ヒキコモリ ケイケンシャ ノ カタリ ニカンスル イチコウサツ エリクソン ノ アイデンティティ ガイネン ヲ テガカリ ニ

論

シャカイテキ ヒキコモリ ニカンスル ブンケン テキ コウサツ

論

The Novel Eryngii Method of Nipple Reduction for Female-to-Male Transsexuals

Nosaka, NobuyukiMastectomy is usually the first and most important surgical procedure in female-to-male (FTM) individuals with gender identity disorder. Nipple reduction is also important in the process of reconstructing the chest wall for a more male appearance. If the nipples remain large after a mastectomy, the results may be disappointing to many FTM transsexuals. Nipple reduction enables these individuals to go to the beach or Japanese public baths, where they may go topless in public. We therefore consider that nipple reduction is indicated for all FTM transsexuals who desire it. There are a variety of methods for the reduction of enlarged nipples for women or non-FTM patients, but only a few reports have described the process used to create masculine-appearing nipples for FTM transsexuals. We developed a novel technique called the Eryngii method for creating male-like nipples using a 4-mm diameter dermal punch knife. The name of the method refers to the Eryngii king trumpet mushroom, which the nipple resembles after the surgical process. The main strength of this method is that it permits the creation of ideal nipples without difficulty. Here we introduce the technique and discuss our history of surgical methods for nipple reduction, including improvements and elaborations

Estimation of the refractive index of volcanic ash from satellite infrared sounder data

AbstractWe investigated the spectral refractive indices (RIs) of volcanic ash materials in the wavenumber range of 700–1100cm−1 using satellite infrared sounder measurements and radiative transfer calculations. The ash RIs of 10 ash clouds from eight volcanoes were evaluated (Bezymianny on 2 September 2012, Chaitén on 3 May 2008, Kelut on 14 February 2014, Kirishimayama on 27 January 2011, Kliuchevskoi on 30 June 2007 and 18 October 2013, Puyehue–Cordon Caulle on 5 June 2011, Sangeang-Api on 31 May 2014, and Sheveluch on 28 October 2010 and 18 September 2012). We elaborated on a dataset of volcanic ash measurements made by the Atmospheric Infrared Sounder (AIRS) onboard the Aqua satellite. The measured brightness temperatures in the ash cloud data revealed silicate absorption features at around 10μm. By applying atmospheric profiles from results of a global data assimilation system and using ash cloud properties (ash optical depth, effective radius, and ash cloud height) as parameters for radiative transfer calculations, least squares analyses for the observed and calculated brightness temperatures were conducted using AIRS channels in the wavenumber range of 700–1100cm−1, except for the O3 absorption channels in the range of 980–1070cm−1. Using the RIs for typical volcanic rocks in the ascending order of SiO2 content, basalt, andesite, and rhyolite, a mixture of basalt and rhyolite and a mixture of andesite and rhyolite for the ash material were considered. The volume fraction of the mixture was used as a retrieval parameter and as the ash cloud parameter. Using the estimated ash cloud parameters as fixed values, and under the assumption that the RI from the estimated volume fraction had some accuracy in the wavenumber ranges of 850–980cm−1 and 1070–1100cm−1, the RI imaginary part of each eruptive ash cloud captured by AIRS was then determined from iterative calculations at wavenumbers between 750cm−1 and 980cm−1. In the wavenumber range of 850–980cm−1, the observed brightness temperatures could be approximately simulated using the reported RIs from Pollack, Toon, and Khare (1973) for andesite, basalt, and rhyolite, and their combinations. Furthermore, some estimated RIs were consistent with the reported rock types of the volcanoes, which had been previously classified by compositional analyses in the literature. Our analysis also identified weak absorptions around 750–850cm−1, which could not be reproduced by the reported RIs. These weak absorptions were likely due to Si–O and/or Al–O vibrations, which have been proposed in reports from previous laboratory experiments for some silicate glass samples. Our results suggest that the detailed RI of volcanic ash can be determined from an analysis of satellite infrared sounder data. The RI of the ash material estimated from satellite infrared sounder data can be used to improve the ash retrieval algorithms of other satellite measurements. Furthermore, an RI retrieved by sounder measurements may provide diagnostic information regarding volcanic activity from comparisons with the ash RIs from past eruptions

Risk Factors for Postoperative Hematoma after Chest Wall Contouring for Female-to-Male Transsexuals: A Clinical Study

Gender dysphoria is a condition in which a discrepancy between biological sex and gender identity causes distress. Many female-to-male transsexuals (FTMTS) are uncomfortable with female breasts. Chest wall contouring surgery is effective for obtaining a male-type chest, reducing mental stress, and increasing sexual satisfaction in such cases. At the Okayama University Hospital Gender Center, we have obtained positive results using an algorithm to determine the most appropriate surgical method for chest wall contouring in FTMTS patients. However, serious complications requiring reoperation, such as hematoma, may still occur. Postoperative hematomas were found in 15 (4.18%) of 358 FTMTS patients who underwent chest contouring surgery at our hospital between 2006 and 2018. Postoperative hematoma was examined retrospectively. The median time to the onset of hematoma was 7 (6-12) h after the initial surgery. The main blood vessels causing bleeding were those in the head-side skin flap region where visual confirmation was difficult and the perforator vessels from the pectoralis major muscle. Intraoperative bleeding and the operation time had a significant impact on the onset of postoperative hematoma. This is the first retrospective study that investigated the blood vessels and other factors contributing to postoperative hematoma development after chest wall contouring

Variations in Clinical Findings of Patients with Identical Tuberous Sclerosis Gene Mutations

Colorectal carcinogenesis involves environmental factors and genetic predispositions. Recent studies have suggested the associations between colorectal neoplasm and functional polymorphism of matrix metalloproteinases (MMPs) and cytokine genes. In this study, we analyzed polymorphisms of MMPs and tumor necrosis factor (TNF)-alpha genes, focusing on the susceptibility to colorectal neoplasm and the tumor progression. The subjects were 186 patients (95 men and 91 women) who underwent total colonoscopy, and were classified into cancer, adenoma and non-neoplasm (control) groups of 47, 72 and 67 patients, respectively. The polymorphisms at the MMP-2 ?1306C/T, MMP-3 ?1171 5A/6A, MMP-7 ?181A/G, MMP-9 ?1562C/T and TNF-alpha ?308G/A loci were analyzed. Regarding background factors, significant differences were found in the age, sex ratio and alcohol-drinking and cigarette-smoking histories in the adenoma and cancer groups, compared to those in the control group. On these factors-adjusted logistic regression analysis of polymorphisms and disease susceptibility, no significant difference was noted in the frequency of any polymorphism in the adenoma and cancer groups, compared to those in the control group. The analysis of the involvement of polymorphisms in tumor progression in the adenoma and cancer groups revealed that the odds ratio for the MMP-3 5A allele was significantly higher in the cancer group (2.74; 95% confidence interval = 1.11?6.74, P = 0.02). The polymorphisms of MMP genes and TNF-alpha genes were not associated with the susceptibility to colorectal neoplasm, but the involvement of the MMP-3 5A allele in the progression of adenoma to cancer was suggested

Long-Term Outcome of Endoscopic Balloon Dilation in Obstructive Gastrointestinal Crohn's Disease: A Prospective Long-Term Study

Background The short- and long-term results of balloon dilation therapy in Crohn's patients with non-anastomotic obstructive gastrointestinal lesions are investigated

Zerobot®: A Remote-controlled Robot for Needle Insertion in CT-guided Interventional Radiology Developed at Okayama University

Since 2012, we have been developing a remote-controlled robotic system (Zerobot®) for needle insertion during computed tomography (CT)-guided interventional procedures, such as ablation, biopsy, and drainage. The system was designed via a collaboration between the medical and engineering departments at Okayama University, including various risk control features. It consists of a robot with 6 degrees of freedom that is manipulated using an operation interface to perform needle insertions under CT-guidance. The procedure includes robot positioning, needle targeting, and needle insertion. Phantom experiments have indicated that robotic insertion is equivalent in accuracy to manual insertion, without physician radiation exposure. Animal experiments have revealed that robotic insertion of biopsy introducer needles and various ablation needles is safe and accurate in vivo. The first in vivo human trial, therefore, began in April 2018. After its completion, a larger clinical study will be conducted for commercialization of the robot. This robotic procedure has many potential advantages over a manual procedure: 1) decreased physician fatigue; 2) stable and accurate needle posture without tremor; 3) procedure automation; 4) less experience required for proficiency in needle insertion skills; 5) decreased variance in technical skills among physicians; and 6) increased likelihood of performing the procedure at remote hospitals (i.e., telemedicine)

Needle Tract Ablation in Liver Tissue Using a Cryoprobe Combined with an Electrosurgical Device: Influence of ex vivo and in vivo Animal Models

To assess the feasibility of needle tract ablation in liver tissue in ex vivo and in vivo animal models using a cryo-probe and electrosurgical device. The experimental device is made by inserting a cryoprobe through an intro-ducer sheath for insulation, with 2-cm of probe tip projecting out. A beagle liver was punctured by the device, and electric current was applied at 30-W with the electrosurgical knife touching the non-insulated device base. The discolored area of cut surface along the device was evaluated in 5 application-time groups (5 , 10 , 15 , 20, or 25 seconds). An ex vivo experiment was performed to determine an ablation algorithm with an appropriate application time by comparison with radiofrequency ablation (RFA) results. Thereafter, an in vivo experiment was performed to verify the algorithm’s feasibility. In the ex vivo model, the cut surface demonstrated different amounts of discolored area according to the application time. The total discolored area in the 20-seconds group was similar to that by RFA. In the in vivo model, the liver did not bleed, the total discolored area was similar to that ex vivo, and coagulation necrosis was confirmed by photomicrograph. Needle tract ablation can be per-formed using the experimental device and electrosurgical device