Compressibility of Liquefied Sand

Laboratory measurement using CCD camera was conducted to trace the sedimentation process of sand grains in a liquefied model layer. The purpose of this measurement was basically intended to obtain a visual evidence of appearance of suspended state in upper part of the liquefied soil. For this purpose, glass bead particles were used as model ground material. The test results prevailed that the glass bead grains were suspended in pore water at the instant when complete liquefaction was brought about to the layer, then they began to settle in the water. The measured pore water kept high value until grains ceased moving. And the moving velocity was far slower than that estimated by Stokes equation for sedimentation of single particle. From these findings, a predicting method was proposed to obtain the compressibility of liquefied sand layer and the continuation time of suspended state of grains

Sarcoidosis-associated hepatocellular carcinoma

Sarcoidosis is a systemic granulomatous inflammation of unknown etiology, and seems to involve the liver parenchyma in most cases. However, sarcoidosis-associated hepatocellular carcinoma is rare. We report here a case in which a hepatocellular carcinoma occurred within the liver, which was probably involved as a result of systemic sarcoidosis. A 57-year-old Japanese man had been followed up for 2 years because of diabetic nephropathy and sarcoidosis. On admission for pneumonia, imaging studies revealed an unexpected hepatic tumor. Histology revealed a hepatocellular carcinoma accompanied by T-lymphocytic infiltration and marked granulomatous inflammation, which was surrounding some tumor nodules. The background liver parenchyma exhibited a moderate degree of fibrosis with granulomatous inflammation. The patient had no other apparent liver disease such as viral hepatitis, steatohepatitis, or primary biliary cirrhosis. Therefore, in the present case, sarcoidosis may be considered the probable background etiology for hepatocarcinogenesis

ジュツゴ ノウキョウ オ ガッペイ シタ バリウム フクマクエン ノ イチレイ

The patient was a ４０-year-old woman. She visited our hospital because of sudden pain developing ４ days after upper gastrointestinal radiography with barium. Her abdomen showed board like rigidity. On the basis of abdominal radiography and computed tomography（CT）findings, we made a diagnosis of barium peritonitis. Emergency surgery was performed on the same day. A ３-cm diameter perforation was noted in the sigmoid colon. The perforated area had been plugged with fecal mass of a size larger than the fist. Purulent ascites, mixed with food residues, were noted in the peritoneal cavity, and the leaked barium had attached to the mesentery and intestine. Cleansing with about１０，０００mL warm physiological saline was carried out to remove these contaminants. Because postoperative inflammatory reactions persisted, thoracic and abdominal CT scans were obtained on the１０th hospital day ; they showed bilateral hydrothorax as well as residual barium and abscess under the left diaphragm. The patient was treated conservatively, but thoracic and abdominal CT scans obtained on the ４４th hospital day allowed a diagnosis of left empyema. On the same day, lavage and drainage of the empyema-affected area were carried out. This resulted in the alleviation of the postoperative inflammatory reactions. The residual barium under the left diaphragm was considered as the cause of the postoperative condition in this case. Upon detection of barium peritonitis, it is essential to diagnose the underling condition as soon as possible and to completely（leaving no residual barium）and immediately remove the barium

ジャクネン セイジン ノ TAPP リョウホウゴ チョウキ ケイカレイ ノ バンキ サイハツリツ バンキ ガッペイショウ マンゾクド ニ タイスル ケントウ

Objective : This study evaluated the long-term outcome after laparoscopic transabdominal preperitoneal（TAPP）inguinal hernioplasty for young adults cases. The first goal is to measure recurrence rate. The second goals are late symptoms, complication, and patient’s satisfaction rate. Method : Young adults patients who underwent TAPP repairs between １９９５ and ２００４ were requested to fill in a postal questionnaire,１９patients are eligible to this study. Study participants ranged from ２０ to ４０ years, with an average age of ３２ years. One participant was female and eighteen participants were male. Follow up range was ５ to１３years, with a mean of ８．２years. Pt’s satisfaction scales ranging from １（not satisfied）to ５（very satisfied）were used. Participants checked yes or no about late symptoms, complications, and recurrence. Result : Of１９operated patients,１４patients（７３．６％）responded. One patient（７．１％）had symptomatic hernia recurrence. Long-term groin discomfort（occasional）occurred in ４ patients（２８．６％）. But there are no patient feeling groin discomfort interfered with daily activity. Pt’s satisfaction rates were５（very satisfied）：２８．６％,４：５０．０％,３：１４．２％,２：０％,１（very dissatisfied）：７．１％. None of them were required mesh removal. CONCLUSION : TAPP repair is a feasible procedure for young adult with acceptable rate of recurrence, no severe complication, late symptoms, and pt’s satisfaction rate

セイジン ソケイ ヘルニア ジュツゴ カンセン ニヨル prosthesis ジョキョレイ ノ ケントウ

Objective : Prosthesis removal is one of important complication in the hernia repair. A clinical investigation was made on cases of prosthesis removal following surgery for inguinal hernia. Methods : We performed ４６６ laparoscopic transabdominal preperitoneal （TAPP） inguinal hernioplasty for inguinal hernia and ２３２ open mesh inguinal hernia repair at our institution from March １９９５ to March ２０１０. These ６９８ cases were enrolled in this clinical study. Prosthesis removal was retrospectively assessed. Result : The five cases who underwent open mesh repair were required the removal of the prosthesis. These all cases were delayed onset infection. On the other hand, no patients who underwent TAPP repair were required removal of the prosthesis. Patients who underwent open mesh repair had high risk for the removal of the prosthesis compared to patients who underwent TAPP repair. Conclusions : Patients with inguinal hernia who undergo TAPP repair have fewer removal of the prosthesis than those who underwent open mesh repair

セイジン ソケイ ヘルニア ノ アプローチホウ ニヨル ビョウケイ シンダンノウ ニ ツイテ

Objective : To compare a laparoscopic transabdomina approach and anterior approach for inguinal repair regarding detectability of type Ⅳ hernia. Summary Background Data : Advantages of laparoscopic transabdominal preperitoneal（TAPP）inguinal hernioplasty, the accuracy of diagnosis is strongly emphasized, but this theory has not verified. Herein, we study this advantage retrospectively. Methods : A retrospective comparative study of８０７elective repairs of a inguinal hernia repair was performed : a control group ０f ３４１ patients undergoing anterior hernia repair with or without prosthesis and a study group of ４６６patients undergoing TAPP repair. Intraoperative diagnosis type of hernia was studied. Result : Fifty-five patients（１１．８％）detected type Ⅳ lateral hernia in the TAPP group as compared to seven（２．０％）patients in the anterior group. （p ＜０．０１）. Conclusions : laparoscopic transabdominal approach can be considered significantly（p＜ ０．０１）superior to anterior approach with regard to detectability of type Ⅳ hernia

チョウ コウレイシャ ニ ハッセイ シタ トクハツセイ タハツ チョウジュウセキ ト カンガエラレタ イチレイ

A 94-year-old woman visited our hospital with chief complaints of abdominal pain, nausea, and vomiting by way of her local clinic. Abdominal MDCT revealed a target sign of the small intestine, and its frontal section showed invagination of the oral intestinal tract into the anal intestinal tract, which led to a diagnosis of adult small intestinal intussusception. The abdominal symptom was minor, and no ischemic and necrotic manifestations of the intestinal tract were observed. Conservative treatment was considered. However the patient was oldest-old with dementia, and her consent to the long-term conservative treatment seemed unlikely to be obtained, as well as the small intestine had intussusception extending more than at least１０cm, and its natural reduction was judged to be difficult. Therefore an urgent operation was selected. Two places in the small intestine showed intussusceptions, which could be relatively easily reduced. Because the entire intestinal tract had no abnormalities such as mass and necrotic lesions, the intestine was not resected. Postoperatively, the patient had dementia symptoms such as wandering and abnormal behavior, but her postoperative course was good, leading to hospital discharge on the seventh postoperative day. We report the case of idiopathic multiple intestinal invagination that has never been reported in the past, with some literature review

ボウコウ ガ カンニュウ シタ リョウガワ ヘイサコウ ヘルニア ノ イチレイ

An 80-year-old woman visited our hospital with chief complaints of nausea, vomiting, and anorexia. She was diagnosed with bilateral obturator hernia involving the urinary bladder by an abdominal CT scan and retrograde cystography. The symptoms resolved with cessation of anticholinergic drugs that she was being given for the treatment of nocturia, and administration of laxative drugs. The bladder as hernia content was considered to have repeated invagination into an obturator foramen and natural reduction. Because intestinal obstruction and peritonitis due to intestinal invagination were likely to occur, the necessity of an operation was explained to the patient, but her consent to the operation could not be obtained, which led to a follow-up of the symptom. This was the second case report of bilateral obturator hernia of the bladder as hernia content in Japan, and was the first case report of synchronous bilateral obturator hernia in the country