False-positive magnetic resonance image in the diagnosis of small acoustic neuroma

A patient presented with sudden hearing loss on her Žrst visit to our department. Gadolinium-DTPA-enhanced magnetic resonance imaging (MRI) of the posterior cranial fossa portrayed an intracanalicular tumour image (2–3 mm), and the pure tone average (PTA) and speech discrimination score (SDS) values were 65 dB and 60 per cent, respectively. Surgical intervention to remove the suspected tumour was scheduled by the translabyrinthine approach. Intracanalicular observations by the retrolabyrinthine approach revealed limited oedema on the inferior vestibular nerve with vascular dilation. The tumour image disappeared two years after the operation. Surgical Žndings and the post-operative course advocate that gadolinium-DTPA-enriched MRI image of an intracanalicular lesion such as arachnoiditis might produce a false-positive result.</p

Surgical intervention in middle-ear cholesterol granuloma

Eleven patients who had been surgically treated from 1988 to 1999 were retrospectively reviewed in order to evaluate the efŽcacy of ventilation tube insertion and mastoidectomy with, or without, mastoid obliteration for intractable middle-ear cholesterol granuloma. The mean age registered was 17.2 years at the time of surgical treatment. All cases were unilaterally affected. Five ears were treated with simple mastoidectomy coupled with the insertion of a ventilation tube, while six others had additional mastoid obliteration. The hearing prognosis was excellent with an improved post-operative hearing level of 16.5.dB (cf. pre-operative 37.7.dB). However, morphological prognosis revealed two ears had a residual perforated tympanic membrane without otorrhoea after displacement of the ventilation tube. Of the remaining nine ears with intact placement of the ventilation tube, Žve had dry ears while four had occasional otorrhoea. Although the morphological prognosis was incomplete, treatments involving at least an insertion of a ventilation tube with thorough mastoidectomy were thought to be necessary.</p

Distribution of the spacing between two adjacent avoided crossings

We consider the frequency at which avoided crossings appear in an energy level structure when an external field is applied to a quantum chaotic system. The distribution of the spacing in the parameter between two adjacent avoided crossings is investigated. Using a random matrix model, we find that the distribution of these spacings is well fitted by a power-law distribution for small spacings. The powers are 2 and 3 for the Gaussian orthogonal ensemble and Gaussian unitary ensemble, respectively. We also find that the distributions decay exponentially for large spacings. The distributions in concrete quantum chaotic systems agree with those of the random matrix model.Comment: 11 page

Discrimination of Oral Mucosal Disease Inspired by Diagnostic Process of Specialist

A discrimination of oral mucosal diseases is very important in clinical site. Therefore, a development of a screening support system for oral mucosal diseases which supports the diagnosis of clinical dentist is required. In this paper, a discrimination method based on fuzzy inference using four attributes (existence of vitiligos, bulges, granular patterns, and reddening) for oral mucosal diseases is proposed. As the results of the experiment, the discrimination rates of squamous cell carcinoma, leukoplakia and lichen planus were 87%, 70% and 87%, respectively. The results suggest that the proposed method is effective in discriminating oral mucosal diseases

Software Defined Media: Virtualization of Audio-Visual Services

Internet-native audio-visual services are witnessing rapid development. Among these services, object-based audio-visual services are gaining importance. In 2014, we established the Software Defined Media (SDM) consortium to target new research areas and markets involving object-based digital media and Internet-by-design audio-visual environments. In this paper, we introduce the SDM architecture that virtualizes networked audio-visual services along with the development of smart buildings and smart cities using Internet of Things (IoT) devices and smart building facilities. Moreover, we design the SDM architecture as a layered architecture to promote the development of innovative applications on the basis of rapid advancements in software-defined networking (SDN). Then, we implement a prototype system based on the architecture, present the system at an exhibition, and provide it as an SDM API to application developers at hackathons. Various types of applications are developed using the API at these events. An evaluation of SDM API access shows that the prototype SDM platform effectively provides 3D audio reproducibility and interactiveness for SDM applications.Comment: IEEE International Conference on Communications (ICC2017), Paris, France, 21-25 May 201

Development of the Rural Generalist Program Japan: meeting the needs of Japanese rural communities

Context: There is a worldwide shortage of physicians, which is worse in rural areas, with a large underserved rural and remote population. Most jurisdictions in countries of all income levels report shortages of rural doctors, often exacerbated where primary care is not strong. Japan is not an exception: Japanese specialist-driven approaches in medical education and public health have resulted in disproportionate distribution of medical services in the country. Issue: Rural generalism, or rural generalist medicine, is emerging in many jurisdictions as one approach to training and provision of care for rural communities. While there is considerable variation in titles, the format of the training and models of care, the emphasis is on training a generalist doctor capable of meeting community needs. This usually includes development of appropriate skills in primary care, inpatient care, emergency medicine, public health and one or more extended skills. These models are well established in Australia, particularly in Queensland, which has offered a rural generalist program for over a decade. The Rural Generalist Program Japan (RGPJ) has been developed to meet the needs of Japanese rural communities. Lessons learned: This article outlines development of the RGPJ using the World Federation for Medical Education standards. While early evaluations are positive, there is much more to do to develop a mature program capable of meeting the needs of Japan's rural and remote communities

Eisenhart Lift of 22--Dimensional Mechanics

The Eisenhart lift is a variant of geometrization of classical mechanics with $d$ degrees of freedom in which the equations of motion are embedded into the geodesic equations of a Brinkmann-type metric defined on $(d+2)$-dimensional spacetime of Lorentzian signature. In this work, the Eisenhart lift of $2$-dimensional mechanics on curved background is studied. The corresponding $4$-dimensional metric is governed by two scalar functions which are just the conformal factor and the potential of the original dynamical system. We derive a conformal symmetry and a corresponding quadratic integral, associated with the Eisenhart lift. The energy--momentum tensor is constructed which, along with the metric, provides a solution to the Einstein equations. Uplifts of $2$-dimensional superintegrable models are discussed with a particular emphasis on the issue of hidden symmetries. It is shown that for the $2$-dimensional Darboux--Koenigs metrics, only type I can result in Eisenhart lifts which satisfy the weak energy condition. However, some physically viable metrics with hidden symmetries are presented.Comment: 20 page

握力は、糖尿病患者の心血管イベントの独立した予測因子である

Diabetes mellitus (DM) is associated with an increased incidence of cardiovascular events and an elevated prevalence of sarcopenia. However, the relationship between cardiovascular events and sarcopenia in patients with DM remains unclear. This study examined this relationship and investigated the predictors of cardiovascular events in this population.This study enrolled 161 patients with DM and no history of cardiovascular diseases who were admitted to our hospital for the treatment of DM between September 2012 and December 2015. Patients were divided into sarcopenia and non-sarcopenia groups, and were followed until March 2019. The primary endpoint was major adverse cardiovascular events (MACE).The mean age was 65.9 ± 1.8 years old and the mean follow-up period was 4.1 ± 0.8 years. The log-rank test indicated that MACE differed significantly between the two groups (P < 0.0001). Multivariate Cox hazard analysis identified the cardio-ankle vascular index (CAVI) and handgrip strength as independent predictors of MACE (hazard ratio [HR] = 1.18, P = 0.039; and HR = 0.70, P = 0.016, respectively).Handgrip strength is an indicator of sarcopenia in diabetic patients, and together with CAVI it was independently associated with the incidence of MACE. This suggests that the handgrip strength test might be useful in the management of patients with DM at high risk of cardiovascular outcomes.博士（医学）・乙第1493号・令和3年3月15日© 2021 by the International Heart Journal Association発行元であるインターナショナル・ハート・ジャーナル刊行会の許諾を得て登録（2021年6月23日付）ジャーナル公式サイト（J-STAGE内）：https://doi.org/10.1536/ihj.20-67

Heavy-Ion Rutherford Backscattering Spectrometry : A Comparison of ¹¹B with ⁴He Ions

The Rutherford backscattering spectrometry was examined with ¹¹B and ⁴He ions. Backscattering spectra improve in the mass resolution, the depth resolution and the channeling minimum yield when 6 MeV ¹¹B ions are used instead of 2 MeV ⁴He ions, which have been used commonly. Then the terminal voltage of a 1.7 MV tandem Cockcroft-Walton accelerator was calibrated by means of a combination of the ²⁷Al(p, γ)²⁸Si resonance method and a new iterative method using ¹H and ⁴He ions. The true terminal voltage of the accelerator is lower than the corresponding nominal values, and the deviation quadratically increases with increasing voltage