely simulate and make predictions taking into account the causes and effects of the tyre operating phenomena. Therefore, it can enhance the accuracy of the tuning and selection of the tyre. The aim of this research project was to provide an understanding of tread friction interacting with the road surface in various operating conditions in order to enhance the knowledge about the application to theoretical tyre model development. The approaches employed to achieve the research aim mainly involve experimental investigations and numerical simulations including the development and application of Gaussian/non-Gaussian surfaces at the contact interface in order to predict frictional behaviours of tread in a realistic way. The review and analyses of the literature involving the empirical and theoretical research field of tyres revealed that existing information regarding the effects on the complex interactions between tyre operating variables was found to be sparse and only qualitative. Recently, a great deal of improvement of theoretical tyre models has been made with innovative representation of road surface asperities. However, this surface model employs only a few simple shapes to represent the road asperity shapes. This should be further improved with inclusion of a greater variety of shapes. Currently the simulation software packages used for the tyre forces and moments prediction are mostly multi-body physics software packages such as MSC.ADAMS for the computing efficiency. In order to maximise the accuracy and evaluate the interaction phenomena in detail, FEA can be utilized.In order to evaluate the effects of important operating variables on frictional behaviours of tread, the main parts of the model: tread material properties and the surface roughness representations, were developed. Each part of the model was investigated separately and then applied to the model. Equivalent Gaussian/non-Gaussian surfaces were generated using the same roughness parameters, in order to assess the effects of these parameters on the friction corresponding to a given roughness. The friction tests were conducted with a unique testing apparatus and the experimental rig was designed based upon piezo-electric load cells such that the road surface was sliding over the tread rubber sheet. The experimental schedule was conceived with the aim of making consistent measurements in order to examine the data with respect to the causes and effects of the four individual experimental variables: tread compound, surface roughness, sliding velocity, and normal load. The experimental data were expressed in terms of the average friction coefficients over the sliding motion.The important model parameters which control the frictional behaviours were determined by a trial and error method to give a match between the friction test results and their simulation results. These parameters were the local friction coefficient corresponding to the effect of the microscopic texture of the contact bodies and the friction stress limit, which represents the limiting shear stress during friction. Comparisons were conducted to verify the validity of the FE models for the predictions with different conditions.Lastly, the prediction of friction for the load controlled (LC) mode, which is a more realistic tyre contact condition, was conducted, with the important model parameters obtained by comparison between the experimental results and their simulations. The effects of each variable on the friction of the tread was discussed in conjunction with the interaction of the operating variables. The conclusions derived from the research conducted to achieve each of these specific aims are summarised separately.These analyses led to the confirmation of the general and specific trends of the friction in contact between tyre tread and road surface. Specifically, the successful applications of the Gaussian/non-Gaussian surfaces enabled a discussion of the effects of each roughness parameters on tread friction. It has been revealed that not only the effects of the relative roughness could cause the variations in the apparent friction coefficient, but also more significantly the skewness and kurtosis could have the effects on the frictional behaviours of tread rubber, and should thus always be included in simulated surfaces. It has been verified that the FE model of the tread-road interaction as a tool to investigate the causes and effects of the operating variables can be used to predict the detailed interaction of the tread rubber and road asperities