Mathematical Model of Ship Collision Probability

A mathematical model for estimating the probability of collision of ships passing through a uniform channel is proposed. The model takes into account the give-way motions of the encountered ships and the wake position characteristics under the given channel conditions such as width, length and centerline like buoys. The probability of collision is defined as the probability of an event where a ship fails to give way. Using this probability of collision, the “Collision Risk of Channel” is defined. The proposed model is examined by the collision statistics of some channels and straits in Japan. According to these statistics, the present model gives a good estimation of the collision risk of a channel. Since the proposed model takes account of traffic characteristics such as traffic volume, ship size distribution, and sailing velocity distribution, as well as channel conditions such as width, length and centerline mark like buoys, the effects of their change or control on the probability of collision can be easily predicted. Therefore, the proposed model is quite useful for the engineering planning and design of any channel

介護施設高齢者の栄養摂取と活動機能

Malnutrition and dehydration in old person are common and are associated with frailty, sarcopenia and poor health outcomes. Relationship between the amounts of energy and water intake and physical function was examined in care home residents. Each amount was positively associated with body weight, BMI, the ability to reach the restroom timely and physical activity, and negatively associated with care-needs levels under long-term care insulance and the rate to use diaper. Thus, nutrition and hydration play an important role in preserving physical function and independence in care home residents

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

16-mer オリゴペプチド ニ ヨル ヒト グリオーマ サイボウカブ ノ ゾウショク ヨクセイ : アクセイ グリオーマ ノ アタラシイ チリョウホウ ノ カノウセイ ニ ツイテ

京都大学0048新制・論文博士博士(医学)乙第11431号論医博第1860号新制||医||874(附属図書館)UT51-2004-G926(主査)教授 藤田 潤, 教授 井手 千束, 教授 橋本 信夫学位規則第4条第2項該当Doctor of Medical ScienceKyoto UniversityDA

A Case of Traumatic Pseudoaneurysm of the Ascending Aorta occurring in a Postoperative Patient who underwent Arch Replacement and Bentall's Operation

A case of traumatic pseudoaneurysm of the ascending aorta occurring in a postoperative patient who underwent an arch replacement and Bentall's operation was reported. A bleeding point was clear at the graft of the ascending aorta, and a pseudoaneurysmal formation was suspected following an echocardiogram. An aortogram demonstrated the presence of an aneurysm approximately 8 cm by 4 cm in size originating 5 cm above the right coronary ostia. An emergency operation was carried out. A Trans-femoral bypass was established before sternotomy. The Operative findings showed that adhesive connective tissue covered a pseudoaneurysm 8 cm by 4 cm in size, and that there was a tear in the anastomosis of the grafts between the ascending aorta and the arch 5 cm above the coronary ostia. Direct suture was performed, using hypothermic circulatory arrest. In this paper, we discuss the mechanism, classification, and operative strategy of traumatic pseudoaneurysm

Surgical Repair of Subacute Right Ventricular Perforation after Pacemaker Implantation

We report an 84-year-old woman who presented with right ventricular perforation 4 days after pacemaker implantation for syncope due to sick sinus syndrome. Median sternotomy revealed no pericardial effusion, but the pacing lead had penetrated the right ventricle and pericardium. When the pleura was opened, the tip of the lead was seen in the visceral pleura. The lead was cut in the pericardial cavity and extracted from the left subclavian wound together with the generator. The right ventricular perforation was sutured and a temporary pacing lead was placed on the right ventricular wall intraoperatively. Ten days after the surgery, a new pacemaker lead was placed in the ventricular septum via the right axillary vein. Right ventricular perforation is a rare complication after pacemaker implantation. Typically, it occurs at the time of implantation or within 24 hours after implantation. In the present case, the perforation of the right ventricle which needed urgent surgery occurred 4 days after implanting the pacing lead at the right ventricular apex. Great care should have been taken not to overlook this life-threatening complication even more than 24 hours after pacemaker implantation

A Case of Isolated Acute DeBakey II Redissection Occurring in a Postoperative Survivor Who Underwent an Arch Replacement for Acute DeBakey IIIb Dissection

A case of isolated acute DeBakey II redissection which occurred in a postoperative survivor who underwent an arch replacement for acute DeBakey IIIb dissection is reported. The operative findings revealed that there was an intimal tear above the left coronary cusp, that there was a false lumen in the native ascending aorta, and that a residual false lumen caused by the initial operation had not been detected. Redissection caused mainly by the operative procedure, such as the failure to include the site of the intimal tear in the original repair and the formation of a new dissection as a result of anastomotic failure, is frequently seen.　　 However, isolated redissection is a rare condition. In this paper we discuss classification, diagnosis and treatment of redissection