Simulation Study of Ballooning Modes in the Large Helical Device

The magnetohydrodynamic (MHD) simulation code MHD Infrastructure for Plasma Simulation (MIPS) was benchmarked on ballooning instability in the Large Helical Device (LHD) plasma. The results were compared to the results of linear analysis by using the CAS3D code. Both the linear growth rates and the spatial profiles were found to be in good agreement. An extended MHD model with finite ion Larmor radius effects was implemented into the MIPS code. Ballooning instabilities were investigated using the extended MHD model, and the results were compared with those using the MHD model. Ion diamagnetic drift was found to reduce the growth rate of the short-wavelength modes; hence, modes with a diamagnetic drift frequency comparable to the ideal MHD growth rate are the most unstable. The most unstable toroidal mode number of ballooning instability in the LHD is reduced to |n| ? 5 for hydrogen plasma with ion number density ni ? 1019 m?3

Predictors of Hypotension after Adrenalectomy for Pheochromocytoma

The management of blood pressure is a significant concern for surgeons and anesthesiologists performing adrenalectomy for pheochromocytoma. We evaluated clinical factors in pheochromocytoma patients to identify the predictors of postoperative hypotension. The medical records of patients who underwent adrenalectomy for pheochromocytoma between 2001 and 2017 were retrospectively reviewed and clinical and biochemical data were evaluated. Of 29 patients, 13 patients needed catecholamine support in the perisurgical period while 16 patients did not. There were significant differences in median age, tumor size, and blood pressure drop (maxmin) between the 2 groups (68 vs 53 years old, p=0.045; 50 vs 32 mm diameter, p=0.022; 110 vs 71 mmHg, p=0.015 respectively). In univariate logistic analysis, age > 65.5 years, tumor size > 34.5 mm, urine metanephrine > 0.205 mg/day and urine normetanephrine > 0.665 mg/day were significant predictors of prolonged hypotension requiring postoperative catecholamine support. Tumor size and urine metanephrine and urine normetanephrine levels were correlated with postoperative hypotension. These predictors may help in the safe perioperative management of pheochromocytoma patients treated with adrenalectomy

Feasibility of Laparoscopic Radical Cystectomy in Elderly Patients: A Comparative Analysis of Clinical Outcomes in a Single Institution

Laparoscopic radical cystectomy (LRC) is a standard surgical treatment for muscle-invasive bladder cancer and high-risk non-muscle-invasive bladder cancer. LRC is a less invasive modality than conventional open surgery. Therefore, even elderly patients with invasive bladder cancer may be candidates for LRC. In this study, a comparative analysis of perioperative/oncological outcomes between elderly patients and younger patients who underwent LRC was performed to assess the feasibility of LRC in elderly patients. Sixty-eight consecutive patients who underwent LRC between October 2013 and March 2018 were enrolled and stratified into those younger than 75 years (n=37) and those ≥ 75 years old (n=31). The median follow-up period was 28.2 months. The preoperative and operative parameters and complications were similar in both groups. The 2-year overall survival (OS) was 64.4% in the younger vs. 76.4% in the elderly group (p=0.053), cancer-specific survival (CSS) was 79.3% vs. 81.7% (p=0.187), and recurrence-free survival (RFS) was 58.2% vs. 75.7% (p=0.174), respectively. No significant differences were observed in OS, CSS, or RFS between the groups. No significant differences were found between the groups with respect to peri-surgical/oncological outcomes. We conclude that LRC is feasible in elderly patients

ヒガシ ドロンイングモードランド セール・ロンダーネ サンチ チガク チョウサタイ ホウコク 2009–2010(JARE-51)

セール・ロンダーネ山地は,東南極・東ドロンイングモードランドに位置している.第51 次日本南極地域観測隊(JARE-51)夏隊の一部は2009-2010年の夏期に,セール・ロンダーネ山地においてベルギー南極観測隊(BELARE)との国際共同により地質,地形,隕石探査の地学野外調査を実施した.地質隊と地形隊はドロンイングモードランド航空ネットワーク(DROMLAN)によりセール・ロンダーネ山地に赴き,隕石探査隊は日本の新南極観測船「しらせ」の処女航海として南極に到着した.地質隊は山地東部を含むセール・ロンダーネ山地のほぼ全域をカバーし,地形隊は山地の西部および中央部で調査を行った.隕石探査隊は山地東部で調査を行った.野外活動は安全かつ成功裏に終了した.地質隊の一部はDROMLAN により帰国し,他のメンバーはセール・ロンダーネ山地からDROMLAN により昭和基地へ離脱したのち,「しらせ」により帰国した.本稿では設営,気象を含めた野外行動全般について報告する.Earth science-related field activities, involving geology, geomorphology and meteorite searches, were carried out in the Sør Rondane Mountains, Eastern Dronning Maud Land, during the 2009-2010 summer season as a part of the 51st Japanese Antarctic Research Expedition (JARE-51), in collaboration with the Belgian Antarctic Research Expedition (BELARE). Geology and geomorphology parties accessed the Sør Rondane Mountains using the Dronning Maud Land Air Network (DROMLAN), and the meteoritesearch party to Antarctica on the maiden voyage by the new Japanese icebreaker Shirase. The geology party covered the entire area of the Sør Rondane Mountains, although with an emphasis on the eastern part. The geomorphology party carried out fieldwork in western and central parts of the mountains, and the meteorite search party performed a survey in the eastern part. All field activities were succes fully carried out. Some of the geology members returned to Japan by DROMLAN, while others flew to Syowa Station from the Sør Rondane Mountains by DROMLAN, and then returned to Japan on board Shirase. This report provides a summary of the field operations, including logistics and weather records

Generation of Radical Species from Cyclohexane-1,2-dione and the Reaction with Olefins : Preparation of 4,5-Dihydro-7(6H)-benzofuranone Derivatives

Oxidation of cyclohexane-1,2-dione with ammonium hexanitratocerate(IV) (CAN) generates 2,3-dioxocyclohexyl radical, which reacts with electron-rich olefins to afford the corresponding addition products. The adducts thus generated are converted to 4,5-dihydro-7(6H)-benzofuranone by acid treatment. In addition to cyclohexane-1,2-dione, radical species are also generated from cyclopentane-1,2-dione and cycloheptane-1,2-dione

ホルモン抵抗性前立腺癌に対するドセタキセル, プレドニゾロン併用療法

Between April 2004 and August 2005, we used docetaxel in combination with prednisolone to treat 14 patients with hormone-refractory prostate cancer (HRPC). Docetaxel was administered at a dose of 70 mg/m2 once every 21 days and oral prednisolone 5 mg was administered twice daily concurrently on days 1-21. The treatment was continued until disease progression or unacceptable adverse events occurred. Prostate specific antigen (PSA) was used as a tumor marker. PSA response was defined as a reduction from baseline of at least 50% that was maintained for 4 weeks. Five patients had measurable soft tissue lesions, which were nodal metastases in 4 and liver metastasis in 1. The median follow-up was 8.4 months. During follow-up, 5 patients died. The median treatment cycle was 7 cycles. Manifestations of hematologic toxicity included 11 patients (78%) with grade 3/4 neutropenia and only I with febrile neutropenia. Two patients with gastric hemorrhage and febrile neutropenia needed hospitalization. During follow-up, 8 patients (57%) achieved a PSA reduction from baseline of at least 50%. Three patients with nodal metastases and 1 patient with liver metastasis had partial response. Combined docetaxel and prednisolone was shown to be effective and feasible in Japanese patients.【目的】ホルモン抵抗性前立腺癌に対しドセタキセル+プレドニゾロン療法を行い, その有用性を検討した。【対象・方法】対象は2004年4月以降に再燃前立腺癌と診断された14例。観察期間は8.4ヵ月, 7コース(5.5コース)施行した。プレドニゾロン(10mg/日)連日投与を併用しドセタキセル70mg/m2を21日毎に点滴投与を繰り返した。全例, 転移巣を有しており, 測定可能病変は4例がリンパ節, 1例は肝臓であった。原則として外来通院治療とした。【結果】14例中8例(57%)で腫瘍マーカーが50%以上減少した。測定可能病変とでは肝臓の1例とリンパ節の2例がPRとなった。鎮痛剤を使用していた7例中4例が減量・中止可能であった。貧血が2例で改善し, 1例で発熱も改善した。血液有害事象では好中球減少ではgrade3/4が11例であった。PDのため4例, 高度の皮膚粘膜病変のため1例が中止し, ステロイドによる出血性胃潰瘍, 帯状疱疹のため1例ずつが休薬となった。発熱性好中球減少のため1例が入院を要した。【結語】好中球減少症を高頻度に認めるが外来治療が可能であり, また抗腫瘍効果, 疼痛の改善においても有用と思われた。(著者抄録

ホルモン抵抗性前立腺癌に対するリン酸エストラムスチン, エトポシド療法

A total of 42 patients with hormone-refractory prostate cancer received E-E therapy. Oral estramustine phosphate (EMP) was administered twice daily for a total daily dose of 560 mg every day and oral etoposide (E-E therapy, 50 mg/body/day) was given on days 1-21 and stopped on days 22-35. Treatment was continued until the disease progression was confirmed radiographically or PSA had increased from base line of at least 25%. The median follow-up period after E-E therapy was 77.4 months (range : 12.5 to 122.3). Nineteen patients (43%) achieved a PSA decrease of 50% or greater. The median survival time of the patients who had a decrease of 50% or greater in the PSA value (PSA responder) was 29.3 months and the patients who did not (PSA non-responder) was 14.1 months (p = 0.01). There were no significant differences between PSA responders and non-responders when taking into account variables. Excluding those patients with only PSA elevation, the survival time was 14.9 months with no significant difference between PSA responders and non-responders. The toxicities (grade 3 or more) were identified as anemia, leukocytopenia thrombocytopenia, cardiovascular events, and gastrointestinal and hepatic disorders, which occurred in 0, 5, 2, 2, 14, and 2% of the patients, respectively. E-E therapy was considered to be an active oral regimen and well-tolerated for outpatients with hormone-refractory prostate cancer in Japanese patients.【目的】日本人における再燃前立腺癌に対する経口リン酸エストラムスチン(EMP), エトポシド(VP-16)併用療法(EE療法)の効果および副作用について検討した。【方法】1995年以降, EE療法が施行された再燃前立腺癌患者42例が対象。EMP:560mgを連日投与, VP-16:50mgを21日投与し14日休薬を1サイクルとした。PSAが50%以上低下したものをresponderとし, 治療は画像上の増悪またはPSAが基準値より25%を認めるまで継続した。【結果】観察期間は77.4ヵ月。19例がresponderであった。42例の生存中央値は20.5ヵ月でありresponderでは29.3ヵ月, non-responderで14.1ヵ月(p=0.008)であった。群間でresponseに寄与する因子は存在しなかった。Grade 3以上の副作用は白血球減少(5%)が2例, 血小板減少(2%)が1例, 悪心が6例(14%), 肝機能障害が1例(2%), 深部静脈血栓症(2%)が1例に認めた。【結語】EE療法は抗腫瘍効果もあり, 副作用も容認でき日本人にも施行可能であった。(著者抄録